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ANNUAL REPORT
OF THE

SURGEON GENERAL of the
U.~.- PUBLIC HEALTH SERVICE
of the UNITED STATES
FOR THE FISCAL YEAR

1935

UNITED STATES
GOVERNMENT PRINTING OFFICE
WASHINGTON: 1935

For sale by the Superintendent of Documents. Washington, D. C. •


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TREASURY DF..PARTMENT

Document No. 3073
Public Health . Service
II

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THE UNITED STATES PUBLIC HEAL TH SERVICE BUILDING , NINETEENTH STREET AND CONSTITUTION AVENUE, WASHINGTON ,


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D.

C.

LETTER OF TRANSMITTAL

TREASURY DEPARTMENT'
OFFICE OF THE SECRETARY,

Washington, J anU'ary 3, 1936.
Sm: In accordance with section 9 of the act of CongTess 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
1935.
Respectfully,
H. MoRGENTHAu, Jr.,
-Secretary.
The SPEAKER . OF THE HousE OF REPRESENTATIVES.

m


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CONTENTS
Foreword _______________________________________________________ _
Division of Scientific Research _____________________________________ _
Cancer ______________________________________________________ _
Heart disease ________________________________________________ _
Leprosy _____________________________________________________ _
Malaria _____________________________________________________ _
Nutrition ___________________________________________________ _
Psittacosis __________________________________________________ _
Rocky Mountain spotted fever _________________________________ _
Tularemia ___________________________________________________ _
Relapsing fever ______________________________________________ _
Tick-host anemia ____________________________________________ _
Child hygiene investigations ___________________________________ _
Dental studies _______________________________________________ _
Dermatoses investigations _____________________________________ _
Epidemiology _________________ _______________________________ _
Industrial hygiene and sanitation ______________________________ _
Milk investigations ___________________________________________ _
Studies of public health methods _______________________________ _
Statistical investigations ______________________________________ _
Stream pollution investigations ________________________________ _
National Institute of Health ___________________________________ _
Mi~cellaneous _______________________________________________ _
Division of Domestic (Interstate) Quarantine ________________________ _
Prevention of interstate spread of disease _______________________ _
Plague-suppressive measures in the Pacific Coast States _______ _
Plague-control measures in the Territory of Hawaii_ __________ _
Trachomaprevention _____________________________________ _
Psittacosis ______________________________________________ _
Typhus-fever controL ____________________________________ _
Supervision of water supplies used by common carriers ________ _
Railway sanitation _______________________________________ _
Shellfish sanitation _______________________________________ _
Reciprocity with Canada __________________________________ _
Cooperative work with States relative to stream sanitation ____ _
Statistical compilations ___________________________________ _
Rural health work _____________________________________________ _
Cooperation on Emergency Relief Administration work-relief projects_
Cooperation with other Federal agencies ________________________ _
Surveys of local health organizations ___________________________ _
Conference of the Surgeon General with the State and Territorial
heal th officers ______________________________________________ _
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
c!~~fi!~n~orts _______________________________________________ _
Medical inspection of aliens ___________________________________ _
Division of Sanitary Reports and Statistics __________________________ _
Morbidity and mortality reports _______________________________ _
Sanitary legislation and court decisions _________________________ _
Publications issued by the division _____________________________ _
Publications distributed and exhibits prepared ___________________ _
V


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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__ ________ _____ _______ _________
Division of Venereal Diseases_______________________________________
Cooperative clinical studies----------------------------~-------Cooperative work with State health departments__________________
Educational and informative activities___________________________
Health survey in the South_____________________________________
Research_____________________________________________________
:Study of serodiagnostic tests for syphilis____ ___ __________________
Venereal disease clinic, Hot Springs, Ark_________________________
Tabular summaries ____________________________ ~_______________
Division of Mental Hygiene_______ ____ _____________________________
Studies of the nature and treatment of drug addiction_____________
Dissemination of information___________________________________
Studies of abusive uses and the medicinal and scientific needs_________
Narcotic farms________________________________________________
Medical and psychiatric services in Federal penal and correctional
institutions_________________________________________________
Studies and investigations on the causes, prevalence, and means for
the prevention and treatment of nervous and mental diseases_______
Division of Personnel and Accounts_________________________________
Personnel___ ______________________________________ ______ _____
Property records_________ _____________________________________
Accounts section______________________________________________
Personnel statement___________________________________________
Chief Clerk's Office__ __________________ _________________ ___ ________
Appendix____ ______________________________________ ______________
Financial statement_ _ _ __________________ ______ __________ ______
Funds transferred from other departments _____________________ _1 _
Miscellaneous receipts-Covered into the Treasury_____________ ___
Quarantine service-Expenditures by stations____________________


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ANNUAL REPORT OF THE SURGEON GENERAL OF THE
PUBLIC HEALTH SERVICE
TREASURY DEPARTMENT,

u NITED STATES PUBLIC HEALTH SERVICE,

Washington, D. 0., October 15, 1935.
· Sm: In accordance with the act approved July 1, 1902, I have the
honor to submit for transmission to Congress the following report of
the transactions of the Public Health Service of the United States for
the fiscal year ended June 30, 1935. This is the sixty-fourth annual
report of this Service, covering the_one hundred and thirty-seventh
year of its existence.
The duties imposed upon the Public Health Service as the principal
public health agency o,f the Federal Government are specified by law.
One of these important duties is the prevention of the introduction
and spread of infectious diseases from foreign countries into the
United States. For several centuries the relation between the spread
of communicable diseases and commercial traffic has been well recognized. In order to secure adequate protection for the United States
from the introduction of disease from without, it is necessary to keep
currently informed as to the prevalence of disease throughout the
world insofar as is possible. The rapidity of modern transportation
by land, sea, and air makes it especially important that current information regarding the prevalence of disease in all parts of the world
be made promptly available. The time required to go by ship or
airplane from many foreign countries to the United States has been
materially reduced within recent years; and the incubation period of
many dangerous communicable diseases is well within such period.
WORLD HEALTH CONDITIONS

An epidemic of influenza occurred in many European countries
during the winter of 1934-35. The disease spread rapidly and attacked a considerable percentage of the population about the same
time, but it was unusually mild and caused few deaths as compared
with the fatalities in some other epidemics.
During the calendar year 1934, 287,000 cases of cholera were reported in Asia and the adjacent islands, with 147,000 deaths. Of
these, about 1,000 cases and 650 deaths occurred in the Philippine
Islands. In 1933 about 100,000 cases of cholera were reported, with
48,000 deaths.
Plague caused 98,000 deaths during the calendar year 1934. Most
of these occurred in Asia, but the disease was present in nearly all
parts of the world. In 1933 there were about 77,000 recorded deaths
from plague. Two cases of plague, with one death, occurred in the
'Territory of Hawaii, and 11 plague-infected rats were found in the,
islands during 1934. Plague did not appear in the Philippine Islands.
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Preliminary reports showed 65,000 recorded deaths from smallpox during the calendar year 1934, as compared with 75,000 in 1933.
Very few cases of smallpox were reported in Europe, but the disease
was present in most countries of Asia, Africa, and the American
continents.
The incidence of typhus fever increased during the calendar year
1934 over that for the 2 preceding years. Preliminary reports
included 100,000 cases for 1934. The greatest reported prevalence of
typhus fever was in eastern Europe, but cases were reported from all
sections of the globe. In Chile typhus fever caused 3,377 deaths in
1934. The disease is responsible for many deaths in Mexico.
During the calendar year 1934 yellow fever was reported in Brazil
and Colombia in South America and in the Anglo-Egyptian Sudan,
Gambia, Gold Coast, Guinea, Ivory Coast, Niger Territory, Nigeria,
and Senegal in Africa.
HEALTH CONDITIONS· IN THE UNITED STATES

The death rate for the calendar year 1934 in States reporting to
the Public Health Service was 10.9 per 1,000 population. This is 0.4
per 1,000 population (3.8 percent) higher than the rate for 1933 for
the same States (10.5 per 1,000), but it is lower than any recorded
rate earlier than 1932, when the rate was 10.8 per 1,000.
The birth rate for the United States for 1934 is 17.1 per 1,000
population. For 1933 the rate was 16.6 per 1,000. The difference in
the rates results from 93,975 more births in 1934 than there were in
1933. The increase of 3 percent is noteworthy, because the birth ra.te
has been decreasing for several decades.
The infant mortality rate increased in 1934 over the rate for 1933.
In the later year there were 129,400 dea.t hs of infants under 1 year
of age, as compared with 120,199 such deaths in 1933. The rates were
as follows: 1934, 59.9 deaths under 1 year per 1,000 live births; and
1933, 58.2 deaths per 1,000 live births. However, the 1934 rate is
lower than the rate for any year earlier than 1932.
The tuberculosis death rate continued to decrease, and the 1934
rate ( 56.2 per 100,000 population) was the lowest ever recorded by
the Public Health Service.
The typhoid fever death rate for the calendar year 1934 wa.s 3.3
per 100,000 population, and the diphtheria death rate was the same.
The decrease in the deaths from these diseases is one of the marvels
of the twentieth century and an outstanding example of the results
of the application of the principles of modern public health science.
In 1900 the typhoid fever death rate was 35.9 per 100,000 and the
diphtheria death rate was 43.3. The figures indicate that there were
in the United States 91,000 fewer deaths in 1934 from these two
diseases than would have occurred if the rates of 1900 had prevailed
in 1934.
Neither cholera nor yellow fever appeared in the United States
during the year 1934. About 1,000 cases of cholera were reported in
the Philippine Islands.
In May 1934 .an outbreak of poliomyelitis ( infantile paralysis)
occurred in California, reaching its peak during June. For the year
the incidence of poliomyelitis was higher than usual in the Pacific


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Coast States and in Montana, Idaho, Arizona, and Nevada. In the
United States for the calendar year 1934, 6.4 cases of poliomyelitis
were reported per 100,000 population, as compared with 4.4 cases in
1933 and 3.3 cases in 1932. Late in the fiscal year 1935 an outbreak
of poliomyelitis occurred in North Carolina and Virginia, and after
the close of the fiscal year increases in the incidence of the disease
occurred in most of the New England States, New York, New Jersey,
Michigan, Kentucky, and some other States.
Dengue fever appeared in Florida late in July 1934. For the calendar year 1934, 2,005 cases of dengue were reported in Florida, 1,962
cases in Georgia, and 1,072 in Alabama. The actual numbers of
cases were much larger, as many cases of dengue fever are not reported. For the calendar year 1934, 775,000 cases of measles were
reported to the Public Health Service, as compared with 397,000
cases for 1933. For the first 13 weeks of 1935, 650,000 cases of measles
were reported. The .average :for the corresponding weeks of the
preceding 7 years was 387,000 cases.
The death rate from pellagra has been decreasing since 1928.
Forty-five States reported pellagra deaths, which give death rates as
follows: 1932, 3.9 deaths per 100,000 population; 1933, 3.6 deaths per
100,000; and 1934, 3.2 deaths per 100,000.
A fatal case of plague was reported in Lake County, Oreg., in May
1934, and a case in Tulare County, Calif., in June 1934. During
that year 197 plague-infected ground squirrels and one plagueinfected rat were found in California. During the first 6 months of
1935, plague-infected rodents were found as follows : California,
98 ; Oregon, 15 ; Montana, 1.
A total of 5,371 cases of smallpox was reported to the Public
Health Service for the calendar year 1934. This is the smallest
number reported since records have been kept. No case of smallpox
was reported during 1934 in Maine, Vermont, Massachusetts, Rhode
Island, Connecticut, New Yo:r:k, New Jersey, Pennsylvania, Delaware, Maryland, or the District of Columbia.
PREVENTION OF THE INTRODUCTION OF DISEASES FROM ABROAD

None of the quarantinable diseases was imported into the United
States during the year under report. One vessel was found upon
arrival to be infected with smallpox and after appropriate treatment
was granted free pratique, and 1,228 vessels were granted provisional
pratique conditioned upon the accomplishment of preventive quarantine measures.
During the year quarantine officers of the Public Health Service
inspected 15,262 vessels and 1,924,556 persons; 12,482 vessels, 544,255
passengers, and 981,361 seamen were inspected upon arrival at continental United States ports; 2,612 vessels, 133,149 passengers, and
219,852 seamen were inspected upon arrival at insular ports; and
168 vessels, 43,860 passengers, and 2,079 seamen were inspected at
ports in foreign countries prior to departure for the United States
or its dependencies. Of a total of 4,081 arriving airplanes, carrying
34,135 persons, only 2,636 airplanes, carrying 30,249 persons, of
whom 1,991 were aliens, were accorded the medical inspections required by law; the remaining airplanes arrived at airports of entry


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at which medical officers of the Public Health Service are not
available for duty.
Fumigations of 1,147 vessels were made at United States ports
either because of the presence of disease on board or for the destruction of rats to prevent the possible introduction of plague. Examinations for plague infection were made of 4,207 of the 5,951 rats
retrieved.
The International Sanitary Convention for Aerial Navigation,
which was opened for signature at The Hague on April 12, 1933,
and was signed on behalf of the United States on April 6, 1934,
was ratified by the United States on June 13, 1935, and will become
effective on November 22, 1935.
At the suggestion of the Public Health Service, the Consular
Regulations of the United States of America were amended so as
to instruct American consular officers in foreign ports to authenticate at ports of issuance foreign certificates of deratization exemption as well as foreign certificates of deratization issued under the
provisions of article 28 of the International Sanitary Convention
of Paris, revised 1926.
The Public Health Service has recommended favorable consideration on the pa.rt of the United States to a proposal submitted by
the International Office of Public Health at Paris to amend article
25 of the International Sanitary Convention of Paris, revised 1926,
so as to permit, under special circumstances, the fumigation of a
vessel arriving from a plague-infected port before or during the
unloading of its cargo, and also to permit a repetition of such fumigation if necessary to complete deratization of the vessel.
MEDICAL INSPECTION OF ALIENS

Medical officers at the various ports o:f entry in the United States
examined 730,777 alien passengers and 696,562 alien seamen, of
whom 14,569 passengers and 1,250 seamen were certified to the
proper immigration officials, in accordance with the act of February
5, 1917, as being afflicted with some mental or physical defect or
disease.
A total of 35,978 applicants for immigration visas was examined
by medical officers of the Public Health Service attached to American consulates in .foreign countries, 23,868 having been examined in
Europe and the remainder in the Western Hemisphere. Five hundred and seventy-four of those examined in Europe and 130 of those
examined in the Western HemisJ?here were found to be afflicted with
one or more of the defects or diseases which render exclusion from
the United States mandatory, and 4,745 of those examined in Europe and 1,443 of those examined in the Western Hemisphere werereported as being afflicted with a disease or condition which was
likely to affect their ability to earn a living. Only two of the aliens,
who had been given a preliminary medical examination in American
consulates in foreign countries and to whom visas had been issued
were certified upon arrival at United States ports as being afflicted
with a defect or disease requiring deportation.
At the request of the Commissioner General of Immigration and
Naturalization, medical officers of the Public Health Service werea uthorized, upon competent request of immigration officials, to make


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thorough physical examinations, in accordance with the standards
set forth by the United States Civil Service Commission, of any
nominees tentatively selected by immigration officials for appointment to the position of immigration patrol inspector.
Because of the high mortality rate from malaria now existing in
the southern part of Texas, and in an effort to restrict the introduction of malaria into the United States from Mexican territory, medical officers of the Public Health Service on duty at Texas-Mexican
border stations were directed, in cooperation with the State health
officer of Texas, to make a microscopic examination of the blood of
any arriving person suspected of having malaria and to notify the
Texas State Health Department of the name and destination of every
person with malaria released for entry into the United States. Arriving aliens found to be infected with malaria are certified to the
proper immigration authorities for consideration of exclusion until
cured.
PREVENTION OF THE SPREAD OF CONTAGIOUS AND INFECTIOUS DISEASES IN
INTERSTATE TRAFFIC

On December 31, 1934, there were 540 counties or districts in the
United States with whole-time health service, as compared with 530
in 1933. The slight gain was due in part to cooperative Federal aid.
With the cooperation of the State health authorities, trachoma
eradication activities were continued in Kentucky, Missouri, and
Tennessee.
Plague-control measures were continued in the Pacific Coast
States, and on the Island of Maui, Territory of Hawaii, in cooperation with the Territorial board of health. Various measures, including trapping and poisoning, and experiments in control procedure were carried on under the program previously inaugurated.
Plague was reported in ground squirrels in 3 counties and in wood
rats in 2 counties in California. A new mobile field laboratory
proved useful in locating new foci of infection in Oregon.
Special activities relatin_g to Negro health work, extending
throughout the year and culminating in the Twenty-first Annual
National Negro Health Week, were conducted in cooperation with
official and voluntary health agencies, the various groups participating in the National Negro Health Week program, and organizations
and institutions affiliated with the year-round movement for the improvement of Negro health. Included in this program were health
surveys, clinical and educational projects, and the publication of the
National Negro Health News, issued quarterly as a helpful medium
for reporting pertinent data in connection with these activities.
From November 1 to the close of the fiscal year the sum of $1,000,000 granted to the Public Health Service by the Federal Emergency
Relief Administration was expended in aiding State health authorities to establish and maintain adequate rural health service.
The certification of sources of drinking and culinary water used
on railroads, busses, vessels, and airplanes was continued with t.he
assistance of State health agencies. Of the 2,269 supplies listed in
1935 by the carriers, 95 percent were inspected and certified, 4,157
certificates being issued. During the year the use of 58 supplies was
prohibited and 401 supplies were provisionally certified.

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Of the 1,750 vessels actively engaged in interstate traffic during the
calendar year 1934, 51.4 percent were reinspected and certified as
·complying with the regulations governing drinking and culinary
water systems. Curtailed shipping activities interfered somewhat
with the efficiency of the inspection service, since inspections preferably should be made while vessels are operating.
·
Since systematic inspections of vessels were inaugurated in 1933,
no case of typhoid fever has been reported among members of crews
of Great Lakes vessels. Down to that year there had been a steady
decline in the incidence of typhoid :fever since 1916, when 70 cases
were recorded.
The district superintendents of the Lighthouse Service and the
Engineering Corps of the United States Army were advised as to
the design and installation of suitable water-treatment devices for
their vessels on the Great Lakes.
In order to determine the efficiency of State control of shellfish
areas and establishments, routine surveys and inspections were
continued.
Assistance was rendered to States engaged on stream-pollution programs. The study of the pollution of the Hampton Roads area, made
at the request of the Chesapeake Bay authority with funds allotted
by the Public Works Administration, was completed.
There has been a steady increase in the amount of public health
engineering service afforded other Federal agencies. In 1935 the field
force devoted 44.9 percent of its time to this service. The increased
volume of consultative work was due to new construction made possible by allotments from the Public Works Administration and to
the enlargement of the National Park Service. Requests for assistance in solving sanitary problems were also received from the Lighthouse Service and the Coast Guard.
INVESTIGATION OF PUBLIC HEALTH PROBLEMS

At the cancer investigations station at the Harvard Medical School,
Boston, Mass., a number of studies are in progress which fall into
the general headings of ( 1) studies of the biological effects of radiation, (2) studies of resistance and susceptibility to malignant
growths, ( 3) biochemical studies, and ( 4) cytological studies.
The action upon biological material of homogeneous beams of
X-rays at different frequencies is being studied, and an X-ray tube
has been especially designed and constructed for this purpose. The
work of studying the ultraviolet absorption spectra of carcinogenic
compounds was continued, and some 23 different compounds have
been studied spectroscopically. The results of experiments in the
production of dibenzanthracene tumors in pure strain mice are now
in press. Experiments have also been conducted upon the effects of
trypan blue upon resistance to the carcinogenic action of dibenzant hracene which have shown that trypan blue lowers the resistance
of mice to the development of spontaneous tumors. A study of the
effects of bacterial filtrates upon a series of transplantable tumors
is in progress, and an effort is being made to determine why transplantable tumors vary in their reaction to the filtrate.


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Biochemical studies have included chemical studies upon tumor
tissue, the chemical treatment of tumors, and studies of carcinogenesis. The cytological studies have dealt with tissue culture and
the effects of dibenzanthracene on cells in vitro.
Studies of heart disease have been concerned chiefly with the geographical distribution of the etiological types of heart disease, the
methods of reporting, recording, and statistically presenting heartdisease mortality, the epidemiology of rheumatic-heart disease in a
locality, and the etiology of rheumatic-heart disease.
Observations have been continued on the clinical development of
leprosy in children born of leprous parents. Investigations were
made of the reactions of patients to a formalinized sterile vaccine
made from the inoculum of rat leprosy. The tindings suggest the·
advisability of further study of these procedures as a means of developing a method of diagnosis of cases in early stages. Further
studies on the significance of the Wassermann test led to the conclusion that the presence of a positive Wassermann or Kahn test in
a leprous patient is of little value in differentiating leprosy from
syphilis. Studies of the pathogenesis of leprosy have included experiments in the transmission of rat leprosy and tests of the vasomotor mechanism in patients.
Studies of malaria control by means of the drugs atabrine and
plasmochin were completed during the year, as a result of which it
was proved conclusively that drug administration methods as known
today do not control the malaria infection rate in the tropics.
Researches in the malaria therapy of paresis have been continued
and improvements in the technique, preparation, and shipment of
this material effected.
The determination of the pellagra-preventive value of seven different foodstuffs was completed during the year. Chicken, rabbit,
and pork shoulder were found to be good sources of the pellagra-preventive vitamin, cottonseed meal and evaporated peaches relatively
poor sources, and prunes and canned beets were, found to contain
little or none of the pellagra-preventive vitamin.
The 1935 net production of Rocky Mountain spotted fever vaccine
was 284.4 liters, 36.6 liters more than the 1934 net supply. The
Emergency Conservation Cqrps was furnished 53.7 liters of vaccine.
It was impossible to supply vaccine for all the camps located in
endemic areas, but there was sufficient to provide for the immunization of personnel in camps in areas where the danger was greatest.
Cases of Rocky Mountain spotted fever have been reported for the
first time from the States of Illinois and Oklahoma, while new
endemic areas have been reported in Montana, California, and Idaho.
There are now 34 States in which spotted fever is known to be
endemic.
Considerable research work on spotted fever and other tick-borne
diseases and their vectors has been done at the Hamilton (Mont.)
Laboratory in addition to its main function, the manufacture of
spotted-£ever vaccine.
Further studies on growth and the economic depression have shown
that no striking differences exist in the weight of children in 1934
as compared with averages of weight for 1921 through 1927.


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Other studies of physical status, growth, and development of children have included a continuation of the study of the hearing of
school children (begun in 1931), age changes in physical resemblance
of siblings, selective mortality in childhood, and sectional variations
in physique and growth of children.
Midwifery as practiced by the colored midwife constitutes one of
the problems in maternal and child hygiene throughout the southern
States. Therefore, a study of midwifery practice was undertaken
in Brunswick County, Va., where approximately 75 percent of the
d~liveries of both colored and white mothers were attended by mid·w1ves.
Over a million and a half dental examinations of children in 26
States were compiled, the data including items relating to present
dental needs and to past dental treatment, with the children classified according to color, sex, age, and size of area in which they lived.
Studies of mottled enamel have dealt with, first, the development
of a quantitative methodology for use in epidemiological surveys of
endemic areas to replace the qualitative measures heretofore in use,
and, second, basic studies leading to the determination of the minimal
threshold of toxicity.
Activities in industrial hygiene have related primarily to (a)
studies of the effect of dust on the health of the worker, particularly
an intensive survey in the anthracite coal fields of Pennsylvania, a
general review of factors involved in the determination and control
of industrial dust, and laboratory research in the physiological response of the peritoneal tissue to dusts introduced as foreign bodies;
( b) the completion of a study of air pollution in large American
cities; ( c) the preparation of a report on the distribution of daylight
within an experimental building as an aid in meeting problems of
natural illumination in factories, schools, and hospitals; ( d) studies
of sickness among industrial workers as carried out in previous years;
(e) field and laboratory studies of specific industrial poisons, including the commencement of an intensive survey of mercury poisoning
among fur cutters and a pathological study of dogs exposed to benzol;
(f) a review of known facts in regard to the relation between housing
and health and participation in various conferences of housing
agencies; and (g) the development of further agreements with the
,chemical industry to safeguard users of dangerous substances, those
:adopted during the year relating to aniline oil, carbon bisulphide, and
henzol.
About 5,000 employees of 22 plants were examined for the occur.Tence of industrial skin diseases. The sickness records of these plants,
:as kept by the plant physician, were examined in order to determine
the frequency of occurrence of skin diseases and their causes.
A study of the California outbreak of poliomyelitis during the
:summer of 1934 constituted the major work of the Office of Epidemiology, which was established during the present fiscal year.
The outbreak was mild as to severity and showed a tendency to
attack older children and young adults to a greater extent than
epidemics of former years. This outbreak presented problems new
in the history of epidemiology which have not yet been settled.
In May 1935 an epidemic of poliomyelitis occurred in North Carolina _.and a study was begun of the possible value of the Park-Brodie
vaccme.

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Studies of public health methods have been continued to evaluate
prevailing practices of health departments in relation to needs of
the people and to render consultation service to other agencies, national, State, and local, on matters pertaining to health administration.
Investigations of milk sanitation have dealt with the effect of variations in pH concentration and the effect of variations in buffer
concentration upon the thermal resistance of the Public Health
Service test organism used in testing milk pasteurization equipment. A s a result of these tests it was determined that future
studies of pasteurization equipment should be conducted at a pH
concentration of 7.2 or a buffer concentration of m/67-5. Further
studies were made of the bacteriocidal treatment of milk cans by
means of hot air, as a result of which it was concluded that a
temperature of 170° F. for 30 minutes would devitalize all milkborne pathogens.
Studies of various phases of the relation of sickness to the de.pression have been undertaken. Persons of low income, and particularly
those whose economic status decreased from that of reasonable comfort to v~ry poor during the depression, have high sickness rates.
However, the greatest difference in sickness rates appears between
persons on relief and those not on relief. An analysis of data on
physical impairments and chronic diseases among the relief and
the nonrelief population of a large city was undertaken in cooperation with the Federal Emergency Relief Administration. A study
was undertaken to determine whether mortality in the families of
the unemployed and others severely affected by the depression increased, remained stationary, or decreased during the period 1929-34.
The data are now being analyzed.
Studies in sewage treatment have as their primary objective the
determination of conditions which affect detrimentally the biological
activity upon which purification of sewage by the activated sludge
process depends. A small experimental treatment plant has been
maintained as a source of laboratory material as well as for observing
the changes in efficiency of purification.
A series of experimental observations has been instituted dealing
with the physical and biochemical changes occurring in sewage
sludge deposits under conditions approaching those in natural
streams. The data thus far obtained have indicated that the rate
of oxidation of the sludge deposits under stream-flow conditions is
somewhat lower than that of normal biochemical oxidation under
strictly aerobic conditions.
There was a definite increase in the number of cases of typhus
fever in some of the So~thern States, spotted fever remaining practically the same. Additional foci of spotted fever were located in
New York State and in North Carolina, and cases which were probably spotted fever were found in northern Alabama.
A total of 881 cases of tularemia was reported from 41 States
and the District of Columbia in 1934. Naturally infected red foxes
were found in Maine during the year.
Studies indicate that immunity to the St. Louis type of encephalitis is wide-spread in the United States. It has been shown that
the instillation of alum into the nostrils of white mice tends to render
them less susceptible to intranasal infection with this virus.

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Following the work on encephalitis virus in mice, monkeys treated
intranasally with sodium aluminum sulphate solution were rendered
resistant to intranasal instillation• of poliomyelitis virus.
Studies on the epidemiology of the amoebic dysentery outbreak
originating in Chicago in 1933 have been completed and the report
has been submitted for publication. Approximately 1,300 cases
occurred in this outbreak, of which about 100 were fatal.
Further studies have been undertaken on dysentery, with special
reference to the bacillary type as it occurs among Indians of the
Southwest .
. Special studies on prophylactic and therapeutic agents covered
by the act of July 1, 1902, for the control of biologic products have
included gas gangrene antitoxin, hemolytic streptococcus, meningococcus, alum precipitated antigens, staphylococcus, and arsenical
preparations.
.
Cancer research at the National Institute of Health has been concerned with cell division in tumor growth, the growth of the Walker
~56 rat mammary carcinoma in vivo and in tissue culture, the
systematic attempt to influence the growth of a spontaneous mammary tumor of the mouse, the histological characteristics of the
Jensen rat sarcoma and Walker 256 rat carcinoma after subcutaneous, and intramuscular inoculations.
Formaldehyde sulfoxylate wa::; employed as a chemotherapeutic
agent in mouse pneumococcus septicemia. It had a striking curative
action on a strain of pneumococcus I grown at the National Institute
of Health. So far other strains of pneumococci were not so easily
influenced by the drug as the Institute strain.
Sugar researches included studies on the oxidation of sucrose, on
the action of various acidic hydrolizing agents on methyl glycosides,
and on the four carbon sugar threose.
.
As a result of the researches on invertase a relatively convenient
method ha.s been deve,loped for obtaining con<;:entrated solutions of
this enzyme.
THE MARINE HOSPITALS AND OTHER RELIEF STATIONS

Hospital and out-patient care was furnished to American seamen
and other beneficiaries at 154 ports; 332,034 accredited persons applied for treatment and other medical service. The Coast Guard, for
whose personnel of 9,413 the Public Health Service has sole medical
responsibility, was served at the regular stations and 103 other
places, and 20 medical and dental officers were assigned to Coast
Guard ships and shore stations. The usual assistance was rendered
the Employees' Compensation Commission i:µ treating injured Federal employees, to the Civil Service Commission in examining applicants and employees, and to other Government agencies that utilize
the Public Health Service.
On September 26, 1934, Treasury Department Order No. 9 directed
that all medical relief activities in the Treasury Department in the
District of Columbia not then a part of or under the supervision of
the Public Health Service be transferred to the Public Health Service and placed under the general supervision of the Surgeon General.
These activities are located in the main Treasury Building, Treasury


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Annex No. 1, Internal Revenue Building, Old Southern Ra~lway
Building, Office of the Register of the Treasury, Branch Treasurer's
Office, Federal Warehouse, Division of Loans and Currency, Bureau
of Engraving and Printing, and the DeMoll Building; and, upon
request of responsible heads, medical supervision of relief activities
in the following departments and agencies has also been undertaken :
Securities and Exchange Commission, Rural Electrification Administration, Federal Housing Administration, Reconstruction Finance
Corporation, National Bureau of Standards, Department of Commerce, Shipping Board, and Suburban Resettlement Administration.
There were 176,032 more hospital days furnished all classes o:f
patients during the fiscal year 1935 than in the fiscal year 1934.
During the year important new hospital facilities were completed
and occupied at Baltimore, Norfolk, Carville, Chicago, and Memphis,
and appropriations will be available in the fiscal year 1936 to replace
the old pavilion ward buildings at Memphis and St. Louis with
modern, fire-resistant structures, and it is intended that these buildings shall be under construction before the end of 1935.
Merchant seamen and dependents of Coast Guardmen continued to
avail themselves, in increasing numbers, of the liberalized amendments to the regulations approved April 3, 1934. In March 1'935 the
Veterans' Administration increased its patients at the Detroit marine
hospital to 150 and requested that this number be hospitalized at
Detroit during the fiscal year 1936, but is prepared to avail itself of
only 300 beds in all marine hospitals (including Detroit) in 1936.
Patients from the Civilian Conservation Corps and the Civil Works
Administration were hospitalized in considerable numbers (see summary of services by class of beneficiary, p. 107), and it is expected
that there will be a much greater demand for hospital bed.s for
patients of the Civilian Conservation Corps and Works Progress
Administration in 1936. .As the Works Progress Administration
has replaced the Civil Works Administration, patients from the
Civil Worlcs Administration should markedly decline.
PREVENTION AND CONTROL OF VENERE.AL DISEASES

Venereal disease control work continued along the same lines as in
the years immediately preceding. The Public Health Service extended advisory assistance to State and local health departments upon
request, stimulated and encouraged the development of programs directed against the venereal diseases, and contributed to the general
informative and educational programs. While in some places the
respective health departments have been tardy in providing for the
control of syphilis and gonorrhea, in many localities reasonably effective work is being conducted. In several States preliminary reports
indicating encouraging results have been made, and it appears evident
that it will be possible to show definite progress in the prolonged campaign against the _v enereal diseases within the next few years.
The investigative work of the Public Health Service in the field of
the venereal diseases has included studies both of a clinical and laboratory nature. Some of the former have demonstrated the effectiveness of treatment in early syphilis, both from a public health standpoint and for the infected person. A series of scientific papers on
20!l 80- 3:'\- -2


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the treatment of cardiovascular syphilis, completed but not yet published, indicates the possibility of the prevention of this form of
cardiovascular disease which causes such a high mortality rate. Definite progress has been made in experimental work on chemical
prophylaxis.
.
.
.
.
The informative and educational program has met with considerable success. The subscriptions to Venereal Disease Information have
more than doubled during the current year, and a great deal of educational material has been distributed upon request to individuals and
to organizations.
During the year 254,551 cases of syphilis and 161,810 cases of
gonorrhea were reported to State health departments. One-day surveys of sources of treatment to determine the prevalence and establish
the trend of syphilis and gonorrhea were continued. As a result of
the latter surveys it has been possible to estimate the number of new
cases of syphilis and gonorrhea which are treated annually in the
United States. This estimate places the number of new cases of
syphilis each year at approximately 518,000 and of gonorrhea at
1,555,000. The need for extensive and concerted effort on the part of
all health organizations is therefore evident if progress is to be made
in the campaign against these d~seases.
NARCOTIC FARMS AND MEDICAL AND PSYCHIATRIC
PRISONERS

CARE

OF

FEDERAL

The narcotic farm at Lexington, Ky., was completed and opened
for the reception of admissions on May 29, 1935. The second narcotic
farm at Fort Worth, Tex., is in process of being developed. The
prelimi1,1ary plans have been approved, and it is anticipated that the
contract for the necessary buildings will be accepted some time during
the autumn of 1935. Preliminary contracts for beginning work at
the institution mentioned above were approved on October l3, 1934,
and ground was broken with appropriate ceremonies for the beginning
of grading and other preliminary construction work.
The Service continued to supervise and furnish the medical services
for the Federal penal and correctional system. The Attorney General has requested an extension of the psychiatric service to the
Federal courts.
COOPERATION WITH OTHER AGENCIES

During the fiscal year the Public Health Service continued its
cooperative activities with official and unofficial organizations in matters concerning public health. A number of these cooperative activities are required by law and the remainder are deemed necessary in the
interest of economical and efficient administration. By means of this
cooperation similar or related activities are coordinated and duplication of effort is avoided. Among the more important cooperative
activities of the Service the following may be mentioned:
1. With the Department of State by detailing medical officers for
duty at consulates in Europe, Canada, Cuba, and the Philippine
Islands to examine medically applicants for immigration visas, to
:furnish information respecting the sanitary condition of ports and


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vessels departing for United States ports, required for the issuance
of bills of health by American consuls, and for related quarantine
work; in efforts to establish an international uniform method of
assaying opium; in notification of the occurrence of plague or cholera
in the United States or its possessions.
2. With other bureaus of the Treasury Department in hospital
care and other medical services for the Coast Guard ; furnishing
advice and .assistance on public health engin·e ering ma.tters to the
Procurement Division and Coast Guard; emergency medical relief to
Treasury Department employees in the District of Columbia; advising with the Bureau of Narcotics relative to medicinal and scientific
needs of the country concerning narcotic drugs; with the Bureau
of Customs in adjudication of violations of act of February 15, 1893,
resulting from the failure of masters of vessels to present American
consular bills of health to collectors of customs upon entry at United
States ports.
3. With the War and Navy D epartments in physical examination
of applicants for Officers' R eserve Corps and citizens' military training camps; medical services for civilians employed on vessels of the
Mississippi River Commission, Army Engineer Corps, and Army
transports ; treatment of officers and enlisted men of the armed forces
(pay patients) ; hospitalization, upon request of the commanding
officer, of patients from the Civilian Conservation Corps; with the
Army Medical Center, Washington, D. C., and the naval hospital,
Washington, D. C., in evaluation of serodiagnostic tests for syphilis
in the United States; with the Army in furnishing advice and assistance on public health engineering matters; with the Navy Department in studies of dust exposure of foundry workers; with the
Na val Academy in survey of lighting facilities.
·
4. With the Department of Justice and local United States district
attorneys in matters relating to the protection of the interests of the
United States in which the administration of the quarantine laws and
regulations is concerned, or in which the proper care and preservation of public property used for quarantine purposes are concerned;
in advisory assistance in connection with milk sanitation; with the
Bureau of Prisons in furnishing medical and psychiatric and other
scientific and technical services in the Federal penal and correctional
system; with the Criminal Prosecution Division in rendering p sy,ehiatric service in connection with the prosecution of Federal
offenders; with the Division of Investigation in furnishing first-aid
instruction to special agents.
5. With the Post Office Department in supplying first-aid and
special plcysical examinations; in furnishing expert witnesses at hearings involving fraud orders.
6. With the Department of the Interior by detailing officers for
duty in the Philippine Islands to perform the medical examinations
required under regulations approved by tlie Secretary of the Interior
in connection with the issuance of workers' permits to Filipino
laborers destined to the Hawaiian Islands; with the Bureau of
Indian Affairs in detailing medical officers to supervise medical
services, in furnishing advice and assistance on public health engi•
neering matters, in a study of health problems among the Indians,
in advisory assistance in connection with milk sanitation, and in a


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PUBLIC' HEALTH SERVICE

study of bacillary dysentery among Indians in southwest United
States; with the National Pa.r k Service in the maintenance of the
venereal disease clinic at Hot Springs National Park, Ark.; with
St. Elizabeths Hospital ,and Freedmen's Hospital in the valuation of
serodiagnostic tests for syphilis; with the Bureau of Mines in connection with a study of the health of miners ; with the Department
relative to the establishment of a hospital on the west coast for the
care of the mentally ill Alaskan and North American Indian and
other beneficiaries of the Government.
·
7. With the Department of Agriculture in physical examinations
and outpatient treatment for members of the Civilian Conservation
Corps in Alaska operating under the Forest Service; by assisting in
the enforcement of plant and of animal quarantine measures on vessels arriving from foreign ports; with the Forest Service and Bureau
of Agricultural Engineering in furnishing advice and assistance on
public health engineering matters.
8. With the Department of Commerce in standardizing and administering quarantine procedure required of aircraft arriving in the
United States from foreign countries, and the development of ma.rine standards, in cooperation with the American Marine Standards
Committee, relating to ship sanitation; in physical examinations,
and instruction and examination in the prnciples of first aid of applicants for license as ship's officers, at the request of the Steamboat
Inspection Service;. treatment of lighthouse keepers and seamen
from vessels of the lighthouse establishment, Coast and Geodetic
Survey, and Bureau of Fisheries; furnishing medical supplies to
lighthouse vessels.
9. With the Department of Labor by detailino- medical officers for
the medical examination of aliens at United s'tates ports of entry
and furnishing medical care to detained aliens.
10. With the Federal Trade Commission in advice concerning
health aspects of various products.
11. With the Federal Emergency Relief Administration in the
treatment of transients at Hot Springs National Park infected with
the venereal diseases, and in other medical relief activities; in lending
the services of a psychologist and statistician for the purpose of
organizing statistical studies with special reference in predicting
the outcome of parole for prisoners; ·in investigation of cases· of
meningitis occurring in transient camps in Virginia, Tennessee, and
Arkansas; in malaria control work in the southern States.
12. With the Civil Works Administration in hospitalizing, upon
request of the proper authority, workmen engaged on Federal Civil
Works Administration projects injured in line of duty.
.
13. With the National Resources Board in furnishing advice and
assistance on public health engineering matters.
14. With the National Emergency Council in advisory assistance
in connection with milk sanitation.
15. With the Emergency Conservation Corps by furnishing Rocky
Mountain spotted fever vaccine~
16. With the Public Works Administration in a study of relation
between housing and health.
: ·
17. With the Tennessee Valley Authority in furnishing advice
and assistance on public health engineering matters, in assisting in


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malaria control, and in the study of possible phosphorus poisoning
among workers.
18. With the Agriculture Adjustment Administration in advisory
assistance in connection with milk sanitation.
19. With other Government departments and agencies as follows:
Securities and Exchange Commission, ~ederal Housing Administration, Rural Electrification Administration, Reconstruction Finance
Corporation, National Bureau of Standards, Shipping Board, and
Suburban Resettlement Administration in furnishing emergency
medical relief to employees on duty in the District of Columbia,
upon request of responsible authorities.
20. With Puerto Rico and the Virgin Islands in a study of the
system of public medical care, and the Virgin Islands in a survey of
their leprosy problems.
21. With all States, Territories, District of Columbia, and Canada
in certification of water supplies used on interstate carriers and in
shellfish sanitation; with California, Oregon, Nevada, and the Territory of Hawaii in plague-control activities; with Missouri, Kentucky,
and Tennessee in trachoma eradication; with Virginia, Minnesota,
and Tennessee in stream-pollution problems; with Alabama in typhus
fever eradication; with South Carolina, Washington, West Virginia,
Texas, and North Carolina in the detail of an officer to assist in the
reorganization of the health department; with St. Louis County, Mo.,
Phoenix, Ariz., and San Antonio, Tex., in making surveys of local
health organizations; with 34 States in aid to State and local health
organizations ; with 16 States in malaria-control drainage ; and with
30 States in community sanitation.
22. With all States in collection of morbidity reports and epidemiological data relating to communicable diseases.
23. With the Alabama State Board of Health and the Macon
County Health Unit in the observation of a group of syphilitic male
Negroes and a control group to determine the effects of untreated
syphilis in the Negro.
24. With the Florida State Board of Health in a post-graduate
course :for physicians, in cooperation with the State medical association and the University o:f Florida, by assistance in a general malariacontrol program, and in the control of an epidemic of dengue fever
at Miami.
25. With California and North Carolina in detailing officers to
assist the State health department in connection with studies of outbreaks of infantile paralysis.
26. With North Carolina and Ohio in control of localized malaria
outbreaks.
27. With Georgia, Alabama, North Carolina, and Virginia by examination of 7,000 blood specimens to determine the malaria-infection rate.
28. With Oklahoma, Missouri, and Pennsylvania in appraisal of
facilities for health protection and medical care.
29. With Virginia in malaria control.
30. With Texas by survey of various communities to determine the
incidence of mottled enamel.
31. With Pennsylvania in a study of health of anthracite-coal
miners.


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32. With Arizona in survey of health conditions of Phoenix.
33. With Illinois by survey of tuberculosis in the southern part of
the State.
34. With 21 States by advisory assistance with reference to milk
sanitation problems.
35. With a number of States by furnishing Rocky Mountain
spotted fever vaccine.
36. With the Territory of Hawaii in care and treatment of patients
at the leprosy-receiving station.
37. With the Office International d'Hygiene Publique, Paris, and
the Pan American Sanitary Bureau, Washington, D. C., in matters
relating to public health and maritime quarantine, and the exchange
of information relative to the prevalence of quarantinable diseases.
38. With the :following institutions in the evaluation of serodiagnostic tests for syphilis in the United States: Blue Ridge Sanatorium, Charlottesville, Va.; Central State Hospital, Petersburg, Va.;
Charity Hospital, New Orleans, La.; Cook County Hospital, Baltimore, Md. ; Mayo Clinic, Rochester, Minn. ; Miami Valley Hospital,
Dayton, Ohio; Municipal Social Hygiene Clinic, Chicago, Ill.; tuberculosis hospital of the Baltimore City Hospital, Baltimore, Md.;
University of Illinois College of Medicine, Chicago, Ill.; University
of Virginia Department of Medicine, University, Va.; also the American Society of Clinical Pathologists.
39. With the American Social Hygiene Association, Inc., in 1-day
surveys to determine the number of cases of syphilis and gonorrhea
under treatment in the United States.
40. With the syphilis clinics of Johns Hopkins University, Mayo
Clinic, University of Pennsylvania, University of Michigan, and
Western Reserve University in cooperative clinical studies of the
treatment of syphilis.
41. With the Milbank Memorial Fund in the study of untreated
syphilis in the Negro in Macon County, Ala.
42. With the University of Hawaii by lectures to classes in public
health nursing.
43. With the Gorgas Memorial Laboratory and Health Department of Panama in studies of malaria control.
44. With the Brookings Institution in survey of State government
of Oklahoma. .
45. With the Johns Hopkins Medical School by furnishing solution
of the four-carbon sugar d-threose.
46. With the Roscoe B. Jackson Memorial Laboratory in connection with investigations of cancer.
Cooperation was also continued with the Health Committee and
Opium Advisory Committee of the League of Nations, with various
committees of the American Psychiatric Association, with the
Scientific Administration Committee of the National Committee for
Mental Hygiene, and with the Committee on Drug Addiction of
t.he N ationa.I Research Council.
The Public Health Service desires to acknowledge assistance received from t he following agencies :
Harvard Medical School by furnishing quarters for Field Investigations of Cancer and various departments of the school for cooperation in these investigations, University of Pennsylvania for use
of office space and clinical material in connection with investigations

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of heart disease, South Carolina State Hospital for laboratory space
and material in connection with malaria researches, National Canners' Research Laboratories for cooperation in connection with
studies of nutrition, Milbank Memorial Fund for assistance in studies
of sickness and the depression, and the Bureau of the Census in survey of dental needs of school children.
RECOMMENDATIONS

The protection of the public health is an essential function of
government. Natural and material resources of any area cannot be
fully developed unless health conditions are safe. In order to protect the public health of the United States, recommendations are
necessa.ry as to the measures and means to be employed to that end.
There can be no truce in the warfare against disease. Each year
brings new problems. Constant developments in the field of industry present additional problems in industrial hygiene; epidemics
of communicable diseases present new· phases from time to time;
and new developments in methods of preventing disease are evolved
and must be evaluated. The outbreak of infantile paralysis in North
Carolina and Virginia just before the close of the present fiscal year
is an instance of a new phase of old problems that constantly arise.
Heretofore we have had no record of a similar outbreak of this disease in the southern section of the United States. The reasons for
this unusual prevalence in this area must be studied, as well as many
other important factors in epidemiology and control.
The recommendations submitted herewith constitute the more
important public health needs at the present time.
SCIENTIFIC RESEARCH

If the additional funds and personnel for research under the Social
Security Act become available early in the next session of Congress,
as expected, the matter of J?roviding adequate facilities for the carrying on of certain new proJects will present a very difficult problem.
The situation could best be met by the construction of suitable buildings on the 45-acre site at Bethesda, Md., which has recently been
donated to the Public Health Service.
STATE AND LOCAL HEALTH WORK

One of the chief handicaps in providing health service is the lack of
efficient public health organizations, especially in small cities and
rural areas. This lack of local organization is particularly noticeable and detrimental when efforts are being put forth to prevent the
interst ate spread of disease. Realizing the importance of increasing
local health service in rural areas, th e Public H ealth Service has for a
number of years cooperated with the States in promoting this effort.
However, owing to the inadequacy of funds and personnel, it has
been difficult to make substantial and lasting contributions to this
important work.
The enactment of the Social Security Act, with its contemplated
allotments to State departments of health for local health service,
opens a new and bright era in the field of public health. However,


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the advantage that has been gained must not be permitted to lapse
through complacency or indifference. Vigorous and continued endeavors will be required on the part of the State health authorities
to insure that these essential funds are used to stimulate the further
expansion of adequate full-time local health service and the appropriate assumption of responsibility by State and local governing
authorities.
The occurrence of a fatal human case of plague and the discovery of
two foci of rodent plague in Lake County, Oreg., direct attention to
the extension of this disease. As the intection has also been found in
Wallowa County, Ore~., about 50 miles from the State lines of Washington and Idaho, it 1s possible that the disease has spread to these
and other States. In view of these facts it is important that adequate
Federal funds be made available for investigations and suppressive
measures in the northwestern States in which the infection is or may
be present.
MAJUTIME QUARANTINE

The advisability of giving appropriate consideration to the personnel requirements of all the inspection services maintained at ports
of entry is respectfully recommended in connection with the consideration of the extension of the hours during which a United States
port may be declared open for entry or the designation of new ports
of entry. Inasmuch as these various inspection services are maintained pursuant to requirements of law for the protection of the country, it would appear that ports should be declared open for entry only
for such hours as can be maintained by available personnel. In this
connection it must be noted that neither legal authority nor funds
have been provided for the payment of overtime compensation to
employees engaged in the quarantine work of the Public Health Service, such as exists with reference to employees of the Customs and Immigration Services, which serves to accentuate the difficulty faced
by the Public Health Service in carrying out, with existing personnel, the duties placed upon it by law requiring all arrivals from foreign territory to undergo quarantine inspection and such other quarantine procedures as may be necessary in ports declared open for entry
beyond the usual hours of duty.
It is the view of the Public Health Service that airplanes destined to interior airports should be required to undergo the quarantine, customs, and other Federal inspections required by law at
airports of entry located on or near international borders or the
coast. These inspections should be accomplished at such of these
airports as may be most convenient to the line of flight; and therefore it is recommended that the designation of airports as airports
of entry be restricted to those airports which are located near the
international land borders or coast lines of the United States, as it
is regarded that the necessary maximum protection is afforded
thereby to the United States with the minimum expenditure of
Federal funds.
It is recommended that the Government of the Panama Canal
Zone amend the maritime quarantine regulations issued by it for the
Canal Zone so as to agree exactly with the quarantine regulations
of the United States administered by the Public Health Service
in all other United States ports.

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VENEREAL DISEASE PROBLEM

Since shortly after the inception of the present campaign against
syphilis and gonorrhea, the work has been handicapped not only by
inadequate appropriations but also by failure of health organizations
to make equable allotments for the control of these diseases. On
the basis of present morbidity reports, syphilis and gonorrhea repre. sent 20 percent of all communicable diseases. Venereal diseases are
as serious and as crippling as other communicable diseases, but funds
are not allocated for their control in an amount which nearly approximates 20 percent of all allocations available for the communicable diseases in general. With a distribution of funds on a reasonable
basis the attainment of the control of syphilis and gonorrhea would
be realized much more rapidly and a real advance in the field of
public health attained.
MARINE HOSPITALS

Appropriations should be made in amounts sufficient to permit the
marine hospitals and relief stations to render first-class professional
services to beneficiaries. New hospitals should be erected at Miami,
Fla., Portland, Me., and Los Angeles, Calif. The marine hospital
at Stapleton, N. Y., should be completed to provide for a total of
1,200 beds. Additional quarters for commissioned and other personnel are required in Baltimore, Norfolk, Fort Stanton, Seattle,
and Savannah, and recreational buildings at New Orleans, Carville,
and Fort Stanton.
PERSONNEL

The most important single factor in the work of the Public Health
Service is an adequate well-trained personnel. The erection of commodious hospitals, the construction of sufficient quarantine stations,
the completion of extensive laboratory facilities with modern equipment and supplies are important for the performance of the work
of the Service required by law. Without the proper personnel, however, none of the activities of the Service can be acceptably conducted.

The commissioned personnel of the Public Health Service

should be enlarged so as to meet the ever-increasing demands occasioned by the addition of new duties such as the opening of the
first United States narcotic farm at Lexine-ton, Ky. The brunt of
the important work of the Public Health Service must of necessity
fall upon the commissioned officers. It is -necessary that the commissioned corps be maintained at a high degree of efficiency by the
regular admission of qualified young men into the career service.
The commissioned corps of the Public Health Service constitutes a
mobile sanitary corps whose members are available for duty anywhere in the United States or in foreign countries. Such a mobile
corps is indispensable for the control of epidemics, for quarantine,
and for the prosecution of investigative studies.
H. s. CUMMING,
Swrgeon 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 at the Harvard Medical School
have been continued under the direction of Medical Director J. W.
Schereschewsky.
STUDIES

OF THE BIOLOGICAL EFFEOTS

OF

RADIATION

Biological action of X-rays.-In the preceding annual report it
was concluded, with the provisions made :for studying the action of
homogeneous beams of X-rays upon biological material at different
:frequencies, that the intensity of the beams :furnished by the apparatus was inadequate for the purpose. Accordingly an X-ray
tube has been designed and constructed in which different target
materials can be placed so that by using the characteristic radiation
of the target more or less homogeneous beams may be obtained having
a sufficient intensity for the purpose .
.Absorption coefficient of X enon.-In the previous annual re.port
mention was made of a series of measurements on the absorption
coefficient for X-rays of Xenon to be used in the Xenon ionization
chamber. The observed measurements differed by as much as 10
percent :from the theoretical values calculated :from Jonsson's universal absorption curve.
This raised the question of the purity of the Xenon on which the
measurements were made. However, spectral analysis showed the
Xenon to be pure, and the absorption data were published in the
Physical Review. It is interesting to note tJhat comparable data
from other laboratories have been in better agreement with the
Xenon results than with Jonsson's universal absorption curve.
Spectroscopic study of carcinogenic compownds.-The work of
studying the ultra-violet absorption spectra of carcinogenic compounds was continued. Through the kind cooperation of Professor
Fieser of the department of organic chemistry, Harvard University,
this laboratory has been supplied with a series of compounds to be
tested for carcinogenic action and related to those known to possess
carcinogenic properties. Thus far some 23 different compounds
have been studied spectroscopically. Since the compounds were all
anthracene derivatives, a certain similarity was found in the spectra.
Three more or less distinct groups of bands can be found in almost
all of them, differing, however, in the position and intensity of single
bands. In those having the strongest carcinogenic action, the position of the bands is shifted somewhat toward the longer wave
lengths.
From the evidence obtained from the known carcinogenic compounds, the tentative hypothesis may be made that all compounds
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showing these bands in approximately the same position are carcinogenic. A number of such compounds have been injected into
mice, in conjunction with the spectroscopic observations. There is
obviously considerable interest attached to the outcome, which is still
pending, of these experiments.
Thus far all the carcinogenic compounds which have been found
are anthracene derivatives. Recently, however, Cook has synthesized
a derivative of phenanthrene-benzphenanthrene, which he has shown
to be carcinogenic.
This compound is being prepared by Professor Fieser. A comparison of its absorption spectrum with that of the carcinogenic
anthracene derivatives should yield information bearing upon the
validity of the hypothesis just mentioned.
Low temperature absorption spectra.-Additional information in
regard to these absorption spectra is being sought by obtaining them
with the absorption cell cooled to the temperature of liquid oxygen.
At these low temperatures a considerable increase in sharpness and
structural details may be obtained, because of the decrease in tbermal
agitation of the molecules and the lowering of the dielectric constant
of the solvent with extreme cold. A mixture of equal parts o-f anhydrous ether and alcohol, distilled several times, made a solvent which
would not freeze at a temperature of -190° C. for several hours and
yet dissolve enough of these compounds to obtain the complete
absorption spectrum.
STUDIES OF RESIST.A.NOE A.ND SUSCffilPTIBILITY TO MALIGN.A.NT GROWTHS

Production of dibenzan.thracene tumors in pwre strain mice.-The
results of an experiment in which pure strain mice were given injections of 1: 2: 5: 6--dibenzanthracene dissolved in lard wern published
in the Public H ealth Reports May 25, 1934.
During the past fiscal year further experiments in which pure strain
mice were injected with a dibenzanthracene-lard solution were carried
out, the results of which are now in press.
Lung tumors following sub(;U)taneo1JJS dibenzamthraoene injections.During the course of the experiments with dibenzanthracene it was
found that members of two strains of mice develop a high percentage
of lung tumors following the subcutaneous injections of a dibenzanthracene-lard solution. On microscopic examination of the lung
growths it was found that practically all were carcinomas, wher eas
tumors arising at the site of injection were nearly all sarcomas.
This finding suggests an organ susceptibility to the carcinogenic
action of dibenzanthracene.
Effects of trypam blwe wpon resistance to the carcinogenic action of
dibenzantliracene.-Previous work from this laboratory has shown
that the injection of trypan blue lowers the resistance of mice to
transplantable tumors.
The influence of trypan blue upon the resistance of mice to the
carcinogenic action of dibenzanthracene has been studied in two experiments. In both these experiments it was found that the mice
receiving the injections of trypan blue developed tumors earlier than
the control animals. This finding may be of some value in further
studies rela.ting to resistance to malignant growths.


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Effects of b(J)cterial, filtrates 'lMpon maJ.lign®1,t growths.-The effect
of the injection of bacterial washings upon the growth of a transplantable lipo-sarcoma in the guinea pig has been reported by Gratia
and Linz, and upon mouse sarcoma 180 by Schwartzman and Michailovsky. The injections of the. bacterial washings produced hemorrhages in the tumor, followed in some instances by complete regression. The findings with respect to mouse sarcoma 180 were confirmed
in this laboratory. In addition it was pointed out that the washing~
were without effect upon the growth of spontaneous tumors. Mention
has been made o:f the effects of a vaccine prepared from a Gram,-negative, motile liquefying bacillus isolated from tumors propagated in
this laboratory which, when injected, produced hemorrhages, followed
by about 60 percent o:f regressions in the case, of mouse sarcoma 180.
Interest in the problem was increased during the past year because
o:f a paper published by Duran-Reynals in which he presented a
simple and easy method for obtaining active material from B. coli
broth cultures.
The following studies have been carried out at this laboratory by
using a filtrate from a week-old broth culture of B. coli:
Cutaneous tumors obtained by the intradermal injection o:f a tumor
emulsion are excellent test objects for activity of the filtrate. In such
tumors macroscopic hemorrhage is evident 3 to 4 hours after the injection of the filtrate. A number of factors enter into the reaction,
namely, the strains of mice or of tumor used, the age of the tumor,
and the amount of filtrate injected. By careful selection of these
:factors it is easy to cause the regression of 100 percent of certain
transplantable tumors ( e. g., S37).
In the case o:f spontaneous tumors no regressions were noted following injections of the filtrate. The filtrate is not specific :for carcinomas or sarcomas, as both may be affected. The first transplant of a
spontaneous sarcoma ( dibenzanthracene tumor) may be affected, but

no influence on the growth of the first passage of any spontaneous
carcinoma was noted. The study o:f a series o:f transplantable tumors
is in progress, some o:f which are influenced by the filtrate while others
are unaffected. An effort is being made to determine why transplantable tumors vary in their reaction to the filtrate.
BIOOHIDMIOAL STUDIES

Chemical stMdies upon twmor tissue.-These experiments have been
continued and extended. The second report of these studies, entitled
" The Effect of Protein on the Swelling of Normal and of Tumor
Cells of Mice in Vitro " appeared in the American Journal of Cancer
for April 1935.
With the collaboration of Dr. M. Belkin it was shown that tumor
cells which stain after the manner of living cells with vital dyes
exhibit this swelling behavior, and, hence, the phenomenon is not
attributable to post-mortem changes. In the course of the vital staining of in vitro preparations of cells, certain staining anomalies were
observed which led to extended observations of the vital staining
reaction of neutral red. Extensive data in regard to tumor cells have
been secured as to type of staining, time of survival, effects of temperature, and the like. Reports on these experiments are being prepared for publication.


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Among the interesting observations was the difference in staining
reaction to neutral red shown by the spindle cells of mouse sarcomas,
as compared with the round cells from the same tumors. This difference in behavior is being further studied. By the use of micromanipulative technique, single tumor cells have been isolated from
preparations of tumor cells in balanced salt solutions and have been
inoculated into mice. Thus far, attempts to initiate tumor growth by
the inoculation of single <!ells have been negative.
These experiments form a part of a study in which attempts are
being made to distinguish malignant from nonmalignant cells by
means of physical and chemical criteria. Although pathologists are
generally of the opinion that this is not practicable as yet, both MacCarty, of the Mayo clinic, and W. H. Lewis, of the Carnegie Foundation, have recently described criteria which are useful in this endeavor. The findings of both these investigators are based upon the
study of living cells. In this laboratory, too, the work is being done
with fresh living cells, and the observations are being correlated with
those made upon fixed and stained preparations of the same material.
Studies on the chemical treatment of twmors.-The second report
on these studies entitled "The Effect of Disturbances in Fluid Exchange on Transplanted Mouse Tumors" has been accepted for publication by the American Journal of Cancer. In this report experiments upon some 2,000 tumor-bearing mice are summarized. In most
of the attempts the results were negative.
Action of bacterial products.-Some progress has been made in an
attempt to isolate the active principle in B. coli filtrates which affects
certain types of transplantable tumors. By means of inorganic
precipitants and adjustment of pH, much of the accompanying
inactive material has been removed.
Dosimetry of tumor emulsions.-A technique has been developed in
aid of certain types of experiment. It consists essentially in preparing suspensions of tumor cells in gelatin-containing solutions and
determining the dilution at which, with constant dose, 50-percent
takes are obtained. The gelatin acts in two ways-it counteracts the
excessive water intake of tumor cells when they are suspended in salt
solutions and it prevents the rapid sedimentation of cells. By using
homogeneous-tumor suspensions, and injecting equal volumes into
pure strain mice, the comparative virulence of different tumors may
be determined.
In addition, when dilute suspensions are used, the time required
for tumor development is materially lengthened, thus increasing the
time available for the trial of preventive or curative treatments.
Studies of carcinogenesis.-These studies have been pursued for the
past 3 years, commencing with the carcinogenic action of 1 : 2 : 5 : 6dibenzanthracene in rats. The development of sarcomas in a high
proportion of the treated animals confirmed the findings of the
English investigators who, by the discovery and synthesis of carcinogenic substances of specific chemical structure, have widely
developed this particular field.
0 ollaboration with the departm,ent of organic chemistry of Harvard University.-The work of the British investigators has shown
that further progress in this field requires the collaboration of organic chemists expert in the synthesis of complex polycyclic hydro-


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carbons. Consequently, the collaboration of Prof. L. Fieser of the
department of organic chemistry, Harvard University, was sought.
During the past fiscal year he and his colleagues have synthesized a
number of int€resting compounds which are being subjected to
spectroscopic study and tests for carcinogenic action in this laboratory.
Current studies of carcinogenic substances.-The various compounds furnished this laboratory by the Cambridge collaborators
are being studied in various ways. They are first subjected to qualitative test for carcinogenic action by subcutaneous implantation in
pure strain mice. The substances are introduced parenterally either
in lard solutions, or, more simply, by implantation of the crystalline substance. In the case of carcinogenic substances, this latter
technique has been found to produce tumors rapidly.
When neoplastic tissue is produced by a compound, it is studied
in two ways-fresh, living tissue is examined in the presence of
vital stains; fixed and stained preparations are studied with the
collaboration of the pathological department of Harvard Medical
S chool.
When a compound is found to be carcinogenic, quantitative experiments are made to determine the minimum amount required for
tumor production.
The active compound is dissolved in varying percentages in melted
cholesterol, which is then cast into pellets of different lengths and
diameters. After tumors are produced, the pellets are removed and
the amount of active compound remaining is determined by spectroscopic analysis.
CYTOLOGICAL STUDIES

Tissue culture.-The study of the effects of bacterial products upon
normal and malignant cells in. vitro was carried on during the first
part of the fiscal year in conjunction with in vivo experiments upon
mice with the same products. It was shown that these products
had a far greater toxic effect upon tumor cells in vitro than upon
normal cells. They also caused regression of mouse sarcoma 180 in
about 60 percent of the mice treated. The effect upon tumors was
analogous to the effects reported by Gratia and Linz, Shwartzman
and Michailovsky and Duran-Reynals. A report on these experiments is being prepared for publication.
Effects of dibenzanthracene on cells in vitro.-Normal mouse fibroblasts are being grown in tissue cultures in contact with dibenzanthracene. This substance does not appear to have an inhibiting effect
upon the growth of the cells, which proliferate in contact with this
substance like the controls. As yet no change in cell characteristics
has been observed from the action of the dibenzanthracene. The
experiments will be continued.
HEART DISEASE

Studies of heart disease have continued under the direction of
Medical Director A. M. Stimson.
Studies of the geographical distribution of the etiological types
of heart disease have been carried on through questionnaires ad-


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dressed to several hundred hospitals throughout the country. A
large bulk of valuable material has been secured, which after analysis
it is hoped will form the most extensive contribution to this subject
up to date.
Studies of heart-disease mortality statistics were suggested by the
grave discrepancies which had been encountered in previous work
between the true :facts as revealed by clinical and post-mortem
studies and the apparent facts, as presented in vital statistics. These
studies have shown that, owing to various imperfections in the existing system, the true situation is not revealed by official statistics.
Misleading conclusions are therefore current among the profession
and laity, and the health officials are not accurately informed as to
the direction which their studies and efforts should take.
Studies of the epidemiology of heart disease have been made
chiefly in the suboffice established in Philadelphia during this fiscal
year, where there is a rich and accessible mass of material. These
studies are still in progress and no report can be made on their
results as yet.
The etiology of rheumatic heart disease has been studied at the
office situated at the National Institute of Health in Washington.
The streptococcal, allergic, and dietetic theories have been reviewed
chiefly by means' of animal experimentation. It has been found impossible to elicit convincing support to these, either alone or in combination, by the means employed. The chief difficulty appears to be
the impossibility up to the present time of producing a disease or
pathological lesions in experimental animals which are the r ecognizable counterparts of the human disease. While there is much in
the known or assumed epidemiology regarding rheumatic heart disease and rheumatic fever which lends plausibility to one or another
of these theories, and while some of the experimental work is more
or less suggestive, no one has yet adduced direct and acceptable
proof in favor of them.
LEPROSY

Studies of leprosy at the Leprosy Investigation Station, Honolulu,
and the care and treatment of patients in the adjoining Territorial
receiving station have been continued under the direction of Senior
Surg. N. E. Wayson.
The experience at the station suggests that the control of leprosy
may be advanced by the development of better criteria for the
diagnosis of early stages of the. disease. The observations of the
clinical development of leprosy in children born of leprous parents
have been continued throughout the year. Though these children
have been exposed only to a relatively casual contact with infected
persons during their lives, several have become leprous. In some
of them it has been · determined that minor neurological findings
were the earliest detectable signs, and these have been followed
through the development of the typical syndrome. Investigations
were made of the reactions of patients to a formalinized sterile vaccine prepared from the inoculum of rat leprosy, and evidence was
obtained to suggest that there is a reaction of sensitivity of leprous
patients to s1tch antigens. The total number of patients in residence
(106) was tested by intracutaneous inoculation, and it was found


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that, among a group of 24 who were classified as clinically quiescent,
or in whom the involvement was clinically mild and the progress
indeterminate, 79.1 percent gave positive tests, while among 62 who
were regarded as active cases 77.4 percent gave negative tests. Other
evidence suggestive of sensitivity was noted in the responses or reactions at the site of inoculation several weeks later when the patient
developed an acute leprous reaction.
The significance of the Wassermann test in leprous patients has
been a subject of dissenting opinions. Supplementing the studies
made at the station several years ago, additional investigations were
made this year on the findings in 481 patients in whom syphilis
was not detected after many repeated clinical examinations. Of
these, 29.6 percent were found positive to the Wassermann and/or
Kahn tests. A greater percentage was positive to the Kahn test
than to the Wassermann, and the Kahn unit estimates ran into the
thousands rather than hundreds in many cases. In comparison with
this frequency among the leprous patients, the findings among individuals of the same racial group of comparable ages and economic
status were made. Thus, among 834 patients attending the venereal
clinic of a local public general dispensary there were 32.6 percent
with positives; among 1,007 selected cases from the general dispensary (including many individuals between 5 and 24 years of
age) there were 10.8 percent .positive; among 526 attending the
prenatal clinic of the dispensary there were 4.2 percent positive;
among 526 individuals whose ages were between 5 and 24 years
who were brought before the juvenile court there were 5.4 percent
positive; while among 221 of the leprous patients within this latter
age group there were 32.1 percent positive. These findings and the
correlation observed between the variations in the test and the
variation in the progress of the leprous process seem confirmatory
of the conclusion that the presence of a .positive
assermann or
Kahn test in a patient is of little value in differentiating leprosy
from syphilis.
Since the acute reactions of leprosy are commonly accompanied
by a neutrophilic leukocytosis, and are many times followed with
apparent recession .of the leprous process, 14 patients were treated by
the administration of an heterologous antigen to produce a mild fever
and leukocytosis. Freshly isolated streptococci were suspended,
killed, and injected subcutaneously or intracutaneously. The inj ections were made once or twice a week during periods of from 2 to
5 months. A slight rise in temperature occurred with each injection
of some patients, and a low-grade leukocytosis of 24 to 48 hours'
duration was obtained in several. It was found that intracutaneous
injections produced these results in better degree and with more
constancy than those given subcutaneously. Improvements in the
leprous condition were noted in some patients. . The method seemed
to be of value in the destruction of local lesions, but its general
systemic effects were indefinite.
Colloidal and soluble bismuth preparations and sodium iodide in
small doses have been found to. be stimulative to acute or subacute
progressions of the disease with succeeding regressions in some cases.
· The results of treatments which have been carried on during this
and previous years with these drugs seem to warrant definitely further study of their therapeutic usage and ultimate value.

,v


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Some types of acute reactions are succeeded by progressive phases
of the disease; and since it was found that many patients showed
some sensitivity to antigens made from the inoculum •o f rat leprosy,
attempts were made to . desensitize a group of 12 patients. These
were given subcutaneous injections of a vaccine made of sterile
formalinized suspensions of the inoculum of rat leprosy in increasing
doses over a period of 3 months. However, acute reactions occurred
in some of the 12 after what seemed a significant period of time, and
the results are not regarded as conclusive. A complication to the
injections in most of the group was the subsequent development of
a necrosis and indolent ulcer at the site of injections, which, though
of minor significance, was slow to heal.
Studies of the pathogenesis of leprosy have included experiments
in the transmission of rat leprosy and tests of the vasomotor mechanism in patients. The experiments this year have contributed additional evidence that rat leprosy may be transmitted among white rats
through the nose without direct contact with leprous rats. These
findings may be important in considering the transmission of human
leprosy.
Several clinical findings in leprosy sugge8t an early involvement of
the autonomic nervous system, and preliminary tests made by alternately exposing an extremity to baths of 5 ° to 10° C. and 40° to 50°
C. may offer some corroboration of this hypothesis.
Renewed efforts have been carried on during the year to grow
the bacterium of rat leprosy and human leprosy, respectively. The
newly published methods, including the modification of media, for
growing acid-fast bacteria have been used, but without success.
MALARIA

Malaria investigations were continued under the direction of
Senior Surg. L. L. Williams, Jr.
St~dies of malaria control by means' of drugs.-These studies were
continued in cooperation with the Gorgas Memorial Laboratory and
the Health Department 0£ Panama.
For many years it has been the hope 0£ sanitarians in the Tropics
that a method might be devised for control of the malaria-infection
rate by means of drugs, thus avoiding expensive mosquito-control
procedure. Many students have reported success and an equal
number have reported failure. The recent introduction of two new
synthetic antimalaria drugs, namely, plasmochin and atabrine, have
greatly stimulated the study. Studies with these drugs have again
resulted in conflicting reports.
Four years ago a careful plan of research on this question was
commenced. A monthly blood index of six Chagres River Valley
villages was made. The inhabitants of five of these villages have
been given various combinations of drugs, but the sixth village has
been left untreated in order to measure the natural ebb and flow of
malaria for the region. In each case the study has been continued
through a natural fall in the rate and into the subsequent rise in
order to determine whether any of the falling malaria rates seen
under drug administration would remain low during a rising rate
and thus make the experiment conclusive.
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Failure to control the malaria-infection rate with qumme alone,
or with quinine and plasmochin, or with plasmochin alone has previously been reported. In 1934, after failure to control the rate with
atabrine alone, a study was begun to determine the effect of atabrine
followed by plasmochin. Studies were started on what proved to be
a naturally falling malaria rate. The atabrine plus the plasmochin
villages showed a rate falling so much more rapidly than the untreated village as to induce the belief that perhaps this combination
was going to prove effective. However, during the latter half of
the year there was an exacerbation of malaria with a sharply rising
rate, and within a 3-month period the rate in the drug-treated villages had risen as high as the rate in the untreated village. The
rate in all villages became as high as it had ever been in any of the
villages.
A s a result of the studies, it is concluded that, although drug
treatment in the Tropics does improve the general health of the
population and increases its capacity to work, it does not control the
infection rate of malaria.
Data have been collected during the course of these studies on
drug control which indicate a decided familial immunity and susceptibility to malaria. It is planned to pursue these observations
at greater length.
In the 1934 report it was stated that an effort would be made to
study the flight of A. albiman.us into the sanitated area, which was
suspected of having originated in Ohara growth of Gatun Lake 12
to 15 miles distant. Lack of funds prohibited any intensive studies,
but it was determined that the profuse plant growth in the lake was
not Ohara but a flowering plant, Naras. This fact will lend to the
complexity of control measures, ·should it be determined that the
flights originated in Gatun Lake.
An important contribution was made to the validity of the types
of certain species of North American mosquitoes and a paper was
published on the subject, namely, N ates on the Validity of the Types
of the Species in the Subgenera Mochlostyrax and Melanoconion
in the United States National Museum (Diptera, Oulicidae).
Researches in malaria therapy of pairesis.-These studies were continued "in cooperation with the South Carolina State Hospital. Improvements in the technique of the preparation and shipment of
malaria sporozoites and other material used in the therapy of paresis
were effected. Much time was given to the determination of methods
for preparation of sporozoite cultures by first treating the malarial
infected Awpheles externally with bactericides. These preparations
were then tested for pathogenic bacteria. The results obtained were
favorable toward pathogen-free cultures but were not so conclusive
as to warrant discontinuance of the researches on this point.
Memphis station.-Activities of this station were varied and were
concerned for the most pl:!,rt in cooperating with State health departments in connection with the supervision of malaria-control projects
of the Federal Emergency Relief. Observations were made on the
life habits of Anopheles and Aedes mosquitoes at the Reelfoot Lake
experimental station and in the laboratory, the latter with special
reference to the viability of eggs under various laboratory conditions.
Some experimentation was possible on certain types of larvicides,
chiefly the finely ground leaves of indigenous plants. Observations

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were made on the preseason broods 0£ Anopheles hatching in highwater river floatage and seasonal broods from the rolling country
both in relation to the prevalence 0£ Anopheles and malaria. Traps
utilizing principles 0£ light attractivity were designed to measure
and sample mosquito fauna. These researches are preliminary to a
more extensive inquiry into the development of an easy method for
measuring the effectiveness of any mosquito-control project.
Florida station.-Studies were initiated in 1933 designed to determine the feasibility of controlling county-wide malaria by the
elimination of only the heaviest foci of infection within the county.
Because of lack of funds and the ad vent of the Relief Administration malaria-control projects, these studies were canceled.
Norfolk station.-Studies of the prevalence of mosquitoes in southeastern Virginia have been conducted. The findings have been correlated with the adequacy, effica.cy, or lack of control measures in
sections of this area.
Thick-film laboratory.-Seven thousand blood specimens have been
examined from Georgia, Alabama, North Carolina, and Virginia in
cooperation with the State health departments. These gave an average of 9.1 percent positive.
Commencing in March 1934, a blood index was taken over a large
part of the malarious section of the country as a Civilian Works
Administration project. This index included approximately 158,000
blood specimens, of which 116,000 were sent to our laboratory for
examination. The present laboratory staff was augmented by two
microscopists for the period February 1934 to February 1935. The
results of the examination of 158,313 blood specimens showed a
general infection rate 0£ 5 percent.
Indexes of local areas from many States and reports from State
health officers taken in conjunction with this index indicate that in
the fall of 1934 there was a higher malaria rate than has been seen
for over 15 years. It is estimated that during the malaria season
there were approximately 5,000,000 cases.
NUTRITION

Nutrition studies were continued under the direction of Passed
Asst. Surg. W. H. Sebrell.
Studies on the effect of sodium fluoride in the drinking water on
the teeth of experimental animals were continued, and a report of
the effect of varying amounts of sodium fluoride on the teeth of
white rats was published in Public Health Reports for September
14, 1934.
In collaboration with Dr. S. P. Kramer, experiments were started
in order to determine whether the fluorine can be removed from
water by special filters. The results indicate that with certain filters
the amount of fluorine can be considerably reduced. Further experiments were in progress at the close of the fiscal year.
·
Experiments were started to determine the effect of various deficient diets on the incubation period of rat leprosy. These experiments were reported in the Public Health Reports for June 29, 1935.
During the year numerous fractions were prepared from yeast
in an effort to secure fractions of high vitamin G potency and, if
possible, to isolate the pellagra-preventive vitamin. The vitamin G

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value o:f these :fractions was tested in rats. Several :fractions o:f considerable activity were obtained, and the work was being pursued
intensively at the close o:f the fiscal year.
Experiments on the effect o:f ultraviolet irradiation and o:f ethyl
alcohol on rats on vitamin G deficient diets were completed during
the fiscal year. There was no demonstrable effect on the onset,
severity, or appearance o:f the lesions in either experiment.
A test on rats indicated that ·the liver o:f dogs dying o:f blacktongue contained vitamin G.
Observations on cataracts in rats produced by vitamin G deficient
diets were continued during the year. A:fter it was shown that cataracts were not affected by tryptophane, cystine, or several dessicated
glandular products, the experiments were temporarily discontinued.
In collaboration with Dr. E. F. Kohman o:f the National Canners'
Association Research Laboratories, experiments were conducted with
rats which essentially confirmed his findings on the decalci:fying
effect o:f oxalic acid in certain foods.
There is in course o:f publication a report on the value o:f seven
different :foodstuffs, namely, chicken, rabbit, pork shoulder, evaporated peaches, cottonseed meal, beets, and prunes. Rabbit meat,
lean pork shoulder, and chicken were found to be good sources o:f
the pellagra-preventive vitamin. Cottonseed meal and evaporated
peaches were found to be relatively poor sources o:f the pellagra-preventive vitamin. Prunes and canned beets were found to contain
little or none o:f the pellagra-preventive vitamin. Tests on canned
mackerel, lima beans, and liver extracts were in progress at the close
of the fiscal year.
The black tongue preventive value of several different liver preparations has been determined, and a comparison is being made between
their efficacy by mouth and parenterally in order to make a more
complete study. The results to date yield data which seem to indicate that the extrinsic pernicious anemia factors and the pellagrapreventive vitamin may not be identical.
PSITTACOSIS

Investigations of psittacosis at the field laboratory in Pasadena,
Calif., were brought to a close during October 1934, and the laboratory was turned over to the State department of health for testing
purposes.
ROCKY MOUNTAIN SPOTTED FEVER

The study of Rocky Mountain spotted fever ard other tick-transmitted and tick-caused diseases of man and animals and the manufacture of the public health service vaccine for the prevention of
Rocky Mountain spotted fever have been carried on at the Rocky
Mountain Laboratory at Hamilton, Mont., under the administration
of Director R. R. Parker.
Vaccine.-The manufacture of spotted fever vaccine for the season
of 1935 was severely handicapped, owing to ~navoidable delays which
arose in connection with the construction of a new refrigeration plant.
"4-s a result, the total gross production for 1935 use was only 315.6
hters (789 lots of 400 cc each), as compared with 335 liters for 1934.

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In spite of this fact, the net usable 1935 production of 248.4 liters
exceeded the 1934 net by 36.6 liters. This was due to the fact that 78.7
percent of the 1935 vaccine was of sufficient potency for administration, as opposed to only 63.22 percent for the preceding year.
Emergency Conservation Corps funds were again available for the
production of vaccine for the immunization of Civilian Conservation
Corps enrollees. For this purpose 53.7 liters were supplied. It was
impossible to supply vaccine for all the camps located in endemic
areas, but it was feasible to provide for the immunization of the personnel in camps in areas where the danger was greatest.
The data for the first 10 years' use of the vaccine (1925-34) have
been summarized. The figures concerning the administration in the
area of highly fatal infection in western Montana are of especial
significance, since this is the only locality in which it is possible to
keep full and accurate records of vaccinations and cases over a considerable period. During the 10 years concerned, there was, in this
area, a total of 83 cases-52 in nonvaccinated individuals, 31 in vaccinated. Excluding the records of children under 13 years of age because of their questionable significance, there were 39 cases in nonvaccinated adults and 32 deaths; that is, a case fatality rate of 82.5
percent. In the vaccinated group there were 24 recoveries and 3
deaths, a case fatality rate of only 11.11 percent. In vaccinated persons, th~r.efore, the case fatality rate has been reduced by 70.94 percent. Fifteen of the vaccinated group were employees of the Rocky
Mountain Laboratory. Only one death occurred in this group, the
case fatality rate being 6.66 percent, as compared with 100 percent in
laboratory workers who became infected while working with highly
fatal strains prior to the use of the vaccine.
The complete data covering the general use of the vaccine in all
parts of the country and against types of the disease of all degrees
of severity have justified the broadening of the scope of the conclusions which were published after the first 4 years' use. The new
conclusions are as follows: (1) The degree and duration of protection vary with the individual and with the degree of virulence of
the infecting strain of spotted fever virus. ( 2) The average person
vaccinated in the spring retains a considerable degree of immunity
during at least the remainder of the calendar year. This degree of
immunity is usually sufficient to afford full protection against the
relatively very mild strains of spotted fever, but is apparently
progressively less effective as the virus virulence is increased. The
degree of protection against the highly fatal type is sufficient to
ameliorate markedly the usually very severe course of infection and
to insure the recovery of most persons; the complete protection of
occasional persons is not unlikely. (3) Children are perhaps better
protected than adults, and among them full protection against virus
strains of high virulence may be more frequent. ( 4) If a person is
infected during the vaccination period, there is a strong probability
that the subsequent clinical course of the disease will be affected
favorably, even in areas of high case fatality rates. (5) In areas
where relatively mild infections prevail and the incubation period
is prolonged, the administration of vaccine as soon as possible after
tick bite may ameliorate an impending infection. This appears :{>articularly probable in persons who have been vaccinated in previous
years. This procedure is not recommended in areas of highly fatal

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infections where the incubation period is short. (6) It is probable
that a considerable percentage of vaccinated persons carry some degree of immunity over into the second year, even against highly
virulent virus. The degree of this residual immunity appears to be
greater in persons who have been vaccinated 2 or more successive
years. The evidence as to whether or not any degree of immunity is
carried beyond the second year is less suggestive. Until further and
more definite data are available, however, it is necessary to recommend that the vaccination of exposed persons be repeated each year
and that three 2-cc injections, instead of the usual two, be used in
areas of high virulence, especially the first year that vaccine is given.
(7) Of persons vaccinated and infected the same year, those who
have received vaccine 2 or more successive years appear to have
greater resistance than those who have received vaccine only 1 year.
Epidemiology.-Cases of Rocky Mountain spotted fever were reported for the first time from the States of Illinois and Oklahoma.
Also, new endemic areas have been reported in Montana, California,
and Idaho. These reports bring to 34 the total number of States in
which spotted fever is now known to be endemic, 21 having been
added during the past 4 years. The occurrence of a highly fatal
type of spotted fever in northern Idaho and eastern Washington
during the past few years is of particular interest, owing to its
seeming restriction to the vicinity of lakes, a condition not met with
elsewhere.
Ernperimental studies.-Considerable research work on spotted
fever, other tick-borne diseases, and their vectors, has been done in
spite of the limited funds available for such studies. Spotted fever
and Sao Paulo typhus-infected rabbits have been shown to produce
ProteilS OX2 agglutinins in sufficient titer to be of diagnostic value,
this fact providing a useful differentiation between these diseases
and endemic typhus. Convalescent sera of cases of spotted feverlike infection in India have been shown to be without spotted fever
virus-neutralizing properties, thus indicating the nonidentity of Indian tick typhus and Rocky Mountain spotted fever.
TULAREMIA

Tick-caused diseases of domestic animals, especially tularemia in
sheep, have again been prevalent in eastern Montana, where epizootic outbreaks were more wide-spread and the losses greater than
in 1934. Bacterium tularense was recovered in pure culture from a
sick, heavily tick-infested calf. Tularemia infection in man has also
been more than usually frequent in both eastern Montana and Wyoming. Tick transmission has been the most important source.
RELAPSING FEVER

Species of Ornitlwdorws occurring in the Northwestern States are
being studied to determine whether or not they are present or potential carriers of relapsing fever. It has been found that ticks of this
genus are more wide-spread in the part of the country concerned than
had been supposed.


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TICK-HOST ANEMIA

Experimental studies have shown that a condition known as" tickhost anemia" is produced in experimental animals by the rapid
withdrawal of blood which results from the feeding of large numbers of female ticks. This is an exsanguination anemia that is frequently fatal. This condition may be at least a contributing cause
to the considerable losses reported each year among heavily tickinfested game animals, such as elk or deer.
CHILD HYGIENE INVESTIGATIONS

The activities of the Office of Child Hygiene Investigations continued under the direction of Surgeon Estella Ford Warner during
the fiscal year.
STUDIES AND INVESTIGATIONS

Study of the }iearing of school ohildren.-This study was begun
in 1931 in the schools of the District of Columbia for the purpose of
determining the incidence and degree of hearing defects, the causative factors, and the degree of progression. At that time approximately 14,000 4-A audiometer tests were made in duplicate (by
simply repeating the test) and 2--A audiometer tests were given to
some 1,500 children who had a loss of nine or more sensation units.
This year about 500 of the children who previously received the 2--A
.audiometer test were retested, a care:ful oto-laryngeal examination
was made, and pertinent history recorded. There. have been some
preliminary analyses made of the materials ootained from the 4-A
t1.udiometer and the original 2-A audiometer tests. An analysis of
the second 2--A audiometer tests in relation to the first test is now
in process. It is hoped to continue this study for at least a third
test on these same children and then to report the total findings.
Studies of physical stat™, growth, and development.-During the
year the following reports have been published: (1) Further Studies
-o n Growth and the Economic Depression (Public Health Reports,
Dec. 7, 1934); (2) Age Chan~es in Physical Resemblance of Siblings
( Child Development, December 1934) ; (3) Selective Mortality in
·C hildhood ( American Journal of Hygiene, March 1935) ; ( 4) Sectional Variations in Physique and Growth of Children (Public
Health Reports, Mar. 8, 1935).
Measurements were taken on approximately 4,000 school children
in Hagerstown, Md., during the year. The data on height and weight
have been added to the records of growth of these children. How-ever, in addition to the usual observations made, additional measurements were taken to satisfy the requirements for computing the
"A C H Index of Nutrition and Growth " for these same children.
Study of midwife practice.-Midwifery, as practiced by the colored
midwife, constitutes one of the problems in maternal and child
hygiene throughout the Southern States. Therefore, an area was
·selected in southern Virginia (Brunswick County) where approximately 75 percent of the deliveries of both colored and ·white mothers
were attended by midwives, and a study of midwifery practice undertaken. Observations were obtained by personal interview with the


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midwife, and by accompanying her as she made prenatal, natal, and
postnatal visits. A preliminary report has been prepared which concerns (1) the social and economic status of the midwife, (2) her
preparation and education, (3) observations on 46 prenatal visits
made with 14 different midwives, ( 4) observation of three deliveries,
(5) 50 postnatal visits with 20 different midwives, (6) conclusions
and recommendations.
DENTAL STUDIES
DENTAL HEALTH SURVEY

The dental health survey, consisting of a survey of existing facilities and a survey of the dental needs of children of school age, was
continued under the supervision of Senior Dental Surgeon C. T.
Messner.
Faoilities.-The survey of dental facilities of State departments
and institutions of the United States was completed and is ready for
publication as a public health bulletin.
Survey of dental needs, of children of school ag·e .-Over a million
and a half dental examinations of children in 26 States were edited,
coded, the data transferred to punch cards, assistance in tabulation
being received from the division of machine tabulation of the Bureau
of the Census. Data on 1,438,318 children 6 to 14 years of age, from
1,007 areas in 648 counties of 26 States will form the basis of a publichealth bulletin. These data include, for each child examined, items
relating to present dental needs and to past dental treatment. The
children are classified according to color, sex, age, and size of area in
which they lived.
Data have also been tabulated and represented graphically for a
study of the relation of retardation in school to dental needs.
A sufficient number of examinations of preschool children was included by the examining dentists to permit a study of dental conditions as observed in this group of children. Tabulations similar to
those dealing with the children of school age have been made.
A questionnaire which had for its object the determination of the
methods of examination that were actually used was mailed to the
various dentists to whom examination blanks had been sent. Thus
far 72 percent of the questionnaires have been returned wjth the
information requested.
OHRONIC ENDEMIO DENT.AL FLUOROSIS (MOTTLED ENAMEL)

These studies were limited· to two fundamental phases-first, the
development of a quantitative methodology for use in epidemiological
surveys of endemic areas to replace g_ualitative methods heretofore in
use, and, second, basic studies leadmg to the determination of the
minimal threshold of toxicity. In connection with the former, a
classification of severity based on degree of affection was developed.
The application of this classification permitted the development of a
mottled enamel index, either actual or approximate, of a community.
During the year 53 communities in 37 counties of west Texas and 13
communities in 7 counties of east central Texas were surveyed for
mottled enamel. An analogous pathology in cattle apparently developed under natural conditions was again observed.

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In connection with obtaining information on the minimal threshold,
monthly water samples from the 11 cities selected for study during the
preceding fiscal year were analyzed. The chemical phase o:f this
study, as in the past, was carried on by the Division o:f Chemistry,National Institute o:f Health. Four o:f these cities (Monmouth and
Galesburg, Ill., and Colorado Springs and Pueblo, Colo.) were surveyed in detail and their actual mottled enamel index was determined
and correlated with the mean annual fluoride content. In :four other
cities the approximate mottled enamel index has been ascertained.
While the minimal thres~old is as ye~ undetermined, it is definitely
less than two parts per million o:f fluoride.
There are a.t present more than 300 endemic areas of mottled enamel
in the United States distributed among 23 different States.
DERMATOSES INVESTIGATIONS

During the year the Office o:f Dermatoses Investigations has continued under the direction o:f Senior Surg. Louis Schwartz.
Studies were made o:f manufacturing processes and their relations
to skin hazards in 22 plants employing 8,770 employees. About 5:000 .
employees o:f these plants were actually examined for the occurrence
o:f industrial skin diseases. The sickness records o:f these plants, as
kept by the plant physicians, were also examined in order to determine
the frequency of occurrence of skin diseases and their causes.
SPECIIAL STUDIES

This office cooperated in a study to discover the cause of dermatitis
which had been occurring among cable splicers of telephone companies. The study proved that the two dyes, malachite green and
crystal violet, used to cover the paper insulation of the wires, decomposed under the 400° F. heat of the boiling-out process and that the
decomposition products which were carried to the skin of the cable
splicers by the hot :fumes o:f a mineral oil used in the boiling-out
compound caused the dermatitis. The substitution of another group
of dyes, the decomposition products of which were different, was
recommended and adopted.
In the course of the work o:f this Office, it is necessary to perform
patch tests. It was noted that many o:f those patch tested developed
dermatitis from the adhesive plaster used in making the tests. A
study was made to determine the irritating materials in the various
adhesive plasters, so that nonirritating materials may be substituted.
At the request of a safety glass manufacturing company, an outbreak o:f dermatitis among a certain group of their workers was investigated and found to be due to mineral oil used in one of their manufacturing processes. Recommendations, which included the furnishing of protective clothing, frequent cleaning of work clothes, and
compulsory shower baths after work, stopped the occurrence o:f new
cases.
At the request of a watch-manufacturing company an outbreak of
dermatitis among the wearers o:f their wrist watches and caused by
the wrist-watch straps was investigated. It was proved that tlie
chie:f irritant in the straps was a dye-amido azo toluene hydro-


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chloride. The chrome-tanned leather used in the straps was also
responsible for a small percentage of the cases. It was recommended
that amido azo toluene hydrochloride and chrome-tanned leather not
be used in articles to be worn next to the skin.
EPIDEMIOLOGY

. The Office o:f Epidemiological Studies established during the fiscal
year is under the direction o:f Medical Director J. P. Leake.
The major epidemic of the year on which work was done by this
Office was the California outbreak of poliomyelitis during the summer of 1934. This outbreak presented problems new in the history
of poliomyelitis which have not yet been settled. These concerned
particularly cases diagnosed as poliomyelitis among the medical and
nursing personnel of the hospital in which the greatest number of
poliomyelitis patients were cared for. The outbreak itself was mild
as to severity and showed a tendency to attack older children and
young adults to a greater extent than epidemics of former years.
This tendency has been increasingly apparent during the last decade,.
Evidence was obtained, through the study by the Public Health
Service, that the disease is particularly likely to attack persons who
undergo unusual physical exertion during the epidemic period.
Swimming pools and beaches were exonerated as being of any special
importance in the dissemination of the infection.
During the latter part of the fiscal year a study was begun of the
possible value of the Park~Brodie vaccine against poliomyelitis in the
1935 epidemic in parts of North Carolina and Virginia. It is unlikely that any positive decision can be made from this study as to the
value of the vaccine, but it is nevertheless believed that the use of
such a product is justifiable only under conditions which give some
hope of yielding trustworthy conclusions as to its efficacy.
All the recent studies on poliomyelitis justify the opinion which
has been expressed by the ~ublic Health Service that the spread is
chiefly by means of human carriers rather than by declared cases of
the disease and that there is no good evidence that nonhuman sources
are of any importance in the dissemination of the infection. As a
result of its studies, the Public Health Service has also been able to
state that the affected carriers are most frequently found among the
portion of the population previously not immunized to the diseaser
that is, among the more juvenile and the more rural groups of the
population.
INDUSTRIAL HYGIENE AND SANITATION
DUST STUDIES

Health of anthradte-coal miners.-A study of the effect of dust
exposure on the health of miners in the anthracite coal field of Pennsylvania was conducted on request of the Governor of the State, with
the cooperation of opeTators and workers. It involved (a) dust determinations and occupational analyses in three representative mines;
(b) individual occupational histories, physical examinations, and
X-rays of the chest on all workers ( underground and surface) in
these three mines; and ( c) supplementary information on disabled
miners, mortality, silica content in urine, and pathology.


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The preliminary report of the study was published by the· Pennsylvania Department of Labor and Industry (Special Bulletin No.
41) ; the complete report is being published as Public Health Bulletin No. 221 ; a paper on the findings as to urinary excretion of silica
was published in the Public Health Reports (Mar. 29, 1935).
Determination and control of industrial dwst.-The methods and
instruments used in conducting dust studies in industry, the manner
of interpreting the results of such studies, and their practical application to industrial problems, especially those phases dealing with the
control of the dust hazard, are discussed in Public Health Bulletin
No. 217.
The physiological response of the peritoneal tissue to du.'3ts introdU),(}ed as foreign b·o dies.-A series of injections of dusts of known
chemical and petrographic composition was made intraperitoneally
into guinea pigs to determine the nature of the response, and the
results were reported in the Journal of the American Medical Association (Sept. 22, 1934), and the American Journal of Public Health
(April 1935).
Puvmonmry infection in ~oconioses ( other than tuberculosis) .-An investigation was made of the relation of pulmonary
infection ( other than tuberculosis) to pneumoconiosis, both bacteriologically and experimentally, with the view of obtaining a better
understanding of the predisposition to, and the mechanism of, infection of the lung in certain dusty trades. (Public Health Reports,
July 20, 1934, and Oct. 12, 1934.)
Study of silicosis and t-wberculosis in dertain mines.-In connection with a clinic cooperatively maintained by the Public Health
Ser vice, Bureau of Mines, mine operators, and the Metropolitan
Life Insurance Co., physical examinations and X-rays were made,
for a period of 5 years, on a group of lead and zinc miners in the
Tri-State (Oklahoma, Kansas, Missouri) District. These data have
been under further analysis, with a view to the preparation of a
brief, final summary of the results.
POLLUTION OF AIR AND ILLUMINATION STUDIES

Air pollwtion 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. Over a period of 2 years, four
trips ( of about 5 days each) were made to each city, records being
obtained as to the number of particles in the air (Owens jet dust
counter), the weight and composition of these particles (impinger),
the number of hygroscopic nuclei, and certain other observations,
including meteorological factors. In 10 of the cities Owens automatic air filters were set up to furnish a continuous record, day and
night, over the whole period of the study.
The report of this study is being published as Public Health
Bulletin No. 222.
Natural . illwmination of factories, schools, hosptitdls, etc.-The
study of the distribution of daylight within an experimental building was published as Public Health Bulletin No. 218. While measurements of illumination were being made within the building


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measurements of the brightness of the portion of the sky producing
the illumination were made outside the building. The results are
expressed as the illumination that would be produced by a sky having a brightness of 100 candles per square foot (338 millilamberts)
and are. therefore independent of variations in the brightness of the
sky and depend only on the dimensions and location of the windows,
the reflecting power of the walls and ceiling, and the physical properties of the 0 -lass used in the windows, its thickness, index of
refraction, coefficient of absorption, and its degree of cleanliness.
STUDIES OF SICKNESS AMONG INDUSTRIAL WORKERS

I ncidence of illness arnong industrial worketrs.-The frequency of
sickness and nonindustrial accidents causing disability for more
than 1 week among industrial employees, with cases classified according to nature of the illness, were presented quarterly in the
Public Health Reports. This is the fourteenth consecutive year in
which industrial morbidity rates have been published. In 1934 the
frequency of cases in this sample of the industrial population was
the lowest of any year of record, bettering by 3 percent the previous
low record obtained in 1933.
SPECIFIC INDUSTRIAL POISONS

Mercury absorption and poisoning amwng fur cutters.-A study
of mercury absorption and poisoning among hatters' :fur cutters has
been started. Surveys of the five plants selected for study ha.ve
been made, and occupational histories and medical examinations of
the workers were obtained.
B enzol poisoning.-In cooperation with the Bureau of Mines and
the industry, experimental studies have been made on the toxicity
resulting from inhalation of benzol vapors. · The data are being
analyzed.
Acute response of guinea pigs to vapors of new commercial organic
compounds.-Reports in this series finished during the year relate to
butanone, pentanone (methyl propyl ketone), and hexanone (methyl
butyl ketone). This work has been conducted by the Bureau of
Mines in cooperation with the Public Health Service.
Spectroscopic methods for the deter1nination of inorganic substances in body tissues and fi·u ids.-These studies were continued,
special attention being given to the problem of quantitative analysis.
The metals studied were silica, mercury, lead, and silver.
AGREEMEN TS WITH CHEMICAL I N DUS.TRY

Agreements between the United States Public Health Service and
manufacturers ( chemical industry) at the present time cover tetraethyl lead gasoline, methanol (synthetic alcohol), carbon tetrachloride and similar volatile chlorinated liquid hydrocarbons, carbon
tetrachloride fire-extinguishers, aniline oil, carbon bisulphide, and
benzol. These agreements are similar in nature and aim to safeguard
the health of users of the products. They provide for the use of
warning labels on containers. The manufacturers agree to use these.


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labels and to advise repackers and dealers of the agreement. In
some cases ( as methanol) other terms are included, such as the use
of coloring matter. It 1s felt that the control of the distribution
of substances under these agreements has been satisfactory and has
safeguarded the public health.
MILK INVESTIGATIONS

The activities of this Office were carried on under the direction of
Sanitary Engineer Leslie C. Frank.
The testing of pasteurfaation macliinery.-The laboratory studies
on the thermal resistance of the B. coli communior test organism
(strain ·11-B) were continued during the year with the ultimate objective of developing a nonpathogemc criterion organism for use in
testing the efficiency of milk pasteurization machinery and the testing of devices and processes for the germicidal treatment of dairy
and milk plant containers and equipment.
Previous research work had shown that if the test organism is
suspended in distilled water, buffered to pH 6.9, the time required
at 145° for a 99.99 percent reduction of the test organism averaged about 18 minutes.
Effect of variations of pH.-It was considered important to determine the effect of varying the pH concentration and also to determine the pH range within which the resistance of the test organism
is maximum. For practical purposes it is desirable to make equipment tests within the maximum resistance range, since there is reason
to believe that for given variations in pH there will be less variation
in resistance at this point than at any other.
During the year, therefore, studies were made to determine the
effect of variations in pH upon the thermal resistance of the organism, both at 145° F. and at 160° F. These are the two temperatures
most widely used in commercial pasteurization practice. .A 50-gallon
commercial pasteurizer was used in order to obviate any factors
peculiar to small scale laboratory type equipment.
A.s a result of this experimental work it appears wise to concentrate future research work and the subsequent tests of pasteurization.
equipment at approximately the midpoint of the pH range 6.9 to 7.5,
that is pH 7.2.
Effect of variations of buffer concentration.-It was considered possible that the buffer concentration used in adjusting the pH value to
7.2 might affect the thermal resistance of the test organism. Accordingly, tests were made to determine the effect of doubling and halving
the buffer concentration above and below the concentration which had
heretofore been used, from which it was concluded that future research
work should be confined to a buffer concentration of m/675.
Importance of speed of miwing inoculum amd of. taking tre61Jtedsamples in the higher temperature range.-In the experimental work
at 160° F., in which the reducing time was only about 29 seconds., it
became evident that the interval required for obtaining a uniform
mixture of the inoculum and the distilled water and the time required
for taking the treated samples were extremely important f.actors.
Hence methods were devised for introducing the inoculum and takin.g
the treated samples at maximum speed.


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Tests were conducted upon the effect of increasing the number of
revolutions per minute of the agitator from 72 to 216 revolutions per
minute. It was found that there was no material difference in the
results with 'the two speeds and that from the standpoint of vibration
the speed of 72 revolutions per minute was more practicable. The
time required for approximately uniform mixing as determined by
bacteriological testing at 1-second intervals from the moment of introduction of the inoculum was about 5 to 6 seconds.
In order to take the treated samples as quickly as possible and have
them at the pasteurizing temperature until the moment they were
introduced into the chilled sample tubes a siphon was introduced into
the pasteurizer so as to lead over the side and down toward the floor.
Flow was started through the siphon after the water had been brought
to the pasteurizing temperature and immediately before the inoculum
was introduced. The respective sample tubes were then passed
through the siphon eflluent at the designated sampling intervals. The
sample tubes were immersed in ice water so as to chill the sample
instantly as it flowed into the tube from the siphon. By this method
it was found that the time interval for withdrawing a sample could
be reduced to 1.3 seconds and that the temperature drop in passing
from the tank proper to the sample tube was so small as to be hardly
measurable.
It is believed, therefore, that the time of mixing the inocu]um and
the time of withdrawing the treated sample have been reduced to the
minimum practicable.
Stwdies of the b(J)Ctericidal treatnwnt of milk ca;ns by dryj heat.-In
view of the fact that dry-heat and moist-heat sterilizing cabinets are
coming into wider and wider use in the dairy industry, and since past
experience has shown that the lethal efficiency of dry heat is lower
than the lethal efficiency of moist heat, it appeared desirable to conduct experiments to determine an effective and practicable temperature and holding time for use in operating dry-heat cabinets. Accordingly a 46 cubic-foot dry-heat cabinet equipped with two gasoline
burners was installed in the experimental plant. Experiments were
conducted to determine the temperature required for a holding period
of 10 minutes to produce a 99.99 percent reduction in the previously
mentioned criterion test organism which is being developed by this
Office for use in determining the efficiency of pasteurization machinery. Four temperatures were studied, namely, 150° F., 160° F.,
170° F., and 180° F.
In order to limit the lethal effect of the heat as nearly as possible
to the holding period, the heating and cooling periods were reduced
to the minimum practicable. The heating period was approximately
30 minutes, and the cans were cooled by removing them from the
cabinet into the outer air immediately at the close of the holding
period.
In order to reduce temperature variations within the cabinet to a
minimum, a 16-inch fan was installed in the top of the cabinet and
kept in operation throughout the heating and holding periods.
The initial inoculation of the cans varied from 42,000 to 51,000 per
cubic centimeter of can content. The mean reduction in bacterial
counts was 99.935 percent ~t 150° F., 99.989 percent at 160° F., 99.997
percent at 170° F., and 99.999 percent at 180° F. It was concluded,


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therefore, that a dry heat cabinet operated so that the temperature
in the coolest zone was not less than 160° F. for at least 10 minutes
would produce adequate bactericidal treatment of milk cans. In
order to provide an adequate factor of safety, it is recommended
that the actual temperature and holding time be set at least 170°
F. for at least 30 minutes, with the proviso that the thermometer must be located in the coolest zone of the cabinet. This must
be determined for each model by actual tests with maximum registering thermometers.
Survey of m:ilk-borne di8ease Olfl)tbreaks for the year 1934.-The
following outbreaks of milk-borne disease were reported to the Office
of Milk Investigations by State and city health authorities for the
year 1934: Typhoid fever, 28; paratyphoid fever, 1; scarlet fever, 3;
septic sore throat, 5; diphtheria, 1; miscellaneous, 5.
Advisory assista;nce to State and local health departments.-During the fiscal year municipalities in the following States were visited
at the request of the State health departments concerned and given
advisory assistance with reference to milk-sanitation problems:
Arizona, Arkansas, Florida, Illinois, Indiana, Kansas, Kentucky,
Louisiana, Michigan, Maryland, Minnesota, Missouri, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, Tennessee, Washington, Virginia, and West Virginia.
STUDIES OF PUBLIC HEALTH METHODS

Studies of public health methods were continued under the direction of Surg. J. W. Mountin.
A special analysis is being made of the programs pursued by different types of county health departments. In one representative county
health department with a small organization composed of a health
officer, a nurse, a sanitation officer, and a clerk, serving approximately
30,000 people, it was found that contact was made with about 23 percent of the individuals and more than half the families during a
period of 12 months. About 19 percent of the population was contacted by the nurse, 12 percent by the health officer, and 10 percent
by the sanitation officer. The program distinctly favored communicable-disease control, general health supervision, and privy sanitation. Less than 1 percent of the contacts were for other purposes.
The school child stands out as the central objective in the program,
since 65 percent of the contacts were among children of school age.
Practically all the service to this age group was in the interest of
immunization and detection or correction of physical defects. Factors which seemed to influence the selection of homes for visitation
by the nurses were as follows : Economic status ; number of children,
particularly babies; and location of home with reference to accessibility. Space available does not permit a summary of findings in
other types of health departments.
At the request of the Commissioner of Indian Affairs a study was
made of health problems among the Indians. In general it may be
said the Indians have all the diseases and physical disabilities found
among the general population. Moreover, the adverse economic position of the Indians forces them to live at a bare subsistence level
amidst environmental conditions which bring about a low state of


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health and a predisposition to particular diseases. The outstanding
disease· problems among the Indians are tuberculosis, trachoma,, and
intestinal disorders of infants. Venereal diseases are known to be
extremely prevalent among certain groups, but the general incidence
is probably much lower than is commonly supposed. The acute infectious diseases of childhood, notably measles and whooping cough,.
are attended by high mortality. The medical service now provided
for the Indians, with few exceptions, is at least equal to, and perhaps
exceeds, that available to the general population, yet the Indian does
not enjoy the same level of health. While some progress is being
made through preventive and curative measures now being applied,.
yet it is questionable whether the health problems can be solved until
the economic position of the Indians has been improved and until
they can be induced to take more active interest in personal health.
Cooperation involving extensive field service was extended to the·
:following agencies: The government of Puerto Rico in studying the
system of public medical care; a special commission in Ohio in determining the requirements for health which should be incorporated
into different types of county charters; the Brookings Institute as
part of its study of State government of Oklahoma; Montgomery
County, Pa., St. Louis County, Mo., and Tulsa City and County,.
Okla., in an appraisal of facilities maintained for purposes of health
protection and medical care.
Special mention might be made of the Puerto Rico study, since a
similar situation is seldom encountered in the United States. Amonga representative sample of families, the range in total family income·
was roughly as follows :
Percent '

Income
: $100 ________________________________________________________
of families·
Under
50
$100 to
--------------- 30
$250
to $249--------------------------------------·
$499_______________________________________________________
10

$500 and over ______________________________________________________ 10,

Confronted with such low incomes and conditions favorable to
malaria, hookworm disease, and tuberculosis, a high prevalence of
illness might be expected. The system of municipal hospitals and
municipal physicians which has been in operation for some time is
proving inadequate to meet the increasing demands for more service
of a higher type than is now available. While the economic rehabilitation of the island is of prime importance, it is believed that much
of the present illness is preventable and that a higher degree of efficiency i~ th~ existing medical service is-possible of attainment through
reorgamzat10n.
The trend in appropriations by local governments :for public-health
purposes during this critical period of our economic history has been
a subject for special consideration. Generally speaking, it was found
that local governments tended to sustain this branch of public service
very well through 1931", thus showing an appreciation of its importance. 1!1, 1~32 and 1933 drast~c r~duc~ions were made, but the figures
for 1934 md1cate that the service 1s bemg restored to its former level _
'
even in advance of other public functions.
STATISTICAL INVESTIGATIONS

The Office of Statistical Investigations continued under the direc-tion of Senior Statistician Relwyn D. Collins.

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SICKNESS AND THE DEPRESSION

Studies of various phases of the relation of sickness to the depression have been continued throughout the year. Three papers in a
series which is to constitute a final report on the subject were submitted for publication in the Public Health Reports, and the first
one appeared in the issue of May 3, 1935. The following table gives
the sickness rates obtained in this study for families classified according to employment in 1932, the year immediately preceding the
survey.
Incidence of disabling illness in the eatrly spring of 1933 in 11,511 C{J//ivassed
white wage•earning families classified according to employment status of the
wage earners during 1932, in 10 localities
Illnesses per 1,000 persons for
3-month period (adjusted
for age)
Employment status of the family's wage earners
Total

Full-time workers (with or without part-time workers) ...•.••.
Part•time workers (1 or more; no full·time) .........•..........
No employed workers .........................................

123
160
182

Onset
within
survey
period

Onset
prior to
but sick
during
survey
period

NUIIlber
of persons observed

------ --91
112
121

32
48
61

21, 02 2
21,224
4,935

Considering all illnesses, the rate for persons in families· with no
employed workers (182 per 1,000) was 48 percent above that in
families with a full-time worker (123 per 1,000).
Persons of low income, and particularly those whose economic
status changed from reasonable comfort to very poor during the
depression, had high sickness rates. However, the greatest difference
in sickness rates appears between persons on relief and those not on
relief. The following table gives the rates:
Incidence of disablirng illness in the early sprilng of 1933 in cam/vassed W'hite
wage•earning f (]Jmilies classiJfi,ed according to change in family income between
1929 and 1932 and relief status in 1!:J32, in 8 large cities
Illnesses per 1,000 persons for
3•month period (adjusted
for age)
Economic and relief status t
Total

Comfortable throughout the period 1929-32 .•.•.•...•..••.•....
Comfortable in 1929 but poor in 1932......•••••••.•.•.••••••••.
Comfortable in 1929 but on relief in 1932••..•.••.....•.........

120
145
208

Onset
within
survey
period

Onset
prior to
but sick
during
survey
period

Number
of per•
sons ob•
served

- - - - - - --90
103
142

30
42
66

4,117
1,479
1,328

1 In all cities except New York "poor" means an income of less than $150 per capita, and "comfortable"
an income of $425 or more per capita. In New York (including Brooklyn), the corresponding figures are
under $250 and $500 and over.

Considering all illnesses, the rate for persons in families which fell
from relative comfort in 1929 to poor in 1932 (145 per 1,000) is 21
percent above that for families who remained in the comfortable
class; those who fell from relative comfort in 1929 to relief in 1932
had a still higher sickness rate, 208 per 1,000 persons, or 73 percent
20980-35-4


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above the rate in those, families which remained comfortable throughout the period (120 per 1,000). (The word "comfortable" is here
used in a relative sense only; the incomes of all of the surveyed
families were very low.)
Since sickness of some member of the family, particularly of the
chief wage earner, is frequently the reason for the family being on
relief, the high rate in the relief group suggests that selection is an
important factor; that is, the relief population contains a disproportionately large number of persons who have chronic diseases or
physical defects or who are susceptible to frequent attacks of acute
illness.
As a further study of the health of the population on relief, an
analysis of data on physical impairments and chronic diseases among
the relief and the nonrelief population of a large city was undertaken
in cooperation with the Federal Emergency Relief Administration,
under whose auspices the information was collected. These data
indicated that (a) a much higher proportion of persons on relief
had serious physical defects or chronic diseases than those of the
same occupational class who were not on relief; (b) in both the
relief and nonrelief populations the proportion with impairments
and diseases increases regularly from the lowest rate in professional,
proprietary, and clerical classes to the highest among unskilled
laborers; (c) that among the" white-collar" occupations illness and
physical impairments are relatively a more frequent reason for getting on relief than among laborers, and particularly among colored
laborers. Among unskilled laborers, where income is always low
and adaptability to new conditions and suitability for new or
changed employment is limited, reasons of a purely economic nature
often put the family on relief, but among the more adaptable
"white-collar" classes the family can more frequently meet new
economic conditions unless handicapped by impairment or illness.
This Office also cooperated with the Federal Emergency Relief
Administration in the analysis of data on physical defects and
chronic diseases among relief families in a large group of cities;
the data were collected as a part of an occupational census of the
relief population of cities scattered throughout the country. A bulletin issued by the Federal Emergency Relief Administration gives
the results ( Federal Emergency Relief Administration Research
Bulletin, series I, no. 6).
MOR'l'ALITY TRENDS AND THE DEPRESSION

Through a cooperative project sponsored by the California State
Health Department and the State Emergency Relief Administration, a study was undertaken to determine whether mortality in the
families of the unemployed and others severely affected by the
depression increased, remained stationary, or decreased during the
period 1929-34. This study consisted of a house-to-house canvass
of some 30,000 families; the canvassing was done as a work project
by "white-collar,,. personnel on the relief rolls. The data were
coded for putting on punch cards by the same personnel, and the
punching and tabulation of the cards and the analysis of the data
are now in progress in this Office in Washington. Ample mortality
records for the general population of the country as a whole and
for individual States and cities are available, but there is no way

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except by such a canvass to determine whether mortality in the
families of the unemployed has followed the downward trend that
has been in progress in the general population. By the use of relief
personnel for this study, the cost to the Public Health Service will
be very small. The results will be helpful in studying the effect of
the depression, because they will measure mortality in the same
group of unemployed families before and during the depression.
RESPIRATORY STUDIES

Work was continued on influenza and other respiratory diseases.
Four papers were published during the fiscal year-Public Health
Reports for July 13, 19'34; American Journal of Hygiene, November
1934 and May 1935; and Bulletin of the International Office of Public
Hygiene, October 1934. Another paper on influenza epidemics from
1920 to 1935 is to appear in the Public Health Reports. In this period of 15 years since the 1918-19 influenza pandemic there have
occurred 10 epidemics of a more or less Nation-wide scope which
caused an estimated aggregate mortality from influenza and pneumonia in the United States of 300,000 deaths in excess of the normal
expectancy.
MORBIDITY STUDIES

The analysis of records of sickness and medical care in the general population was continued during the year. Two papers on the
causes of illness and death at specific ages were published (Public
Health Reports for Feb. 22 and Apr. 12, 1935) and a third is in
proof.
In cooperation with the Committee on Economic Security, data
were assembled on the expectancy of illness in terms of cases and of
days of disability for persons of the working ages.
CURRENT PREVALENCE OF DISEASE

The 4-week reviews of the prevalence of
tinued throughout the year and have been
Health Reports.
The semiannual and annual summaries of
various States were prepared and published
for Nov. 9, 1934, and Apr. 26, 1935).

diseases have been conpublished in the Public
current mortality in the
(Public Health Reports

MISCELLANEOUS

A study of the incidence, mortality, and fatality of smallpox in
t.he last 2 decades in the various States and in different countries
is in press.
A note on the increased death rate during the excessive drought
and heat in the Middle West during the summer of 1934 was pubJished in the Public Health Reports for August 31, 1934.
A paper on the prevalence of defective vision among adults of
specific ages was published in Human Biology for May 1935.
STREAM POLLUTION INVESTIGATIONS

Research studies in stream pollution, sewage treatment, and natural purification of water have been continued at the headquarters
station of this activity at Cincinnati, Ohio, under the direction of
Sanitary Engineer J. K. Hoskins.

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Stream pollution and natural purifiaation.-Critical study of theextensive experimental and observational data on polluted water·
collected in recent years has permitted the derivation of logical con-clusions concerning the mechanism of biological purification in fl.owing streams. Rates of bacterial decrease in polluted water and the·
progress of nitrification in sewage mixtures have been described in
articles appearing in the Public Health Reports for March 22, 1935,.
and October 5, 1934, respectively. These studies have indicated,.
moreover, the desirability of practical limits of pollution for streams
and lakes, for the avoidance of nujsance conditions, and for the pro-tection of surface sources of public water supplies, both of which
subjects have been discussed in a series of published papers (Journal
of the American Water Works Association, vol. 27, January and
February 1935, and Public Health Reports, Aug. 24, 1934). Factors
to be considered in the formulation and administration of an inclusive program for water-pollution control have been summarized as .
a logical supplement to the research findings (Sewage Works J ournal, May 1935).
Studies in sewag0 treatment.-The-se studies, as explained in last
year's report, have as their primary objective the determination of ·
conditions which affect detrimentally the biological activity upon
which purification of sewage by the activated sludge process depends.
A small experimental treatment plant of this type has been maintained in operation as a source of laboratory material as well as for ·
observing the changes in efficiency of purification effected by various
procedures. One source of lowered efficiency of the process frequently ·
encountered has been confirmed in the experimental plant, namely,
the J?henomenon of sludge bulking resulting from abnormal growths .
of fungus in the sludge floe. Extended tests have indicated that small
amounts of chlorine properly applied will control such objectionable ·
fungus growths, and this conclusion has been confirmed in at least
one mumcipal plant where sludge bulking was corrected by this means.
The active agency in the absorption of colloidal and dissolved im- purities in sewage by the activated sludge treatment process appears
to be the zoogleal or slimy material composing a considerable part of ·
the sludge body. Accordingly, attention has been focused on the for- mation and composition of this active principle. An organism isolated from the zooglea of activated sludge and capable of reproducing ·
such material in pure culture has been studied at some length and its cultural and other characteristics were described in the Public Health.Reports for May 17, 1935. Chemical research upon this same material has demonstrated a marked similarity of properties to those of zeolites, which justifies its designation as a biozeolite. This zeolitic theory of the nature and properties of activated sludge is being ·
developed in a series of papers, some of which have been published
(Public Health Reports, Feb. 1, 1935; Sewage Works Journal, May ·
1935, and Industrial and Engineering Chemistry, June 1935).
Study of stream oandation.-During the year a series of experi- mental observations has been instituted dealing with the physical and ·
biochemical changes occurring in sewage sludge deposits under con- ditions approaching those of natural streams. Because of the diffi- culties inherent in evaluating these changes under natural conditions,
they have remained, to a large extent, an unknown factor in the •
measurement of oxidation in sewage polluted streams; hence, their ·
determination experimentally has appeared the only practicable solu- 
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tion of the problem. With especially designed apparatus it has been
found possible to observe for any desired period of time the progressive oxidation of a known volume of sludge, over which a stream of
water is recirculated at a depth and velocity capable of wide variation, the dissolved oxygen supply of this stream being replenished
continuously at a known rate through direct absorption :from the atmosphere. The experimental data thus far obtained have indicated
that the rate of oxidation of the sludge deposits under stream-flow
conditions is somewhat lower than that of normal biochemical oxidation under strictly aerobic conditions. These results have suggested
the importance of amerobic bacterial decomposition in the breaking,d own and subsequent oxidation of sludge deposits, as this action is
known to be measurably slower than its aerobic prototype.
Determination of the oxygen requirements of polluted streams and
,of the rate at which such oxygenation proceeds are of utmost practical importance in planning stream cleaning and sewage treatment
measures. From available field data a comprehensive method has
been evolved for the evaluation of the rate and extent of natural oxi·dation in polluted streams of known characteristics. A full description of this method, with illustrative examples, has been published in
a series of two papers dealing with these studies (Sewage ·works
Journal, March and May 1935).
NATION.AL INSTITUTE OF HEALTH

The National Institute of Health continued under the administration of Director W. G. McCoy and Assistant Director R. E. Dyer.
During the fiscal year the new buildings provided under the Ransdell Act, approved May 26, 1930, were occupied. These gave urgently needed improved facilities, making possible the carrying on
of the work of the institute under better conditions.
DIVISION OF PATHOLOGY AND BACTERIOLOGY

Typh.us-Rocky Mountain spotted fever.-There was a definite increase in the number of cases o:f typhus :fever in some of the Southern States, while spotted fever remained practically the same as ,for
last year. Additional foci of spotted fever were located in New
York State and in North Carolina, and cases which were probably
spotted fever were found in northern Alabama.
In a study of the longevity of typhus virus in animals, the virus
of endemic typhus was recovered from the brains of guinea pigs
2 weeks after recovery from symptoms of the disease. Efforts were
made to produce protective vaccines against typhus and spotted
fever, using extracts of organs of infected animals. Strains of
typhus fever from wild rats trapped at typhus foci and viruses from
suspected cases of spotted .f ever were identified. The typhus viru~
was maintained through 7, and spotted virus through 12 successive
passages in the chick embryo.
Epidemic encephalitis (St. Louis type) .-Studies indicate that
immunity to the St. Louis type of encephalitis is wide-spread in
the United States, as shown by a positive mouse serum-protection
test in approximately 10 percent of serums from over 200 persons
from 21 States who gave no history of exposure. Serums from
clinically definite cases of encephalitis in the St. Louis area showed
immunity in approximately 95 percent of cases. Normal persons

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:following definite contact with cases showed immunity in 36 percent,
owing probably to subclinical in:fection. A similar type of immunity
was demonstrated in white mice.
It has been shown that the instillation o:f alum into the nostrils of
white mice tends to render them less suspectible to intranasal infection
with this virus.
Benign vymphocytio choritJmenvngitis.-The workers in epidemic
encephalitis have studied a virus isolated during the St. Louis outbreak, which has been identified as the etiologic agent of a disease o:f
man heretofore designated as" acute aseptic meningitis." About 200
miscellaneous serums submitted to the serum-protection test against
this virus showed the presence o:f potent antibodies in approximately
2 percent of them. Strains of this virus have been isolated :from noninoculated monkeys, which suggests a source of possible danger in the
administration o:f tissue vaccines from monkeys, such as are being
employed in poliomyelitis.
This virus has been cultivated through three successive passages
in the chick embryo.
Bacteriophage.-Two reports on bacteriophage were prepared and
published in the Public Health · Reports. In one, four serologically
distinct races of steptococcus bacteriophage were described. In the
other it was shown that the value of bacterial substance as an immunizing agent is slightly better in the form of whole cells killed by
a low degree of heat than when dissolved by bacteriophage.
About 500 strains o:f hemolytic streptococci are being classified
according to phagological and :fermentation reactions. The distribution and pathogenic activity of the several species are under investigation.
Relapsing f ever.-Investigations have demonstrated the survival of
virulent infection for 4 years in naturally infected adult ticks of the
species Ornithodoru'8 twricata collected in Texas and deprived of :food
throughout that time.
Tul(lfl'eniia.-In 1934 tularemia was reported by State health officers
from 41 States and the District o:f Columbia, a total of 881 cases being
reported, as compared with 892 in 1933. The infection was recovered
from naturally infected red foxes killed in Maine. Bacteriwm tularense was found to retain viability and maximum virulence for 10
yea.rs in guinea-pig spleen tissues suspended in pure glycerin at
-15° C.
Poliomyelitis.-Studies were continued on the effect of formalinkilled virus combined with aluminum hydroxide. No appreciable
immunity in treated monkeys has been observed. Following the work
on encephalitis virus in mice, monkeys treated intranasally with sodium aluminum sulphate solution were rendered resistant to intranasal instillation of poliomyelitis virus.
Bacterial vari(1/ll,ts and mutants.-Irradi,a tion of bacteria by radium
emanations through many culture transfers induced at times, but not
regularly, profound cultural and morphological changes. Methods
were developed showing graphically the killing effect of beta as compared with gamma rays of radium. Continuous irradiation of the
same culture for 30 days did not always produce bacterial changes.
Sublethal irradiation resulted in retardation of cell division of bacteria, molds, and protozoa, and in retarded ~etabolism of bacteria.


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Trach011Ul).-The living embryo and media containing :frozen chick
embryo extract and :fresh chicken embryo extract were used in attempts to cultivate the causative agent of . trachoma. Bacteriwm
granulosi,s was not cultivated by any of these methods. The use of
the living embryo is being contmued in the study.
Amebic dysentery.-Studies on the epidemiology of the amebic
dysentery outbreak originating in Chicago in 1933 were finished and
the report was submitted for publication. There were about 1,300
cases, of which about 100 were fatal. Experiments on the viability
of cysts of E. histolytica on the hands after natural contamination
indicated that the hands rarely were infected. At the request of
sanitary engineering authorities, experiments on the effectiveness of
filtration of water supplies have been continued on an experimental
scale approximating actual filtration processes.
Bacillary dysentery.-Studies have been initiated on dysentery
with special reference to the bacillary type as it occurs among Indians
of the Southwest, which, thus far, indicate that these infections are
more wide-spread and more prevalent than has been recognized.
Leprosy.-Experiments were begun on the effect of various deficient diets on the incubation period of rat leprosy. Local lesions
occurred in rats fed vitamin B 1 deficient diet and injected subcutaneously with material :from a human leprous nodule. These experiments were reported in the Public Health Report~, and further work
is in progress.
Pathology.-The histologic diagnostic service to marine hospitals
and other agencies was continued, over 1,800 specimens being exttmined and reports submitted thereon. In addition to this diagnostic work, specimens from about 1,600 experimental animals were
examined histologically and reports submitted. In this work, some
21,000 slides were stained and studied.
There follows a tabulation of specimens received during the fiscal
year:
Diagnostic service :
Human surgical material __________________________________ cases __ 1,663
Human autopsy material ____________________________________ do____
181
Experimental pathology in animals ______________________________ do ____ 1, 592
Prepared for study by other divisions __________________________ do____
123
Total tissue specimens ____________________________________ do____ 3, 559
Blood and spinal fluid for Wassermann and Kahn tests ________________ 18, 768
Blood for other diagnostic tests _____________________ ¥ ________________ 3,115
Other specimens (not including routine)______________________________
383

Total _________________________________________________________ 22,266

Bioloqic products.-At the close of the fiscal year 49 establishments
held licenses to engage in the interstate sale of biological products.
Of these firms 11 were foreign and 38 were domestic. The licenses
covered 155 different preparations.
The Director of the Institute was detailed to attend the meeting of
the Permanent Standards Commission, Health Organization, League
of Nations, held at Copenhagen in August 1934. At this meeting
standards were adopted for Vibrion septiqwe antitoxin, oedematiens
antitoxin, pneumococcus serum, Type I, pneumococcus serum, Type
II, and staphylococcus antitoxin.


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SPECIAL STUDIES ON PROPHYLAOTIO AND THERAPEUTIO AGENTS COVERED BY LAW OF
JULY 1, 1902 (THE BIOLOGICS LAW)

During the year, activity was especially marked in connection with
human convalescent serums, with vaccines :for prevention o:f poliomyelitis, and with smallpox vaccines made by methods other than the
orthodox calf propagation. ·
Gas gangrene antitoxin.-The standardization o:f gas gangrene antitoxin ( oedematiens) was undertaken in cooperation with other countries under the direction o:f the Permanent Standards Commission,
Health Organization, League o:f Nations. A dried standard toxin
:and a dried standard antitoxin have been prepared and the potency
-0:f these was determined in terms o:f the international unit o:f antitoxin
.a dopted at the August 1934 meeting o:f the Commission.
Histolyti()'US and sordelli antitoxins have been obtained and dried in
preparation :for standardization.
H emolytic streptococc11)8.-A study was continued of the several
.a ntigenic metabolic products elaborated by hemolytic streptococci isolated from the various clinically recognized infections involving this
,organism.
M eningococcus rneningitis.-Studies were made on the course o:f
meningococcus infection in mice. Strains of sufficient virulence readily produced a generalized infection in these animals. Protection
:afforded against such infection by polyvalent therapeutic anti-meningococcus serum was investigated. Many serums protected well,
while others gave no better protection than some normal horse serums.
Studies on the toxins of the meningococcus were continued and
investigations on their neutralization by antitoxins have been begun.
Meningococcus cultures have been stored in neutral glycerine at
-15° C. :for more than 2 years with no apparent change in viability,
m.orphology, or in serological or biochemical characteristics. Storage
without glycerine has been successful for 8 months, and studies on
-the optimum conditions for such below-freezing storage are still in
progress.
Alwm precipitated antigens.-It has been shown that alum precipi·tated diphtheria toxoid remains antigenic in the tissues of the guinea
;pig for at least 7 weeks, which probably explains its unusual activity.
Studies in sensitization and immunization with alum-precipitated
·bacterial products have shown that sensitization with fat-free tubercle
bacilli and with old tuberculin may be produced in guinea pigs by a
-single dose of the alum precipit~te. Immunity in such sensitive
;animals is being tested.
Stapliylococcus studies.-Studies were continued on staphylococcus
products. An international standard staphylococcus antitoxin has
~been adopted, and based on this a United States_standard antitoxin
has been made and part o:f it has been prepared in stable, dry :form in
vacuum. A standard staphylococcus toxin has also been prepared and
measured against the international standard antitoxin. Immunization and other experiments have been carried out and commercial
-staphylococcus antitoxin and toxoid samples have been assayed to
·determine sterility, innocuity, and potency.
Arsenical, preparations.-Studies on the therapeutic efficiency of
neoarsphenamine in experimental syphilis in rabbits were continued,
the results obtained indicating that different brands of neoarsphen~amine which have been examined are remarkably uniform in thera_p eutic activity.

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DIVISION OF PHARMACOLOGY

The work of this division continued under the direction of Pharmacologist Director Car1 V oegtlin.
Oarrwer research.-A. systematic investigation was made of the
effects of certain chemical ,a gents upon the various phases o:f mitosis
in Amoeba proteus.· Based on the experimental data so obtained, a
theory of cytoplasmic fission has been advanced.
In view of the importance o:f cell division in tumor growth, the
factors controlling the activity of nuclear enzyme of malignant
tumors were studied. The pH optima for enzymatic hydrolysis of
nucleic acid were ascertained, and the influence of ascorbic acid,.
glutathione, crysteine, and oxygen lack upon nuclease activity was
determined.
In continuation of the work on the pH of tumors and normal tissue,.
a new theory of the glass electrode was worked out.
The study of growth of the Walker 256-rat mammary carcinoma
in vivo and in tissue culture was continued :from last year. The
strain, successfully carried in vitro a total o:f 370 days and then inoculated into rats, resulted in some instances in a sarcomatoid metaplasia. A. study of the factors permitting the growth of such cells.
in vitro and the causes leading to metaplasia is now in progress.
The systematic attempt to mfluence the growth of a spontaneous
mammary tumor of the mouse, referred to in last year's report, has
been continued. The effects of many chemicaJs synthesized for this.
purpose were examined. A.n attempt has also been made to influence
the growth of this tumor by diet. The results of these studies seem
to indicate that the rate oi tumor growth can be influenced by
chemical means.
The research dealing with the histological characteristics of the
Jensen rat sarcoma and Walker 256-rat carcinoma, after subcutaneous.
and intramuscular inoculations, has been completed and has appeared,
as part o:f a National Institute o:f Healt h Bulletin. This bulletin
also contains papers dealing with the effect of the :injection o:f various.
sugars on the pH of malignant tumors in living animals and on the·
relation of pH to protein synthesis in extracts of normal and neoplastic tissues.
·
.
Prevention of fatal bichloride of mercwry poisoning.-Further
work has been done on this subject. In rabbits it was possible to.
obtain complete protection o:f the kidneys from two fatal doses of
bichloride by use of :formaldehyde sulfoxylate as the antidote. O:f
30 human cases treated in local hospitals, 27 survived and in 26 there
was practically no kidney damage.
Chemotherapy of pnewmococ(J'IJ)8 infection.-Upon the basis of its.
strong reducing action, formaldehyde sul:foxylate was employed as.
a chemotherapeutic agent in mouse pneumococcus septicemia. A._
striking curative action was found :for a strain of pneumococcus I.
grown at the National Institute o:f Health. Morphologically thisaction is associated with marked phagocytosis of the organisms in
the peritoneal cavity. So far other strains of pneumococci were not
so easily influenced by the drug as the Institute strain. Hence, in
collaboration with the Division o:f Chemistry, an attempt has been
made to develop more effective substitutes and to determine thenature of the chemical properties which are requisite :for the thera-peutic action of sul:foxylate.

56549


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Research on experimental anemias.-Phenylhydrazine anemia has
b€en studied in the albino rat, and the effect of certain nutritional
deficiencies on the rate of hemoglobin and red-cell regeneration has
been examined. The results of the investigation of vitamin B 2
deficiency on hematopoiesis were published in the Public Health Reports. In an attempt to work out a method for the bio-assay of liver
extract, its effect on the reticulocyte response in experimental anemia
resulting from B a:rtonella mJUris infection was examined. Studies
on the influence of some of the essential amino acid deficiencies on
hematopoiesis are in progress.
The pharnuwology of the nervous system.-With the cooperation
of the Division of Chemistry, the phosphoric triesters of several alcohols were prepared and their pharmacologic actions were examined.
Further data were thus obtained showing that, by phosphorylating
physiologically active alcoholic groups to the triester form, important change in the pharmacodynamic properties of such compounds
may be brought about. In the instance of the phosphoric triester of
choline, it has been possible to dissociate the curare from the muscarine and nicotine actions, which are usually associated in choline and
refo,ted substances. In the course of this work a method was devised
for quantitative studies on neuromuscular irritability.
DIVISION OF CHEMISTRY

The work of the Division of Chemistry continued under the direction of Prof. Claude S. Hudson.
Sugar researohes.-Studies on the oxidation of sucrose were continued along the lines of the last report. Some evidence was obtained indicating that the crystalline brucine salt, prepared from
the products of the oxidation of sucrose, is the tribrucine salt of
the tricarboxylic acid corresponding to the sucrose molecule with the
three primary alcohol groups converted into carbo4yl groups.
Additional evidence was obtained on the structure of the strontium
salt, prepar ed from the products of the oxidation of a-methyl-d-mannoside, and on the p-bromophenylhydrazine derivative of the corresponding hydrolized acid.
There was also a continuation of the study of the action of various
acidic hydrolyzing agents on methyl glycosides and on the reduction
of a-galaheptose to a-galaheptitol. The acetyl and formal derivatives of this compound have been isolated for the first time, and
considerable study was made on the effect of borax upon its rotation.
A continuation of studies on the four-carbon sugar, threose, included quantitative studies of the hydrolysis of d-threose diacetamide, molecule weight determinations, which showed d-threose acetate
to be monomeric, and work with the acetates of threose, which indicated that these acetates have a cyclic structure.
Investigations were conducted on neolactose and new results obtained, which confirm the conclusion of Kunz and Hudson that
neolactose is d-galactosido-d-altrose.
The first practical method for recrystallizing xyIonic amide was
devised, and a method was developed for separating sodium glucoheptonate from a-glucoheptose. An improved method has been developed for the preparation of d-mannoheptulose from the pulp of
the avocado. The contaminating impurity in d-arabinose from cal
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53

~cium gluconate has been identified and means :for its removal pointed
-out.
Enzyme researches.-The researches on invertase were continued .
.As a result o:£ the work already reported, a relatively convenient
method has been developed :for obtaining concentrated solutions of
this enzyme. These solutions were utilized in a study o:£ the exact
,chemical configuration o:£ the substrate on which invertase acted.
'The chemical constitution o:£ the pure crystalline gamma-methylfructoside, previously reported, has been confirmed and its relation·ship to sucrose established. A study o:£ the behavior of this :fructo· side with various chemical reagents has shown that it can be used
:for the synthesis o:£ other derivatives o:£ gamma fructose, one of
which, a tetraacetyl gamma-benzylfructoside, has been obtained in
the crystalline state.
DIVISION OF ZOOLOGY

Survey of ectoparasites.-In connection with typhus control work,
-over 300,000 ectoparasites, including fleas, lice, and mites, o:£ rats
·and other mammals were identified .
.Amebiasis.-An investigation o:£ amebic dysentery in Georgia, extending over a period o:£ several months, was carried on.
Ewamination of parasites for diagnosis.-This part o:£ the work of
the Division continued throughout the year, and more than 250
.specimens were examined :for various Government hospitals, State
.health departments, universities, and :for practicing physicians.
MISCELLANEOUS

During the fiscal year '7 public health bulletins and 2 National
Institute o:£ Health bulletins were issued and 165 scientific articles
for the Public Health Reports or outside publication were submitted
to this Division :for review and recommendation as to publication.


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DIVISION OF DOMESTIC (INTERSTATE) QUARANTINE
Asst. Surg. Gen. C. E. WALLER in charge
PREVENTION OF INTERSTATE SPREAD OF DISEASE
PLAGUE-SUPPRESSIVl!l MEASURES IN THE PACIFIO COAST STATES

Plague-suppressive measures in California were continued, as in
previous years, in cooperation with State and local authorities. No
human plague was reported in California during the year, but one
case with onset of illness in June 1934 died in September 1934.
Rodent plague in ground squirrels was reported in San Luis
Obispo, Modoc, and Lassen Counties, in wood rats in San Luis Obispo
and Modoc Counties, and in one field mouse in Modoc County.
In addition to investigations in the above-mentioned counties, the
State Department of Public Health has made field surveys in Kern,
King, Monterey, San Benito, San Bernardino, Santa Clara, Santa
Cruz, and Tulare Counties, and no plague was :found. In Kern and
Tulare Counties, where an extensive focus of rodent plague was discovered in 1934, rodent-control measures carried out by the State and
local authorities reduced the number of rodents to such an extent
that plague was not found after July 1, 1934. A second survey was
made in the months of March and April 1935, with negative results.
MEASURES TAKEN AGAINST GROUND SQUIRRELS

Public Health Service activities in California heretofore have been
confined to the work of maintaining .a squirrel-free zone around the
cities on San Francisco Bay, in cooperation with local authorities.
These activities consist 0£ inspection 0£ areas £or evidence 0£ squirrel
infestation, the application of poisoned grain, and the treatment 0£
squirrel burrows with carbon bisulphide when conditions are favor, able for the use of this agent. The following tabulation shows the
extent of these operations :
Number:
Inspections___________________________ _______ __ ___ ____ _______
1,759
Reinspections_____________________________ _____ _____ __ ________
3, 819
inspected----·
·----------------------------------------282,
875
Acres
Acres reinspected ____________________________________________ 768,183
Acres treated with waste balls____________ ____________________ 34, 661
Acres treated with poisoned grain _____________________________ 152, 376
Burrows treated __________________________________ ____________ 108, 642
Materials used:
Carbon balls
bisulphide
(gallons)---------------------------------1, 691½
Waste
______________
___ ___ ________ _______ ____________ ___ 108,642
Poisoned grain (pounds) :
Strychnine______________________________________________ _ 12,039
Thallium ------------------------------------------------ 19, 911 ·
Phosphorus_______ ____ __ __ ____ ___ ____ ________ ____________
8,845
Poison mixed for landowners under supervision of Public Health
Service (pounds) _____________________________________________ '...
2,070

In April 1935 a mobile laboratorY. was put in the field by the Public
Health Service to search for possible new foci of rodent plague infection in the Pacific Coast and Northwestern States. This mobile
unit began activities in Modoc County, Calif., where work was done
in cooperation with the State department of public health.
54


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55

MEASURES TAKEN AGAINST RATS

This phase of the activities is confined largely to the trapping of
rats in San Francisco and vicinity and the examination of those
caught for evidence of plague. All rat complaints in the city of San
Francisco are handled by the plague station in San Francisco in
cooperation with the. city health depa,r tment. The city health department has rendered valuable service in the abatement of rat nuisances.
During the year 1,537 rat complaints were investigated in San
Fr.anc1sco.
From February 21 to June 22, 1935, trapping operations were
conducted on hog ranches in San Mateo County near the San Francisco County border to secure information as to possible plague
infection of the rats on these ranches from ground squirrels, and at
the same time to give assistance to local authorities in .an investigation
of trichinosis in the vicinity of San FranciE:co.
RODENT PLAGUE IN OREGON

At the beginning of the fiscal year information had been received
confirming the occurrence of a human death from plague in Lake
County, Oreg., in a sheep herder who was taken sick about 60 miles
northeast of Lakeview, Oreg. As the ground squirrels of this region
( Oitellus oregonus) go into hibernation in the latter part of July,
·further investigations were not practicable until the spring of 1935.
About May 1, 1935, the new mobile field laboratory began investigations in Lake County, Oreg. During May two foci of rodent
plague, one about 2 miles east, the other 25 miles northeast, of Lakeview were found. A survey of the wild, mountainous country where
last year's human case was taken sick, was made in June, with
negative results. Numerous reports that the marmots (Mar1rWta
ftaviventer) of that region were dying from an unknown cause were
investigated. Several specimens from marmots were sent to the
laboratory, but thus far no plague has been found in marmots.
In June 1935 an officer of the Public Health Service accompanied
the State health officer of Oregon on a trip to Wallowa County,
Oreg., to investigate a report of an unknown fatal disease in ground
squirrels of that county. One ground squirrel found dead about 5
miles northeast of Wallowa was found to have plague. At the close
of the fiscal year arrangements had been completed to have the
mobile field laboratory begin work in Wallowa County on July 1,
1935. This focus of plague in the, northeastern county of Oregon,
about 50 miles distant from the State lines of Washington and
Idaho, suggests the possibility that plague infection may be found
in those States.
While investigations were being made in Lake County, Oreg., the
work extended into the adjoining portions of Nevada, but at the
end of the fiscal year no infection had been found in N e,v ada.
MOBILE FIELD LABORATORY

A mobile field laboratory, mounted on a 1½-ton panel truck, was
equipped in March and April and placed in the field on April 16,
1935. This laboratory is equipped for hunting and trapping rodents,
and provides facilities for the dissection of the rodents in the field,
the taking of specimens from those found suspicious, and the forwarding of such specimens to the San Francisco laboratory in insu
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PUBLIC HEALTH SERVICE

lated re£rigerat€d shipping cases. With this procedure, specimens
are received at the laboratory in excellent condition. The following
table shows the operations of the field laboratory from April · lo
to June 30, 1935:
County

Ground
squirrels

Modoc County, Calif_ _____________________ ------------------ _____ _
Lake County,
Oreg
__ ---------------------------------------------Washoe
County,
Nev
_____________________________________________ _

747
1,074
83

Total ________________ ------------------------ _______________ _

1,904

Marmots

-----------153

Approximate area
surveyed
Sq. miles

42

35
296
225

195

556,

PUBLIO HEALTH SERVICE LABOR;ATORY, SAN FRANOISCO, OALIF.

The activities of the laboratory at San Francisco continued along·
the same lines as in previous years, the work increasing to some-extent. In April 1935 a new building to house laboratory animals.
and provide a separate building for the dissection of rodents was.
completed.
The number of rats examined from San Francisco, Oakland, Rich-.
mond, San Mateo County, and from ships after fumigation is shown
in the accompanying table. No plague infection was found in those·
rats. In addition to the rodent examinations, the laboratory continued the examination of water samples from the supplies of interstate carriers and from national parks and serological and bacteriological work (including animal inoculation tests) for various Public·
Health Service stations and other Federal activities.
The following table shows the number of specimens examined:
Received
Examination of rodents for plague:
Rats from San Francisco ____________ ------------------------ _______________ _
27,750
Rats from Oakland, Alameda County ______________________________________ _
2,487
Rats from Richmond, Contra Costa County_______________________________ _
458
Rats from hog ranches in San Mateo County ______________________________ _
2,807
Rats from fumigated ships _________________________________________________ _
95
Serological examinations:
Wassermann reactions:
Blood ____
-- -_____
- -- - ----- -- - -- - -- -- -- -- -- - --___________________________________________
-- - -- --- -- --- -- - -- - - -- -- - -- - -- - - - -- --- - -- - -_
-----------------------Spinal
fluid
_
Hydrocele
fluid ____________________________________________________________________
Pleural fluid ________________________ ------------------------ _______________________ _
Ascitic fluid ________________________________________________________________________ _
Knee fluid ____________________________ ------------- ---------- -- --------- -----------Kahn tests:
__ - -- -_______________________________________________________________________
--- --- - -- -- - ------- -- --------------- - -- ------ -- -- ---- -- --- - ---------- --_
Blood __fluid.
Spinal
Hydrocele fluid ____________________________________________________________________ _
Pleural fluid ____ ---------------- ___________________________________________________ _
Ascitic fluid ________________________________________________________________________ _
Knee fluid _________________________________________________________________________ _
Wida! reactions _______________________ -- -- _----------- ____________ --------- - _--- -------Agglutination tests for tularemia _______________________________________________________ _
Agglutination tests, heterophilic _______________________________________________________ _
Bacteriological examinations, culture and microscopic:
Water
________
-__ -- --- -- ________________________________________________________________
_-- __ ---------------- ------ ---------------- -- ---- ---- ---- --------_
Cultures
for diphtheria
Culture for tularense ___________________________________________________________________ _
Leprosy _______________________________ -- ---- ---------- __________________ --- - ------ -----Bacteriological
examinations,
with animal inoculations:
Tuberculosis
___________________________________________________________________________
_
B. tularense ___________________________________________________________ ------ ------ -----Virulence test for diphtheria ___________________________________________________________ _
B. pestis _______________________________________________________________________________ _
Relapsing fever ________________________________________________________________________ _
Lymphogranuloma inguinale ________________________________________________ -----~------


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Examined

25, 537 ·
2,390458 :
2,807"
95.7,867
503:

1
1
1
1·
7,871

499•l
1:
1,

1

2--

3;

1.

549 •
109•

1
9•
83..

1
1
20
1
4

PUBLIC HEALTH SERVICE

57

RAT LEPROSY

During the year 60 rats from San Francisco and 1 rat from Oakland
were found to show evidence of rat leprosy.
VACOINATION OF CANNERY CREWS

In addition to the usual work of the San Fr ncisco plague station,.
supervision of the vaccination of cannery crews going to Alaska was
furnished by the station personnel. The number was much smaller
than usual, on account of curtailment of cannery operations ±or theyear : 684 men were inspected and 404 were vaccinated against
smallpox.
PLAGUE-CONTROL MEASURES IN THE TERRITORY OF HAWAII

Plague-control measures on the island of Maui, Territory of
Hawaii, were continued in cooperation with the territorial board of
health. No human case was reported during the year, but 6 plagueinfected rats were found, all in the Makawao district. This is the·
same general area from which plague rats have been taken in recent
years and is located from 8 to 10 miles from the port of Kahului. The·
first three plague rats were found in October 1934 at pigpens adjacent
to a gulch and located within an area extending a distance of threequarters of a mile along the gulch. The other three were found in
March and April 1935 in another gulch and in an area extending
about one-half mile along the gulch.
FIELD EXPERIMENTS

Field experiments were continued through the use of both arsenic·
and thallium sulphate preparations. The procedure consisted in placing poison in the regular trapping districts about once a month in
order to note whether there resulted any decrease in the rate of rat
catch due to placing the poison. The results of this work confirmed
the figures obtained during the preceding year in that there was no,
noticeable decrease in the rate of rat catch which could be attributed
to the poison, either immediately after or at any time after the placing
of the poison. This work was carried out in 14 of the trapping districts where there. were numerous rat harbors and where there was a
plentiful supply of natural food during all seasons of the year. · In
a small control district there was a marked drop in the rate of rat.
catch apparently attributable to trapping only.
RAT TRAPPING AND HARBORAGE ELIMINATION

On July 21, 1934, the trapping work was almost doubled, through
the use of local funds for hiring additional trappers. The force was.
increased to · 15 trappers with 200 traps each. In October it was.
decided to attempt the elimination of rat harborage and breeding·
places in the open country in an effort to effect a more rapid reduction in the rat population than would be possible by trapping alone ..
Inspection of the trappers' reports showed that the majority of the


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rats were being caught in gulches, or adjacent to them, and investigations disclosed that, after such areas were cleared, rat burrows
could easily be located. It was believed that, if the heavily ratinfested gulches and other rat centers could be cleared of rat harborage, the rat population might be reduced to a point much lower than
would be possible by trapping alone. The work of clearing heavily
rat-infested areas was started in October through the use of FERA
labor and was gradually expanded. It consisted in cutting out and
-burning brush of wild berries, seeds, and plants, followed up by
treating the burrows thus exposed. It was first attempted to force
the rats out of the burrows and bring them to the laboratory. However, the only practicable method of driving them out was that of
filling the burrow rapidly with water; and since this was impracticable on a large scale, it was decided to kill the rats in the burrows.
After various gases were tried out for this purpose it was found that
the simplest and most economical method was the placing of a few
drops of carbon bisulphide from an ordinary oil can in each opening
and igniting the gas, which resulted in an explosion and the creation
of fumes. This was followed by plugging the holes with earth and
tamping. This procedure was found to be effective in killing rats
of all three species encountered.
A number of burrows were dug open to obtain information concerning measurements. It was found that the length varied from 5 to
18 feet; the diameter of the hole from l½ to 2 inches; and the depth
below ground level from 6 inches to 3½ feet. Burrows encountered
had from 1 to 7 openings and often had laterals at different levels.
There were from 1 to 4 nests for each burrow, usually located at
dead ends and at elevations above the main tunnel.
POISONING

It was found that poison in the form of thallium-sulphate-treated
wheat wrapped in waxed paper in torpedoes was fairly effective if
placed immediately after the clearing of an area and the exposing of
burrows. At such a time the rat's natural food supply was cut down
and the harborages had been disturbed. Under such conditions jt
was believed advisable to use all means at hand to kill as many rats
as possible in order to prevent any migration. The percentage of
the native field rat, R. hawaiiensis, of the total number of rats
brought into the laboratory rose from 60 percent at the beginning
of the fiscal year to approximately 80 percent at the end of the
year. According to results of cage experiments, this changed condition in the field should make the application of the thallium
sulphate preparation a more valuable adjunct in the work.
SANITARY INSPECTION

Sanitary inspections of buildings and premises were continued by
two sanitary inspectors. A noncompliance n9tice was prepared; and
where changes or improvements involving the expenditure of large
sums of money were necessary, owners of the property were notified
in writing, through the use of this form.


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59

OTHER MEASURES

In and around the Port of Kahului the rat population in the
kiawe trees was kept down by shooting. Since these trees are found
only at elevations near sea level, the problem does not exist in the
plague zone proper.
There has been ·excellent cooperation on the part of managers o:£
-sugar and pineapple plantations in the area worked. Much o:£ the
progress made was due to assistance from these plantations in plow•
ing under rat-infested fields and in furnishing men and conveyances
-:for the work.
SUMMARY OF RESULTS

Classification of rodents trapped and killed:
R. hawaiiens is___ __ ___________ _______ _____________________ ___
46,830
R. alexandrinus --------------------------------------------17,830
R. rattus___________ _______________ ______ ___ _________________
6,414
R. norvegicus -----------------------------------------------2
~I. musculus___ ________________ __ ____________________________
56,865
Mongoose_ ______ ______________ ________ _______________ ________
424
Number of ra ts trapped in Port of KahuluL__ _________ _____ ______
2, 909
Number of rats trapped, total__________ _________ ____ ________ ___ __
68,691
Number of rats killed by shooting, etc______ ______________________
1, 535
u1nber of rats found dead______________________________________
110
Number of rat trap days, totaL ________ __ ______ _________ ____ _____ 1, 039, 328
umber of rats per 100 traps per day ( all districts)_____ _____ __ ___
6. 6
Number of rats per 100 traps per day (Kahului) ___ __________ _____
3. 9
Number of packages of poison placed __________ _____ _____ _________ 1, 703, 858
Number of man-hours in rat harbor elimination______________ ____
45, 944
Numbe1· of burrows treated with carbon Disulphide______________
7, 873
Number of inspections of buildings and premises__________________
1, 008
Number of r einspections of buildings and premises________________
541
Tumber of noncompliance notices issued (major changes)______ ___
20
Numbe.r of rats received at laboratory __ __ ____ _________ _________ __
70, 336
Number of total rodents received at laboratory_____________ _____ _
127, 523
Number of rats examined macroscopically_____________ ____ _______
70, 115
Number of rats examined microscopically_________________________
37
Number of mass inoculations made____________ __ ________ _______ _
576
Number of single inoculations made______________________________
17
umber of cases of human plague_________ ______________ _________
0
Number of cases of rodent plague__________ __ ____ _____ _________ __
6
D ate of las t case of human plague.: September 19, 1932.
Date of last case of rodent plague: April 23, 1935.
CAGE EXPERIMENTS

Cage experiments to determine the effectiveness of poison were
.continued with the use o:£ both arsenic and thallium sulphate preparations. At the end of the year a total of 30 experiments had been
completed from which the following conclusions are drawn: (1)
-One or more rats usually eat the poison the first night and occasion.ally later and become sick or die. (2) After one or more rats have
become sick or have died from eating poison, the remaining rats in
the cage almost invariably refuse to eat it. (3) Rats die more
quickly from the effects of arsenic than from thallium sulphate in
the proportions commonly used, but become aware of the presence
-0f arsenic more quickly and a smaller percentage of the total number
,of rats eat arsenic. ( 4) Rats of the species R. alerx:(Jfndrinus and R .
.rattus consumed the thallium sulphate preparation somewhat morP.
20080-35--5


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PUBLIC HEALTH SERVICE

readily than they consumed arsenic. ( 5) Rats of the species R'_
hawaiiensis consumed the thallium sulphate preparation much more~
readily than they consumed arsenic.
TRACHOMA PREVENTION

Trachoma-control activities were continued in Missouri, Kentucky,.
and Tennessee, in cooperation with the State health authorities, thelatter bearing approximately one-half of the cost of the work. During the latter part of the fiscal year, field work was greatly hampered
because of the abnormal rainfall throughout the regions in which_
trachoma work was being done.
MissOW'i.-Fewer field clinics were held during the year and
slightly fower new cases of trachoma were discovered. There was.
an increase, however, in admissions to the hospital at Rolla, resulting in a greater number of days of hospital relief. Among the new
cases seen, there was an increase over last year in the number of persons industrially blind in both eyes. The hospital at Rolla con-tinued its cooperation with two different groups doing research in
trachoma. The percentage of early cases found continued about thesame as during the past several years.
Kentucky.-This trachoma-prevention unit, which cooperates with
various research orianizations, continues to serve a useful purpose..
The hospital at Richmond underwent considerable repair. There·
were fewer new cases of trachoma discovered during the year and
£ewer admissions to the hospital. This was due, no doubt, to theheavy rainfall during the spring and summer months. There was a
decided increase in new hospital cases that needed the grattage oper-ation.
Tennessee.-The work of the field unit at Gainesboro was completed. From this unit 13 mountainous counties were served. Dur-ing the 3 years of its existence 782 active cases of trachoma we.re
contacted and most of the severe cases were arrested through treat-ment.
;Much time has been spent during the past 4 months in survey
work in middle Tennessee. It is the opimon of the trachoma field
clinician in Tennessee that trachoma work should continue in that
State for a few years longer. Trachoma is hardly endemic in any
area of Tennessee now, but there are, no doubt, many scattered cases
throughout the State. A new and larger unit probably will be:
established in middle Tennessee by the State authorities.


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PUBLIC HEALTH SERVICE
Dispensary and hospital relief, operations, etc.

Richmond, Rolla, Mo. Gainesboro,
Ky.
Tenn.

Activity

Total

DISPENSARY RELIEF

Number examined ____ _________ _____________ ___ ____ ---Old cases of trachoma ___ -----------------------------New cases
of trachoma
____ ----------------------------_
Total
attendance
_____________________________________
Average daily attendance ___ __ __ _____ ________ _____ ____ _

605
260
165
605
1. 65

2,144
954
253
2,144
5. 87

1,308
701
50
1,308
3. 58

4,057
1,915
468
4,057
11. 10

254
225
48
137
77
83
27

516
438
78
140
77
56
47

211
178
46

981
841
172
327
299
209
97

COMBINED DISPENSARY AND FIELD CLINIC DATA

Total
number
individual trachoma cases dis_______of-,-new
__________________________________
__ _
covered
Pannus in new cases __________________________________ _
Entropion in new cases _______________________________ _
Corneal opacities in new cases------- -- ----- --- ----- --Vision 20/200 or worse, both eyes ______________________ _
Vision 20/200 or worse, 1 eye __ ___ __ __ _________________ _
Ulcers arising in all cases, old and new _____ __ _______ ___

50
145
70
23

HOSPITAL RELIEF

Hospital capacity __________ -- ----- ------------------- -34
Cases admitted during the year (total) ________________ _
323
Number cases first admission _________________________ _
215
9,206
Days relief furnished __ ------------------------------- Rations furnished_. _______ ______________4t _-- --- _-- _--11,430
Cost of rations ________________________________________ _ $2,969.36
Average cost of rations furnished _____________________ _
26. 06¢
Per diem cost_ _____ _________________________________ __ _
$1. 72
Average stay in hospital, days ____________.____________ _

32
310
195
8,647
10,513
$2,231. 78
21. 22¢
$1. 94

6

7Z

71

704
456
19,245
23,330
$6,192.01
26.54¢

46
1,392
1,398
$990. 87
71.43¢
$2.83

------------

28. 50

27. 89

19. 60

------------

7
812
127
89

16
1,441
175
263
93
302

173
2,333
1,045
161
555
1,631

196
4,586
1,347
513
649
1,933

14

15
416
1,080
2,137
397
1,908
97

142
11,293
11,266
13,054
1489
I 1,813
I 66

57
1,709
3,542
8,063
1,053
4,238
177

0
0

0
1

7
64

7
65

FIELD WORK

Field clinics:
Number
clinicsexamined
held_ - -------- -----------------_
Number of
persons
_______________________
Trachoma cases seen, old tracboma_______________ _

r:~i~~~~~

0

== ========_
Treatmentsc~s~c::~~~~================
given at clinics _______________________
Field nurse activities:
Public health talks given _________________________ _
People (estimated) in audiences __________________ _
Homes visited _______ ____ --- -_-_______ -_______ -___ _
People examined in homes ____________ ____ ________ _
Suspicious cases in homes _________________________ _
Number pupils examined in schools ______________ _
Suspicious cases in schools ________________________ _
Number treatment clinics, nurse only ____________ _
Number treatments by nurse ___________ __________ _

1
0
0
0
1,196
2,872
167
517

OPERATIONS

General anesthesia_____________________________________
1
0
0
Local anesthesia ___________________ ---- -- ------- -- _____
211
214
49
Grattage __ ------------ __ -- ______ --- -- ---- --- -- -- -- __ __
137
127
1
Entropion _________________ -------------- - _______ ____ __
45
33
34
Canthoplasty _ ______________ ____________ __ __ ________ __
21
22
8
3
10
Cautery puncture_-----------------------------------8
7
Electric epilation ____________ ------------ --------- _____
11
28
Vataconin injections
_____________ ---------------------42 -------- ---- -----------Enucleation
____________________________
• __________ • ___
1
1 -----------Ectropion. _------------------------------- ____ ____ ____
1 ------------ -----------Chalazion curetted __________ -------- -- ---------------2 ------------ -----------Milk injections ________________________ ---------------51
2
2
Pterygium __ • ____________ ----------------------------- ___________ _
6 -----------Removal of folliculoma, corneaL __________________________________ _
2 ·----------Ulcer cauterized _________________ __ -• _--- _________________________ _
2

------ ------

1

1
474
265
112
51
21
106
42
2
1
2

55
6

2
2

Represents work of nurses and field clinician.
PsrrrACOSIS

It has ooen _gratifying to note that, as a result of rigid enforcement by the State Health Department of California of the State
requirements in connection with the certification of interstate ship
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PUBLIC HEALTH SERVICE

ments of parrakeets and other birds of the psittacine family, no
human case of psittacosis traceable to an interstate shipment was
reported to the Public Health Service during the year ending June
30, 1935.
.
Officers of the Public Health Service continued to render advisory
:assistance to the State health authorities of California in planninO'
:measures for the eradication of psittacosis in aviaries located in that
:State. The disease has not become a problem in connection with the
·bird-breeding industry elsewhere.
TYPHUS-FEIVER CONTROL

Following the completion of the typhus-fever study carried on
in Georgia, Alabama, and Texas as a Civil Works Administration
project, the Public Health Service entered into a cooperative program with the Alabama State Health Department for an experimental project for the eradication of typhus fever, having as its objective the demonstration of rat-proofing of buildings as a rodentcontrol measure. A suitable staff having been chosen by the State
health department for the local promotional activities to be undertaken, an officer of the Public Health Service thoroughly experienced in rat-proofing work was detailed to demonstrate appropriate
methods to the State health department personnel. Emphasis was
placed particularly upon the rat-proofing of buildings where grain
and other foodstuffs are stored, since it is believed that the most
certain and effective rat-eradication procedure consists in preventing
access of the rodents to a food supply. State employees engaged
in the work so far have experienced little difficulty in obtaining the
cooperation of :food-handling establishments.
SUPERVISIO N

OF W A TER SUPPLIES USED BY COMMON OAR.BIERS

The inspection and certification of water supplies used for drinking and culinary purposes on interstate carriers, in cooperation with
the State health departments, was continued. The carrier companies
listed 2,269 sources from which they desired to take their water
supplies. 'Of these, 1,827 were public supplies. Ninety-five percent
were inspected and certified. It was found necessary to prohibit the
use of 58 of the supplies listed.
Assistance was rendered to the States in the preparation of certificates of inspection, and 86 supplies were inspected in the States having no engineering division in the State health department. A
comparison of the certification work with that of previous years
is shown in table 1 :
1.-Peroentaue of completed certifications of water su,pplies used on railroads, vessels, and airplanes for each yea,r from 1930 to 1934, inclu,si'lie

TABLE

Percent of completed certifications inCarrier
1930

- - - - - - - - - --

·- - - - - - -! - --

1931
92. 8
95. 9
85. 8


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1932

1933

1934

--- --- --- - -95.1

94

97. 2
97. 4

· 97

93

95
93
85

63

PUBLIC HEALTH SERVICE
STATUS OF WORKS BY ST.A'I'ES

The accompanying table summarizes and shows the status of the
work by States during the calendar year 1934:
TABLEl

2.-Sowroe and certification status of icater sup,piies used by interstate
carriers during the calendar year 1934 by Stat es
Certification status

Source classification
State

Alabama __________
Arizona ___________
Arkansas ________ __
California _________
Colorado. _________
Connecticut. ______
Delaware~--------District of Columbia . . ____ ___ _____
Florida ____________
Georgia ____________
Idaho __ ____ - -- -- -.
Illinois __ _____ ----Indiana ___________
Iowa. ______ _______
Kansas_. _____ ._. __
Kentucky _________
Louisiana __ . ______
Maine ____________ _
Maryland _________
Massachusetts _____
Michigan __________
Minnesota _________
M ississippL ___ ____
Missouri. _________
Montana __________
Nebraska __________
Nevada ___________
New Hampshire ___
New Jersey ________
New Mexico ______
New York _________
North Carolina .. __
North Dakota. __ ._
Ohio ______________
Oklahoma _________
Oregon ____________
Pennsylvania ______
Rhode Island ______
South Carolina ____
South Dakota _____
Tennessee _________
Texas _____________
Utah ______________
Vermont. _________
Virginia ___________
Washington _______
West Virginia ____ _
Wisconsin _________
Wyoming _________
TotaL ______

Satis- Provi- Probibfacsional
tory
ited
- - - - - - - -- - - - - - - - - Private 2

Company

Total

36
20
38
55
26
16
9

0
6
1
12
1
0
0

0
9
5
22
6
0
0

36
35
44
89
33
16
9

36
12
18
64
29

1
35
50
15
66
46
52
73
35
26
33
20
51
54
47
32
48
19
39
12
16
40
12
90
42
13
66
38
28
121
4

0
10
0
1
4
5
1
0
1
4
0
3
0
3
2
3
0
0
0
0
0
3
1
4
3
5
1
1
0
2
1
1
0
2
25
0
0
3
1
3
7
0

1
9
5
6
9
4
4
5
6
6
6
3
0
9
18
5
6
8
7
9
0
3
12
12
0
14
9
3
1
12
0
1
8
5
39
4
1
6
3
10
8
3

2
54
55
22
79
55
57
78
42
36
39
26
51
66
67
40
54
27
46
21
16
46
25
106
45
32
76
42
29
135
5
26
29
34
165
17
11
59
48
61
68
15

322

2,269

Publie I

24
21
27
101
13
10
50
44
48
53
12

1,827,~

- - - - --

Percent
of
Certificates
Action sources
issued
pend- acted
upon
ing
-----

--

9

0
22
12
9
4
2
0

0
1
0
0
0
0
0

0
0
14
16
0
0
0

100
100
68
82
100
100
100

76
38
38
267
51
46
17

2
42
41
20
52
28
23
68
25
36
30
26
50
66
42
39
42
25
9
20
16
45
24
94
32
10
56
23
27
111
5
23
6
31
91
12
10
51
38
45
59
12

0
12
12
1
21
27
32
7
14
0
9
0
1
0
14
1
10
2
24
1
0
0
1
10
5
8
6
7
1
0
0
0
16
1
73
4
1
4
8
9
7
3

0
0
2
1
6
0
2
3
0
0
0
0
0
0
0
0
1
0

0
0
0
0
0
0
0
0
3
0
0
0
0
0
11
0
1
0
2
0
0
0
0
1
4
13
6
11
0
24
0
3
7
0
0
0
0
4

100
100
·100
100
100
100
100
100
93
100
100
100
100
100
83. Ii
100
98
100
96
100
100
100
100
99
91
59
91. 5
74
100
82
100
96
76
100
100
100
100
93
100
100
98
100

6
119
106
22
151
96
100
99
58
104
79
85
146
116
80
53
97
30
61
25
21
100
30
252
68
20
152
45
91
136
40
68
32
51
296
29
16
167
185
75
94
23

1, 689

401

14

11

0
0
1
0
1
4
1
8
1
1
0
0
0
0
2
1
1
0
0
2
7
1
0

0

0
1
0

------ --- --- --- --58

121

95

4,157

1 The column headed "Public" includes supplies owned by municipalities as well as those used by
municipalities but owned by private companies.
2 A "Private" supply refers to a small well or spring used only by the carrier and the person owning it .

~

SUPERVI•SION OF WATER SUPPLIES ON VESSELS

Operating companies reported 750 vessels in active status. Of
these, 52.6 percent were inspected and certified, while 23 percent were
jssued temporary certificates pending inspection.
One thousand one hundred and sixty-three laboratory samples of
water taken from drinking-water supplies on interstate vessels were
examined by health departments of cities on the Great Lakes and the

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64

PUBLIC HEALTH SERVICE

Mississippi and Ohio Rivers. Of the samples collected, approximately 86 percent conformed to the Drinking Water Standards of
the Treasury Department.
Table 3 gives the status of the inspection work carried on during
the year:
3.-Number of vessels on aotive status .and type of cer:tifioation of drinking water, in each of the interstate sanitary districts during the calendar
year 1934

T ABLE

District

Type of drinking water certification 1
PercentPercent- Percentage of
age of
age of
Vessels
on active total vesdistrict
total
sels in
Penna- Tempo- Not apvessels
vessels
status
Total
rary
proved
certified certified
nent
district
--- --------- -----40. 6
44
315
359
50. 6
710
0
20. 5
97
5. 5
78
5
0
83
85.6
4. 7
49
402
23.0
353
0
402
100.0
23.0
146
8. 3
105
14
123
84. 2
0
7.0
22. 6
316
21
2
339
395
85.8
19.4

---

l _- - - ----- ---- -- ---2_ - - - - -- -- -- -- -- -- --

3 _- - - - -------------4_
- - - -6----- -------5 and
_____________
Total. . _______

- - - - - - - ---- - - -- - - - - -896
- - -404
1,750
6
1,306
74.6

----------

----------

1 Only the latest certificate issued on a vessel was counted in case that vessel was both temporarily and
permanently.certified during the year.

•

Twenty-four cases of typhoid fever were reported among crews and
passengers on vessels during the year. Very few cases occurred on
vessels coming under the Interstate Quarantine Regulations, and in
no case was the water supply implicated. For the second consecutive
year no case of typhoid occurred on commercial vessels amenable to
the Interstate Quarantine Regulations operating on the Great Lakes .
RAILWAY SANITATION

One hundred and fifty-four inspections of coachyards, terminals,
and watering points and 250 inspections of dining cars and commissaries were made during the year. Plans were perfected for a more
careful check on sources of milk supply and shellfish used on dining
cars. Excellent cooperation was obtained from the railroad officials
in this work.
SHELLFISH SANITATION

As in the past, assistance was rendered to the several shellfish-producing StateS- in connection with their sanitary-control work. A
major study of a shellfish-growing area in which the Public Health
Service cooperated was carried on by the State of New Jersey in
Raritan Bay and adjacent waters.
Information obtained in the study of the pollution of the Hampton
Roads (Va.) area furnished valuable information for the Virginia
State Department of Health relative to the sanitary conditions of
shellfish-growing areas. Following the completion of the survey, the
use of one large area was restricted.
The publication and distribution of the list of shellfish dealers
certified by the producing States has continued. The publication of
this list of certified dealers is of great importance in maintaining
proper sanitary control within the States, since the maintenance of
markets by shippers is largely dependent upon the appearance of their
names on this list. During the year, 1,949 certificates issuea by approved producing States were listed. Sixteen growing areas and 69C

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65

shucking and packing plants were inspected in connection with surveys to determine the efficiency of State control.
REOIPROOITY WITH CAN ADA

The inspection and certification of drinking and culinary water
:supplies used by interstate carriers, supervision of drinking-water
.supply systems. on vessels operating in the Great Lakes and border
waters, the certification of international shellfish shippers and inspection of dining cars operating internationally, with particular refer1ence to milk supplies, were continued through reciprocity with the
Department of Pensions and National Health of Canada. Sixty-five
United States water supplies used by Canadian carriers were inspected
and certified. The Canadian authorities were supplied with 10 reports on United States supplies used by United States carriers crossing
the international line. Reports were also given the Canadian authorities on sources of milk supplies for dining cars operating internationally.
Copies of all certificates issued by shellfish shippers by producing
States, approved by the Public Health Service, were supplied to
Canadian authorities, and they in turn furnished 56 certificates on
Canadian shippers desiring to ship to the United Sta.tes.
COOPERATIVE WORK WITH STATES RELATIVE TO STRE'A M SANITATION

A considerable portion of the time of the Office of Stream Sanitation was devoted to the completion of field work connected with the
study of the pollution of the lower part of Chesapeake Bay and the
preparation of a report on this study. This work was financed
through a grant of $25,000 from the Public Works Administration,
made at the request of the Chesapeake Bay Authority. The State
Department of Health of Virginia cooperated in the field work.
Cooperative assistance was also given to the State health departments of Minnesota and Tennessee in connection with stream-pollution problems.
STATISTICAL COMPILATIONS

In table 4 is shown the time expended by the field personnel of the
,engineering section and the type of work performed for various
Federal agencies during the fiscal year 1935.
4.-Di,<stribution of time, in days, and type of work pelf'formed by the
field personnel under the engineering section ( exclusive of engineering personnel employed on Public Works Administration projects) during the fisca,l
year 1935

·TABLE

Interstate quarantine:
Days
Office _____________________ 1,401
Field:
Water___________ _____
696
Shellfish______________
256
National Park Service:
Office _____________________ . 498
Field--------------------247
,office of Indian Affairs :
Office_____________________
300
220
Field_____________________
Chesapeake Bay study:
Office_____________________
353
Field --------------------54

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Tennessee Valley Authority:
Field --------------------Other agencies :
Office____________________ _
Field --------------------'l'echnical meetings ___ )
Conferences __________________ _
Committee meetings __
Le~ve ________________________ _

Days

253

120
142
74

255

Total days ______________ 4,869

66

PUBLIC HEALTH SERVICE

Table 5 summarizes the activities involving supervision of water
supplies, railroad sanitation, shellfish sanitation, and miscellaneous
cooperative services with governmental agencies.
5.-Summary of activities involving supervision of water supplies, of
vessels, railroad sanitation, shellfish sanitation, and miscellaneous cooperation with governmental agencies during the fiscal year 193,5

TABLE

A. VESSEL WATEJl-SUPPLY SUPERVISION

Number
First inspections :
76
Passenger_________________
147
Freight_____________ ______
8
Water boats______________
Reins11ections :
230
Passenger__________ _______
388
Freight__________ _________
17
,vater boats_________ ______
Certificates issued:
906
Regular, favorable________
7
Regular, not approved_____
690
Temporary, favo•r able______
Plans for vessel water systems
examined.:
3
Approval granted_ _________
3
Approval withheld________

B.

RAILROAD SANITATION SUPERVISION

Num ber
Inspections:
86
Sources of water supply____
58
Coachyards_______________
33
Terminals_________________
63
Watering points___________
227
Dinin~ car~ _______________
23
Comm1ssanes _____________
Certificates :
Data reports reviewed _____ 1, 743
Certificates prepared _______ 3, 690

C.

Number
Water examinations :
U. S. Public Health Service
79
laboratories__ ______ _____
651
Other laboratories____ _____
Major conferences :
40
With railroad officials_____
54
With others_______ ________

SHELLFISH SANITATION SUPERVISION

Number
Inspections:
16
Areas_________________ __ __
690
Plants____________________
State Certificates:
Approved ________________ _ 1,949
11
Not approved------------Approval withdrawn ___ ___ _
0
Canceled ___________ __ ____ _
196

D.

Number
Ma jor conferences:
52
With shipping officials___ __
JO
With others_______________
·w ater examinations made:
U. S. Public H ealth Service
1
laboratories______________
Other la boratories _________ 1, 162
Typhoid-fever cases r eported:
U. S. Public Health Service
24
hospitals________________
U. S. Public Health Service
0
quarantine stations______
O
Health departments_______

Num ber
Laboratory examinations:
U. S. Public Health Service
0
laboratories _____________
Other laboratories _________ 1, 224
83
Conferences-------------------

MIS CELLANEOUS! COOPERATION WITH GOVERNMENTAL AGENCIES

Number

Public H ealth Service ( other divisions) :
Surveys___________________
Conferences_______________
ational Park Service :
Surveys___________________
Conferences_______________
Water examinations_______
Offi~e of Indian Affairs :
Surveys__________________ _


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2
17

89
85
537

126

Number

Office of Indian Affairs-Contd.
Conferences _______________
Water examinations_______
Burea u of Prisons:
Surveys___________________
Confer ences _______________
Others:
Surveys______________ ____ _
Conferences ---------------

45

76
4
5

66
8

PUBLIC HEALTH SERVICE
RURAL HEALTH

67

wORK

At the end of the fiscal year 1933, as a result of reduction of the
appropriation for Studies and D emonstrations in Rural Sanitation
from $300,000 to $25,000, all Federal aid to State and local health
organtzations had to be withdrawn. The Rockefeller Foundation
likewise reduced its contribution to loca.l health units and prepared to
retire as soon as po sible from this field of activity. At the same
time, on account of the failure of local sources of revenue, the appropriating bodies in many of the counties were obliged to make drastic
reductions in the allocations to their health departments, with the
result that many of the local organizations had to be abandoned and
a considerable proportion of the rema jnder were rendered relatively
ineffective.
In view of the threatened break-down of these local health services
considered valuable as an aid in the relief of distress among the
unemployed in the rural areas, the Federal Emergency Relief Administration agreed to allot to the Publi c Health Service the sum of
$1,000,000 for rural health work, on the ground that the added health
services to the poor made possi ble through the grant would more
than pay for the cost by preventing illness that might result in a
much larger outlay for medical r elief at the expem:e of the Federal
Government. This grant of $1,000.000 from relief funds to the
Public Health Service for rural hea1th work was approved by the
General Counsel of the Treasury Department, the Office of the
Attorney General, and the Comptroller General.
It was believed that, since the fund was not large enough to go very
far toward providing health service for the whole rural area of the
country, it could be used to best advantage chiefly for restoring to
efficiency the existing health units, where trained medical health
officers already were available for supervising the work.
The $1,000,000 was allotted to the Public H ealth Service in October
1934, and cooperation was renewed in a number of counties effective
November 1. Complete organization was accomplished about J anuary 1, 1935.
Invitations were extended to all of the State health departments
to participate on a matching basis. Allocations were made to 31
States an<l the Territory of Puerto Rico, covering 28 State health
department projects for promotion and supervision of local health
units and 356 county or district projects.
Additional requests were received after the fund had been completely allocated for many counties that could not be given assistance.
Of the previously existing units, 274 were not reached, preference
having been given to the organizations where the local health officers
could readily meet accepted standards for training. In view of the
comparatively small sum available, no attempt whatever was made to
extend aid to cities, many of which need aid as badly as the rural
a.reas.
At the close of the calendar year 1933 there were 530 county health
units in operation. With the aid of the special fund referred to
above, by means of which 400 projects were set up in 34 States, there
wa.s a net increase of 10 units, making 540 in operation at the end
of the year 1934. Incidentally 1,315 individuals were accorded em-


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68

PUBLIC HEALTH SERVICE

ployment in various capacities. The distribution 0£ these health
organizations by States is shown in the following table:
State

Number
of units

Alabama ____________ _
Arizona ______________ _
Arkansas ____________ _
California ___________ _
Connecticut_ ________ _
Delaware ____________ _
Florida _________ -----Georgia _________ _____ _
Illinois ______________ _
Iowa ________________ _
Kansas ______________ _
Kentucky ___________ _

50

4
19
15
2
3

State

Number
of units

Louisiana ____________ _
Maine _______________ _
Maryland ____ ____ ___ _
Massachusetts _______ _
Michigan ____________ _
Minnesota ___________ _

361 ~f~~~~~f_~~===========
Montana ____________ _
1

3
70

New Mexico _________ _
New York ____ ___ ____ _
North Carolina ______ _

State

1

Ohio _________________ _
Oklahoma ___________ _
Oregon _____ ___ ______ _
South Carolina ______ _
Tennessee ___________ _
Texas ________________ _

~
4

32
5
23
3
32
2

6
5

41

Number
of units
3S
1

T
23

39

s·
2

Washington _________ _
West Virginia _______ _

~[:g~n1a==============

17

13

TotaL ________ _

540-

s

CooPERATION ON EMERGENCY RELIEF ADMINISTRATION WoRK-RELIEF
PROJECTS

Continuing the cooperative activities carried on with the Civil
Works Admmistration and the State health departments during thepreceding year, the Public Health Service gave its assistance in the
conduct 0£ two projects which afforded employment 0£ Emergency
Relie:f Administration beneficiaries and at the same time aided in
safeguarding the health o:f the people in certain communities.
One o:f these projects dealt with an intensive malaria-control drainage program in 16 States where malaria has prevailed most extensively. Another was the construction o:f sanitary privies in small
towns and villages or in the unsewered districts o:f large cities.
In order that these projects might have proper technical supervision
the Public Health Service was charged with their guidance, special
allotments being made :for the employment o:f additional personnel as
well as necessary traveling and incidental expenses.
All activities undertaken under allotments from the Federal Emergency Relie:f Administration were conducted in cooperation with State·
departments o:f health, · the health officers being made agents of the
Public Health Service :for the time being.
Arrangements :for the inauguration o:f similar projects under theworks Progress Administration program were being worked out at
the close o:f the year.
Works Progress Administration project applications £or sealingabandoned mines for the purpose o:f reducing acid discharges to the
streams as a protection to public water sup_plies were submitted foreight States.
MALARIA CONTROL

Although the death rate from malaria is not high in comparison
with the rates from other diseases, in a number 0£ States it exceeds
the death rates :from typhoid £ever. Moreover, the high morbidity
rate makes malaria a major public-health problem, particularly in the
Southern States. Therefore the control measures were concentrated,.
especially where the effects of the infection were particularly noticeable among the people on :farms and plantations and in industries.


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69

The plan followed was essentially the same as that in operation
under the Civil Works Administration last year. However, with a
greatly reduced supervisory field force, accurate reports of achievements were more difficult to obtain. Therefore, the number of miles
of average outlet ditches cut in malarious regions can only be estimated. It is also necessary to estimate the number of men employed.
Although the work was better planned, the accomplishment per manhour of labor was not as great as under the Civil Works program, for
labor was paid at a much lower rate and individual laborers did not
work continuously.
In the 16 States comprising the malarious regions of the United
States the average daily number of men employed during the past
year was approximately 40,000. . It is estimated that about 8,000 miles
of average-sized outlet ditches were dug, the total to date under the
malaria control of the Public Health Service, in cooperation with the
relief agencies, being 16,000 miles.
Under this program a blood index, comprising approximately
150,000 specimens, was taken. The examination of these blood films
has been completed, and a brief analysis of the findings will be
found under the report of the Division of Scientific Research.
While this index was taken before the malaria season started, it
was found that the average endemic infection rate was approximately 5 percent.
COMMUNITY S A NITATION PROJECT

This project had to do with the construction of sanitary privies.
Experience gained during the preceding year with the community
sanitation project showed this to be a profitable means of employing semiskilled and ordinary labor and, at the .same time, performing a service of value to the whole population of rural and semirural communities.
The work was carried on in 30 States, the number of persons
employed during the peak of operations being 2,835. Following
plans t hat were previously found to be practicable, each State program was set up under and administered through the St at e dep artment of health. The supervisory personnel consisted of a State
director in general charge of the entire field program, district supervisors having responsibility for the work in a group of counties,
and a count y supervisor for each county. This group promoted
the local adoption of the pr ogram, interested individual house owners in the project , and trained as well as super vised the labor engaged in construction. Wherever materials were furnished by property owners or by public agencies, the necessary labor was assigned
for construction purposes. For the most part, the work was confined
to unsewered towns and villages or the unsewered ar eas of larger
communit ies. The records show that 254,359 sanitar y privies and
4,618 septic t anks were built during the year under this progTam.
It is beli eved that the communities in which the sanitation project
has been operative sh ould eventually benefit to a marked extent in
the r eduction in the prevalence of excreta-borne diseases and in the
introduction of a higher standard of sanitation which will extend
and improve public-health facilities generally.


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PUBLIC HEALTH SERV.tOE
COOPERATION WITH OTHER FEDERAL AGENCI:ES

ASSISTANCE TO F'EDERAL EMERGENCY RELIEF ADMINISTRATION IN
ACTIVITIES

MEIDIOAL RELIEF

Beginning October 1, 1934, a representative of the Public Health
Service was detailed to assist the Federal Emergency Relief Administration with the field supervision of the medical relief measures of this agency and to act as consultant to the several divisions
of the Administration on matters pertaining to health. Later an
additional officer was provided and technical advice of various specialists from the Public Health Service waS' made available.
An outbreak of meningitis in transient camps made it necessary
to recommend specific measures which were apparentlv helpful in
preventing further serious outbreaks of this disease. Various other
services were rendered by the Public Health Service to the Federal
Emergency Relief Administration in connection with medical care.
Among these may be mentioned advice and supervisory assistance
in hygienic, sanitary, and nutritional matters, coordination of Emergency Relief Administration nursing programs, and elimination of
health hazards among employees engaged in potentially dangerous
occupations.
COOPERATIVE PUBLIC HEALTH ENGINEEffiNG ACTIVITIES

Cooperative public-health engineering work with other divisions
of the Public Health Service and with Federal agencies has occupied
approximately 45 percent of the time of the field engineers, equalling
1934 engineer days. Of this time, 1,265 days, or 26 percent, was
devoted to work for the National Park Service and the Office of
Indian Affairs. '
·
National Resources B oard.-At the request of the Water Resources
Section of the National Resources Board approximately 3 months'
time was devoted to the collection of data relative to pollution of
water and the preparation of a report on this subject. At the request of the National R esources Board, applications for projects
having to do with studies o:f stream pollution were prepared and
submitted to the proper authorities for consideration as Works Progress Administration projects under the Emergency Relief Appropriation Act of 1935. An engineer officer of the Public Health
Service was designated as a member of a special advisory committee
on water pollution to the Water R esources Section.
T ennessee Valley Authority.-During the year the Office of Stream
Sanitation cooperated with the Tennessee Valley Authority relative
to stream pollution problems.
National P ark S ervice, Interior Depart1nent.-Cooperative work
with the National Park Service required much of the time of the
engineers. In the eastern division of the Park Service there are
54 reservations of all kinds, located in 16 States and the District of
Columbia. Surveys and investigations were made in 21 areas, in
18 of which studies were made of, and recommendations and J?lans
prepared for , water supply and sewage treatment. In the Nat10nal
Capital parks, swimming pools were inspected at routine intervals
and samples of water collected and examined. The tourist camp in
Potomac Park was inspected periodically. The cooperative work

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also included the investigation of water supplies under the jurisdiction of the Park Service, inspection of restaurants and cafeterias,
and a study of the pollution of Roaches Run. The work also in·cluded an inspection of several Federal buildings in the District of
Columbia.
In the western division, surveys and investigations were made in
17 of the 19 national parks and 13 of the 47 national monumen:s.
Plans for 16 sewage-disposal plants, 4 water-treatment plants, and 2
garbage incinerators were prepared, and 144 plans for projects involving sanitary facilities were reviewed. The district engineer
acted as chairman of the building code, committee, which prepared a
'revised code during the fiscal year, and as a member of a committee
to make recommendat ions for types of cabins to be built in the national parks.
At the request of the regional director, Emergency Conservation
Work, State Parks Division, the district engineer made a. survey of
7 State parks under development in Texas.
O'ffice of l ndtktn Affairs, Interior Department.-During the year
126 surveys of the Indian reservations and schools and 76 examinations of water supplies were made and 45 conferences with officials
relative to sanitation and sanitary projects were held. Plans and
specifications :for 66 sewer systems and sewage-treatment plants and
5 water-supply systems were prepared during the year. Several
projects inaugurated the preceding year under public works allotments were completed.
Bwre(JJU of Prisons, Depmrtm,ent of Jus tice.-Inspections were made
ancl advice was given relative to sanitation, ,Yater supplies, and sewage treatment of the Detention F arm at La Tuna , T ex., and the
Penitentiary at McNeil Island, Wash.
Bureau of Agricultural Engineering, Department of Agriculture.The designs for the sewage treatment plant at Beltsville, Md., were
completed early in the year.
Procurement Division, Treasury Department.-Investigations at
sites :for water supplies and sewage disposal were made at 4 border
customs inspection stations. Advice relative to sanitation and improvement in sewage-disposal plants was given following inspections
at 4 border ins~ection stations.
Advice was given regarding the private water supply of one postoffice building.
Forest Service, Department of Agricultu.re.-Advice was given to
regional offices of the Forest Service relative to sanitation and particularly on protection of water supplies for small groups of workers
and camps.
Lighthouse Service, Department of Oommerce.-An inspection was
made of water-supply facilities at 18 light stations in the eleventh
lighthouse district, including a tour of inspection with the senior
engineer of the district. Arrangements have been made effecting the
cooperation with 3 State and 2 city health departments in making
chemical analyses and bacteriological examinations of water supplies.
Public Health Service.-A survey of milk-pasteurization plants in
New Orleans was made at the request of the Hospital Division.
Some assistance was given to Medical Director L. L. Lumsden, at
New Orleans, in the preparation of maps, charts, and graphs for
·use in connection with a tuberculosis survey.

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United States Army.-Advice was given, when requested, relative

to sanitary problems at Civilian Conservation Corps camps. At the
request of the Lake Survey Office, a complete survey was made of

the U.S. S. P eary.
Oo{J)st Gward, Treaswry Department.-Sanitary inspections were
made of the Coast Guard stations in the seventh district, and recommendations were prepared concerning water-supply improvements
:at the Coast Guard Depot, Curtis Bay, Md.
T ennessee Valley A uthority.-An engineer officer, assigned at the
request of the Tennessee Valley Authority to organize a publichealth engineering program included in Tennessee Valley Authority
activities in the Muscle Shoals (Ala.) area, was on this duty the
greater part of the year.
District of Oolwmbia.-At the request of the sewer department a
study was made of the biochemical oxygen demand of sewage discharged into the Potomac River.
About June 1 the Public Health Service assumed supervision of
mosquito-control work in the District after a lapse of 2 years.
SuRVEYS OF Loc~<\.L HEALTH ORGANIZATIONS

In response to requests from State and local health authorities,
the Public Health Service made surveys of local health organizations
in St. Louis County, Mo., Phoenix, Ariz., and San Antonio, Tex.
Appropriate reports, with recommendations as to suggested improvements, were filed with the State and local authorities.
CONFERENCE OF THE SURGEON GENERAL WITH THE STATE AND
TERRITORIAL HEALTH OFFICERS

The Annual Conference of the State and Territorial Health
Officers with the Surgeon General of the Public Health Service was
held June 17, 18, and 19. In anticipation of the enactment of the
social-security bill before the end of the calendar year, the entire
time was given to discussion of the proposed program to be carried
out under the provisions of the bill. Recommendations were presented to the Surgeon General with respect to the proposed allotment of funds to the States and the regulations governing submission
of plans and payments from allotments.
_ The following States were represented :
Alabama
Arkansas
California
Colorado
Connecticut
. D elaware
District of Columbia
· Florida
Georgia
Idaho
Illinois

Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri


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Montana
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island

South Carolina
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

DIVISION OF FOREIGN AND INSULAR QUARANTINE
AND IMMIGRATION
Asst. Surg. Gen. F. A.

CARMELIA

in charge

During the fiscal year 1935 the various quarantinable diseases continued to prevail in many parts of the world. While cholera was
,confined to Asia and the adjacent islands, its incidence in India was
higher than it was during the preceding fiscal year. Three cases of
cholera were reported near Manila, Philippine Islands, in June 1935,
and a number of cases were discovered on vessels. Plague was prev.aJent in many localities. Reservoirs of plague infection among
rodents were reported as being present in California, Oregon, Hawaii,
the Union of South Africa, and in a number of ports. Two cases of
human plague occurred on the Island of Hawaii, Hawaii Territoryone in October 1934 and one in March 1935. Y e1low fever appeared
in Colombia and in Brazil in the States of Amazonas, Bahia, Ceara,
Goyaz, Maranhao, Mato Grosso, Minas Geraes, Para, and Sao Paulo.
In Africa, yellow fever was present in the Anglo-Egyptian Sudan,
Middle Congo, Dahomey, Gambia, Gold Coast, French Guinea, Ivory
Coast, Niger Territory, Nigeria, Sierra Leone, and French Togoland. ·
'Typhus fever continued to exist in many countries. The virulent type
of this disease is rare in the United States, but it causes many deaths
in Mexico and in Chile and some other South American countries.
:Smallpox was wide-spread during the year. In England the incidence of smallpox decreased 2 and few cases were reported in most
.European countries. The disease caused 59,000 deaths in British
India during the calendar year 1934, however, and cases were reported
in ports in all of the grand divisions of the world except Australia.
There was some increase in the number of vessels arriving at
ports in the United States during, the past year as - compared with
the number which arrived during the preceding year. A total of
15,094 maritime vessels, carrying 1,878,617 persons, was accorded
inspection at United States ports by medical officers of the Public
Health Service prior to entry in order to assure freedom from any
·o f the quarantinable diseases. Because of the continued cooperation of shipping interests in rendering ships ratproof, however,
and owing to the increased uniformity and oetter coordination of
quarantine procedures applied to international commerce as a result of increasingly universal application of the International Sanitary Convention of P aris, 1926, the number of necessary fumigations
·on arriving ships continued to decrease. Only 1,147 of the arriving
.s hips were required to undergo fumigation. Examinations for plague
infection were made of 4,207 of the 5,951 rats retrieved following
fumigation. During the year, 2,388 vessels from foreign countries
presented international standard certificates of deratization of which
only 128 were not accepted, and 2,262 vessels presented foreign certifi73


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cates of deratization exemption, of which only 131 were refused.
Quarantine officers at United States ports issued international stand•
ard certificates of deratization exemption to 1',886 vessels.
In view of the nonavailability of medical officers of the Public
Health Service for duty at all airports in the United States which
have been officially designated as airports of entry, only 2,636 airplanes, carrying 30,249 persons, of whom 1,991 were aliens, of a total
of 4,081 arriving planes, carrying 34,135 persons, were accorded the
quarantine and immigration inspections required by law.
The new airport of the Pacific Alaska Airways, Inc., at Juneau,
Alaska, was designated as an airport of entry for the landing of
aircraft coming from foreign countries, as was also the Weeks Municipal Airfield at Fairbanks, Alaska. Temporary permission was
granted two air lines affiliated with the Pan American Airways to
land their aircraft at the Grand Central Air Terminal at Glendale,
Calif., during the year 1935, in connection with air transportation
servic_e between Mexico City and Los Angeles. The Public Health
Service, however, was unable to concur in the recommendation made.
for the designation of the airport at Fairbanks, Alaska, because no
medical officer of the Service was on duty at Fairbanks and avail•
able funds would not permit the appointment of a medical officer
to conduct the required quarantine inspection of arriving planes
and the medical examination of crews and passengers £or immigration purposes.
There occurred no instance of the introduction of any of the
· quarantinable diseases into the United States during the fiscal year.
One case of smallpox and one suspect discovered among the steeragepassengers of a vessel which arrived at San Francisco were removed,
with all contact passengers, to the quarantine station and properly
treated. No detentions of vessels were made because of the presence
on board of quarantinable diseases. During the· year 65,073 persons
were vaccinated against smallpox, and 69 persons were vaccinated
against cholera.
It was necessary for the Department to assess, during the year,.
fines aggregating only $215 for violations of the quarantme laws of
the United States by masters of vessels coming from foreign ports.
The systematic studies which have been carried on by the Public·
Health Service for some time past in an effort to improve the
efficiency of ship :fumigations were continued throughout the year.
Experiments were also conducted to develop a fumigation method.
for the destruction of mosquitoes on airplanes. From these latter·
studies, which are still in progress, it appears at present that fumigation with pyrethrum extract while airplanes are in flight is.
feasible and reasonably, effective.
During the year there was completed the rehabilitation of the
Charleston ( S. C.) quarantine station; the rehabilitation of the Pen•sacola (Fla.) quarantine station; the construction of one single attendant's quarters and mess building at the San Francisco (Calif.)
quarantine station; the construction of one new senior medical
officer's quarters at the San Diego (Calif.) quarantine station; theconstruction of the nucleus of a new quarantine station at Los Angeles, Calif.; and the construction of a new quarantine station at~
Port Townsend, Wash.


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Construction of floating equipment during the year included a
100-foot, wrought-iron, Diesel electric vessel designated the W. H.
Welch for the New York quarantine station; two 70-foot, wroughtiron, Diesel-propelled vessels, the R. D. Murray and P.H. Bailhache,
for the Fort Monroe (Va.) and Port Townsend (Wash.) quarantine
stations, respectively; 8 wooden, Diesel-propelled 40-foot launches,
designated as Q-1, Q-2, Q-8, Q-12, Q-21, Q-22, Q-23, and Q-24,
and 1 wrought-iron, Diesel-propelled, 40-foot launch~ the Q-27, and
the reconstruction and repowering of the Diesel launches Donald
Currie at Astoria, Oreg., and H . .A.. Stansfield at Honolulu, Hawaii.
On April 1, 1935, the Reedy Island quarantine.station was opened
as a boarding and inspection station for all vessels desiring to undergo quarantine inspection there between the hours of sunrise and
sunset. The principal reason for opening this station, however, was
to facilitate the inspection of vessels bound for ports south of
Marcus Hook, Pa., which formerly were required to go beyond
their destination to the Marcus Hook quarantine station for quarantine inspection and any necessary treatment.
The International Sanitary Convention for Aerial Navigation was
opened for signature at The Hague on April 12, 1933, and was signed
on behalf of the United States on April 6, 1934. · Inconformity with
articles 63, 64, and 65, the convention becomes effective between adhering countries on August 1, 1935, 120 days following the deposit with
the Government of the Netherlands of the first 10 notifications of
ratification, namely, those of Australia, Egypt, the United Kingdom
of Great Britain and Northern Ireland, Morocco, Monaco, the
Netherlands, Rumania, Syria and Lebanon, and Tunis. The convention was ratified by the United States on June 13, 1935, and becomes
effective for the United States on November 22, 1935. The convention has also been ratified by Germany and adhered to by Bolivia,
Brazil, Chile, Iraq, and Sudan. The Ninth Pan American Sanitary
Conference of Directors of Health, meeting in Buenos Aires in
November 1934 adopted a formal resolution recommending the
adherence to and ratification of this convention by Pan American
governments. The United States especially has a vital, direct interest
in this convention, owing to aerial intercourse between extensive areas
in South America., particularly in Brazil, which are endemic foci
of yellow fever infection, and the highly infectible area and largely
nonimmune population in our Southern States and Puerto Rico and
the Virgin Islands. The Panama Canal Zone is particularly exposed
to yellow fever in nearby Colombia.. Should the infection spread
to other nearby countries, especially in the Caribbean or in Central
America, the menace would be considerably increased. Similarly on
the Pacific coast the impending establishment of aerial transport
across the Pacific, linking up with airlines already established in the
Orient from Shanghai and interior of China via Manila to the East
Indies and Straits Settlements, exposes our Pacific coast as well as
Hawaii and the Philippine Islands to infection, particularly with
cholera and smallpox, from endemic and epidemic foci of quarantinable diseases in the Orient. Furthermore, should India and the
Orient become infected with yellow fever from infected areas in
Africa, either directly or through infection of intermediate countries,
a very real menace of infection of our highly infectible Pacific pos20980-35-6


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PUBLIC HEALTH SERVICE

sessions with yellow fever would exist. This convention, in addition
to its international sanitary importance, also :presents other important
aspects in that it protects aerial transportation from the imposition
by foreign countries of unnecessary quarantine restriction with its
incidental delays and expense which otherwise might continue on
occasion to retard and harass the commercial development of aerial
intercourse.
The Quarantine Commission of the International Office of Public
Health has reported the conclusion of international regional arrangements relating to the exemption from consular visa and the abolition of bills of health, the texts of which were finally prepared following the deliberations of the Permanent Committee of the Office
in May 1934. These agreements were signed at Paris on December
22, 1934. The Commission states that it sees in this action an expression of the intentions of the various governments to bring their
sanitary regulations, as far as is compatible with the conditions
peculiar to each country, into conformity with the development of
international communication. It is anticipated by the Commission
that the delegates of countries which are not yet participants in
these new agreements will endeavor to obtain the adhesion of their
governments. The Public Health Service, however, is definitely opposed to the abolition of bills of health, because the American bill
of health is designed not only to set forth important details respecting the sanitary conditions prevailing in the port of issuance and
contiguous territory but, more importantly, includes data respecting
the sanitary status of passengers or cargo taken thereat, data of
correlative sanitary importance regarding the disposition and conduct of the vessel while in that port, and other similar pertinent
data desiried for the information of the quarantine officer at the
United States port of arrival. The quarantine treatment accorded
vessels arriving at United States ports :from :foreign ports is based
in no small degree upon the evaluation of the sanitary significance
of the data thus presented. The interchange of sanitary information
regarding the prevalence of disease in ports through the International Office of Public Health at Paris under the provisions of the
International Sanitary Convention supplies but a small part of the
information desired and now supplied to our quarantine officers
through the medium of American bills of health. The information
contained in bills of health issued or required by certain European
nations is in most instances confined practically to a notation respecting the mere presence or absence of quarantinable disease in the port
of issuance. It is appreciated that the interchange of sanitary information provided for under the terms of the International Sanitary .
Convention of Paris ( revised 1926) might warrant the abolition of
bills of health of such character, but the information contained in
those bills of health cannot be compared with that contained in the
American bill of health.
The Treasury Department and the Department of State for some
time past have been urging the Panama Canal Zone Government to
adopt quarantine and bill-of-health requirements exactly in conformity with such requirements as uniformly apply in all other United
States ports. Until such requirements are adopted, the lack of uniformity, particularly as regards the requirements for bills of health


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in foreign ports in the Caribbean area, may be expected to continue
to be confusing.
At the suggestion of the Public Health Service, the consular regulations of the United States of America were amended so as to instruct
American consular officers in foreign ports to authenticate at ports of
issuance ( or at nearby ports when American consular officers are not
available at ports of issuance), without reference as to whether the
vessel is destined to proceed at that time to a United States port, both
foreign certificates of deratization and of deratization exemption
issued under the provisions of article 28 of the International Sanitary
Convention of Paris, 1926, in accordance with the provisions of the
quarantine regulations of the United States requiring the authentication by American consular officers of either form of certificate when
issued in foreign ports.
The Public Health Service has recommended favorable consideration on the part of the United States of a proposal submitted by the
International Office of Public Health at Paris to add a fourth paragraph to section 6 of article 25 of the International Sanitary Convention signed at Paris on June 21, 1926, so as to permit the fumigation
of a vessel under certain special circumstances before or during the
unloading of its cargo and also to permit a repetition of such fumigat ion if necessary to complete deratization of the vessel. The Quarantine Commission of the International Office of Public Health has
expressed great satisfaction at the manner in which this proposal has
been received by a large number of countries.
At the request of the quarantine service of Habana, Cuba, the
routine supervision by a medical officer of the Public Health Service
of maritime fumigations performed by officers of the port quarantine
service for deratization purposes on vessels at Habana destined to
proceed to United States ports was discontinued. This action was·
taken, however, with the understanding that it would not prejudice
t he right of representatives of either service at any time in the future
to observe such fumigations under the provisions of the informal
agreement of 1931 between the quarantine service of Cuba and the
United States Public Health Service regarding the reciprocal recognition of certificates of deratization issued by duly accredited quarantine officers of either service.
On October 1, 1934, the port of El Paso, Tex., was declared open for
entry 24 hours daily. This arrangement was effected without the concurrence of the Public Health Service, which is able to maintain at
El Paso, with existing appropriations, a force of employees sufficient
to take care of daylight duty only, and the extension of the hours of
entry beyond sunset makes it impossible for this Service to carry out
the ~uties placed upon it by_ la"'.' requi~ing all arrivals from foreign
territory to undergo quarantme mspect10n and such other quarantine
procedures as may be found necessary.
Owing to lack of funds for the appointment of additional personnel,
the Public Health Service was unable to concur in a recommendation
for an extension of the hours during which the port of Y sleta, Tex.,
will be maintai.n ed open for entry on Sunday mornings and certain
holidays.
Foreign Quarantine Division Circular No. 49, regarding the deratizat_ion requirements of the Service, was amended on March 5, 1935, to


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provide that until further notice vessels coming from all River Plata,
ports, South America, except Mont~video, shall b~ r~garded as rotentially dangerous from ~he standpomt of tra_ns~1ttmg plagwJ. mfec- .
tion and shall be. reqmred to undergo fum1gat10n upon arrival at
United States ports unless an acceptable certificate of deratization or
deratization exemption dated subsequent to call at River Plata ports .
is presented. This requirement is exercised under the third reserva- ·
tion made by the Senate of the United States in connection with the
ratification by it of the International Sanitary Convention of Paris~
(revised 1926).
F oreign Quarantine Division Circular No. 32, relating to the quar- antine treatment of United States naval vessels at Ynited States:
ports, was amended on August 23, 1934, to authorize medical 0fficers
in charge of quarantine stations to extend to vessels of the United
States Coast Guard which carry a medical officer of the Public Health
Service the same privileged quarantine treatment as is at present
accorded vessels of the United States N a.vy.
Medical inspection of aliens.--During the fiscal year, 730,777 ,alien
immigrants were examined and 696,562 alien seamen were inspected
at United States ports of entry by medical officers of the United
States Public H ealth Service for mental or physical defects or diseases in accordance with the provisions of the immigration laws,
the examination of 258,939 alien seamen for immigration purposes .
having been performed at quarantine stations in conjunction with
quarantine inspections. Twelve hundred and eighty-eight alien immigrants and 628 alien seamen were certified to be afflicted with
one or more of the defects or diseases requiring exclusion, and 13,281
alien immigrants and 622 alien seamen were certified to be afflicted
with a defect or disease which was likely to affect their ability to .
earn a living.
There were 35,978 applicants for immigration visas examined by
medical officers in American consulates in foreign countries. Of ·
this number 704 were reported by the medical officers to the American consuls as being afflicted with one or more of the defects or·
diseases requiring exclusion, and 6,188 were reported as afflicted
with a disease or condition which was likely to affect their ability ·
to earn a living. Only two of the aliens who had been given a preliminary medical examination in American consulates in foreign
countries and to whom visas had been issued were certified upon
arrival at a United States port as being afflicted with a defect or ·
disease requiring deportation.
At the request o:f the Commissioner General of Immigra.tion and
Naturalization, medical officers of the Public Health Service were
authorized, upon competent request of immigration officials, to make
thorough physical examinations, in accordance with the standards .
set forth by the United States Civil Service Commission, of any
nominees tentatively selected by immigration officials for appointment to the position of immigration patrol inspector, as authorized
in Bureau Circular, No. 34 for Civil Service applicants. The duties
of immigration patrol inspector are very strenuous, and it is necessary for such inspectors to be in excellent physical condition in order ·
properly to perform their duties.
.
Because of the high mortality rate from malaria. now existing in
the southern part of Texas, and in an effort to restrict the introduc- ..

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tion of malaria into the United States from Mexican territory, medical officers of the Public Health Service on duty at Texas-Mexican
border stations were directed, in cooperation with the State health
,officer of Texas, to give careful consideration to the possibility of
malaria being present in any arriving person who is medically examined and, whenever malaria is suspected, to make a microscopic ex.amination of the blood sufficient to establish the diagnosis of malaria
in persons so afflicted. The medical officers were further instructed
:to certify properly to the immigration authorities all aliens thus
·found to have malaria, and to notify the Texas State Health Department of the name and destination of every case of malaria
released for entry into the United States.
During the latter part of the year, the Public Health Service.
issued a pamphlet entitled, " Information Regarding Quarantine and
Immigration for Ship Surgeons." This pamphlet outlines the basic
objectives of the medical inspection of arrivmg aliens and is being
distributed to ship surgeons in an effort to secure a higher degree of
cooperation between them and the boarding officers of the Service.
TRANSACTIONS AT MARITIME QUARANTINE STATIONS
TABLE

1.-Swmmary of transactions at marUime stations for the '{isCO!l year 1935

Station

.Aberdeen, Wash ____________________
.A ngel 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, CaliL ______________________
Fall River, Mass ___________________
Fernandina,
Fla. (Cumberland
Sound) ___________________________
.F ort Monroe, Va ___________________

Vessels
Bills of
fumigated
health Amount
Vessels
and
of bills
Vessels granted
Passen- Crew in- port rendered
gers in- spected
infree
sani- for quarspected pra- Cya- Sul- spected
tary
antine
tique nide phur
statements services
issued
--- -- -- - - - - - --- --17
425
43
470
0
9
838
5
2
144
28
1
3
6

15
279
38
419
0
9
689
5
2
141
28
1
3
6

0
37
7
56
0
0
76
0
0
8
0
0
0
0

2
348

2
332
7
527
0
13
139
149
0
572
21
747
129
3
22
1,032
9
2,997
0
26
39
5
18

0
5
0
23
0
0
13
0
0
48
0
37
3
0
0
32
0
204
0
1
1
0
0

Freeport, Tex _______________________
7
Galveston, Tex _____________________
547
Georgetown, S. c ___________________
0
Gulfport, Miss ______________________
13
Jacksonville, Fla. (St. Johns River)_
151
Key West, Fla ______________________
157
Lewes, Del. (Delaware Breakwater)_
0
Marcus Hook, Pa ___________________
636
Marshfield, Oreg. (Coos Bay) _______
21
.M iami, Fla ___ ______________________
747
Mobile, Ala _________________________
156
N ew Bedford, Mass ______ ________ __
3
New London, Conn ________________
22
New Orleans, La ___________________ 1,099
N ewport, R. !_ _______________ ______
9
New York, N. Y.2 __________________ 3,372
Ogdensburg, N. y __________________
0
.Panama City, Fla __________________
26
Pensacola, Fla ______________________
50
Plymouth, Mass ____________________
5
Port Everglades, Fla __________ ______
18
1 Includes
2 Includes

Port Aransas, Tex.
Perth Amboy, N. J.


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3
0
0
0
0
0
0
0
0
0
0
0
0
0

0
25,490
24
117
0
6
29,312
0
0
187
22
0
0
0

636
36,762
1,704
15,235
0
306
56,608
191
24
5,243
861
22
122
307

399
0
689
0
0
0
0
0
0
0
560
2
22
54

$190. 00
10,554.47
597.10
9,579.66
0
190. 00
18,038. 47
45.00
0
1,605.92
270. 00
5. 00
30.00
85. 00

0
2
22
8,827
1
0
538
0
0
0
2
0
0
70
4 11, 748
0
0
0
508
1
0
0 18,098
1
88
5
0
48
0
0 10,304
28
0
0 395,256
0
0
140
0
20
0
20
0
2,826
0

12
33,077
212
17,475
0
383
3,138
9,128
0
20,134
864
17,998
5,132
20
606
42,030
562
499,651
0
913
1,461
137
3,381

25
0
0
0
1
80
661
31
0
4,158
55
594
0
15
27
4,208
18
18,903
0
79
881
0
0

10. 00
5,309.81
70. 00
8,194.28
0
125. 00
1,993.56
2,201.80
0
10,395.49
227. 50
5,833.00
1,983.00
15. 00
130. 00
16,252.00
45. 00
68,868.77
0
410. 22
749. 97
65. 00
267. 00

80

PUBLIC HEALTH SERVICE

Bills of
Vessels
health
fumigated
and
Vessels
Passen- Crew in- port
Vessels granted
gers in- spected
saniinfree
tary
spected pra- Cya- Sul- spected
statetique nide phur
ments
issued
--- -- -- --- ---- ---

Station

Portland, Maine _______________ ,._ ___
54
0
111
0
98
Portland, Oreg ______________________
28
15
0
14
14
Port
3an
Luis,
Calif.
(San
Luis
Obispo) ___________________________
0
0
0
53
53
Port Townsend, Wash.a ____________
0
0
30
30
57
Providence, R. !_ _____________ ______
3
0
40
0
37
Sabine, Tex _________________________
0
73
11
251
321
San Diego, Calif. (Point Loma) _____
2
0 14,341
627
633
San Pedro, Calif_ ___________________ 1,397
1,141
0 25,396
56
Savannah, Ga ______________________
14
0
82
64
83
Searsport, Maine _____ _____________ _
0
0
0
14
14
South Bend, Wash _____ _____ _______
1
1
28
0
28
Southport, N. C. (Cape Fear)_. ____
1
6
0
26
27
Tampa, Fla _________________________
534
22
0
213
254
Vineyard Haven, Mass _____________
0
0
0
2
2
West Palm Beach, Fla ______________
68
0
0
68
68
TotaL ______ ______ __ __ ________ 12,482 11,108
701
33 544,255
---------Alaska:
Ketchikan ______________________
0
0
0
0
0
WrangelL ______________________
0
0
0
0
0

Amount
of bills
rendered
for quarantine
services
- - --

3,251
619

61
2,432

1, 165. 00·
1,924.98

1,889
1,113
1,293
10,848
82,433
95,002
2,412
357
1,125
814
5,586
20
264

0
2,682
58
0
580
8,018
0
14
64
0
588
0
0

1,085.00
3,904.88
535. oo,
3,259.12
3,747.92
23,891.94
1,523.51
135. 00
290. 00
339. 84
2,496.83
10.00
340. oo·

981,361

45,959 208,986.04

0
0

0
0

0
0

0
209
38,465
0
0
1
1

35
781
46,905
68
35
36
69

39
205
827
156
87
55
27

10.00
71. 00
3,953.92
25.00
10.00
15.00
20.00

0
8
1,393
96
902
0
91
533
0
385
0
8
112 72,752
0
0
894
16 •

876
5,578
"5,502
4,019
817
1,393
100,291
0
3,645

1
434
149
197
41
90
1,318
0
111

0
0
0
0
0
0
0
0
0

122,121

2,341

0

----0 - -0 ---0 ----0 ---0 ----0
TotaL ____ ____________________ --0
0

Hawaii:
AhukinL _______________________
Hilo ____ ------- --- --- ---- --- - -Honolulu
_______________________
KahuluL _______ _______ _____ ___ _
Port Allen ______________________
Lahaina ________________________
Mahukona _____ __ __________ _____
TotaL ___ _____________________
Philippines:
Cavite ________________ ___ ____ ___
Cebu
Davao____------------------------________________________
Iloilo __________________ ________ _
J olo ________ ____________ _________
Legaspi_ ____ ____________________
Manila _________________________
Olongapo _______________________
Zamboanga __ ___________________
TotaL __ ______________________
Puerto
Rico: ___ ____________________
Aguadilla
Arecibo ___ _______ __ ____ ________ _
Arroyo __________________________
Central Aguirre _________________
Fajardo _________________________
Guanica ____________ ____________
Humacao _______________ ____ ____
Mayaguez ______________________
Ponce ___________________________
San Juan _________ ______________
TotaL ________________________
Virgin Islands:
Christiansted ___ _______________ _
Frederiksted __________________ __
St. Thomas _____ _____ ____ _____ __

----

---=
1
9
186
2
1
1
2

1
9
185
2
1
1
2

4
105
82
78
23
32
1,037
0
50

4
0
3
0
0
1
196
0
0

0
0
18
0
0
0
0

--

0
0
0
0
0
0
0

- - - ---- - - - --------202
18
47,929
0 38,676
201
4,104.92
l, 396
- - - - - - - - - - - - - - - -- - - - =
0
2
0
0
0
0
43
0
0

---- --- ----

- - - --- -- -- --1,411
45
315 76,875 l
204
---------4
1
5
0
10
44
9
43
51
466

4
1
5
0
9
44
5
43
44
415

0
0
0
0
0
0
0
0
0
13

0
0
0
0
0
1
0
0
0
0

22
22
0
0
1
298
0
204
64
9,618

124
69
34
0
75
771
88
1,703
1,121
27,933

64
60
90
59
344
69
75
202
335
713

40.00
15. 00
25.00 ·
0
70. 00
307. 50
50.00
310. 00
390. 00 ·
6, '227.12

5
52
309

5
52
269

0
0
2

0
0
19

13
3,227
4,129

62
3,891
13,931

276
94
378

40. 00
808. 00
3,735.36

12,409

779

- - - ------ 13- - - -------633
570
7,434.62
10,229
2,011
31,918
--- --- ---- --- ---- -------

- - - - -- - -- - - - - - - - - - - - - - - - - 326
366
2
4,583. 3&,
17,884
19
7,369
748
--- -- --------- ------Total, all stations _____________

TotaL ____ ____ ______ __ __ ______

- --

15,094

1

Includes all ports on Puget Sound.


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

368 677,404 1,201,213

52,455 $225,108.94

81

PUBLIC HEALTH SERVICE
TABLE

2.-Statement of quarantine services rendered at maritime quarantine
stations d'f!,rinu, the fi,Scai yewr 1935
Inspection
s~rvices

Detention
services

Aberdeen, Wash __________________________
$175. 00
Angel Island, Calif. (San Francisco) ______
5, 6,59. 00
Astoria, Oreg __________ --- ----- ----------420. 00
Baltimore,s.Md_-------------------------Beaufort,
c _____________________________ 4,855.00
0
Boca Grande, Fla _______ ____ ______________
190. 00
Boston, Mass _____________________________ 10,510.00
Brunswick, Ga ___________________________
45. 00
Carrabelle, Fla ___________________________
0
Charleston, S. c __________________________
1,395.00
270. 00
Corpus
Christi,
Tex.'
------------------Eastport, Maine ________________ __ _____ ___
5. 00
Eureka, Calif_ ____ __ ____________ ---------_
30. 00
Fall River, Mass _________________________
55. 00
Fernandina, Fla. (Cumberland Sound) ___
10. 00
Fort Monroe, Va _________________________
3,926.00
Freeport, Tex _____________ ------------ ____
70. 00
Galveston, Tex ___________________________
5,708.45
Georgetown, S. c _________________________
0
Gulfport, Miss ____________________________
125. 00
Jacksonville, Fla. (St. Johns River) _______
1,250. 00
Key West, Fla ____________________________
2,141.00
Lewes, Del. (Delaware Breakwater) ______
0
Marcus Hook, Pa _________________________
6,815.00
Marshfield, Oreg. (Coos Bay) _____________
200. 00
Miami, Fla _________ ___ ____ _______________
5,648.00
Mobile, Ala ______________________________
1,630. 00
New Bedford, Mass ________ ____ _____ _____
15. 00
New London, Conn ______ _______________ _
130. 00
12,263.00
New
Orleans,
--- -------Newport,
R. !_La_------------___________________________
45. 00
New York, N. Y . 2 _______________________ 45,375. 00
Ogdensburg, N. y ________________________
0
Panama City, Fla ______________ : _________
285. 00
Pensacola, Fla ____________________________
520. 00
65. 00
Plymouth, Mass ______ ------~------------Port Everglades, Fla _____________________
267. 00
Portland, Maine __________________________
1,125.00
Portland, Oreg ___________________________
140.00
Port San Luis, Calif (San Luis Obispo) ____
965. 00
Port Townsend, Wash.3 ___________________
685. 00
Providence, R. !_ _________________________
465. 00
2,525.00
Sabine, Tex ___ ---------------------------San Diego, Cali! (Point Loma) ___________
3,145.00
San Pedro, Calif_ _____________________ ---- 17,633.00
Savannah, Ga _________ _____________ ___ ___
815. 00
135. 00
Searsport,
Maine
__ _______________________
----------------------South Bend,
Wash
285. OU
Southport, N . C. (Cape Fear) ____________
270. 00
Tampa, Fla ______________________________
1,771. 73
Vineyard Haven, Mass ___________________
10.00
West Palm Beach, Fla ____________________
340. 00

0
$504. 00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3.00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4.00
0
0
0
0
0
0
0
0

140,407.18

511. oo

Alaska:
Ketchikan ____________________________
Wrangell_---------- -·----- ______ ______

0
0

0
0

0
0

0
0

0
0

TotaL __ -- - - -- -- - -- --- - -- - --- - -- - -- -

0

0

0

Station

TotaL ______________________ ________

Special
services

Fumigation
services

Total
charges

0
40. 00
320. 00
120. 00
415. 00
70. 00
475. 00
510. 00
2,120.00
60. 00
0
5. 00
0
300. 00
0
0

$5.00
2,906.97
177. 10
3,094.66
0
0
7,008, 47
0
0
150. 92
0
0
0
0
0
1,108.81
0
1,170.83
0
0
623. 56
30.80
0
2,800.49
7. 50
185. 00
0
0
0
2,299.00
0
16,338. 77
0 \
5. 22
79. 97
0
0
0
1,464.98
0
2,804.88
0
259. 12
88. 92
4,138.94
648. 51
0
0
69. 84
425.10
0
0

$190. 00
10,554.47
597.10
9,579.66
0
190. 00
18,038.47
45. 00
0
1,605.92
270. 00
5. 00
30. 00
85. 00
10. 00
5,309.81
70. 00
8,194.28
0
125. 00
1,993.56
2,201.80
0
10,395.49
227. 50
5,833.00
1,983.00
15.00
130. 00
16,252. 00
45. 00
68,868.77
0
410. 22
749. 97
65. 00
267. 00
1,165.00
1,924.98
1,085.00
3,904.88
535. 00
3,259. 12
3,747.92
23,891.94
1,523.51
135.00
290. 00
339. 84
2,496.83
10. 00
340. 00

19,574.50

48,493.36

208,986.04

$10. 00
1,484.50
0
1,030.00
0
0
520. 00
0
0
60. 00
0
0
0
30. 00
0
275. 00
0
1,315.00
0
0
120. 00
30. 00
0
780. 00
20. 00
0
350. 00
0
0
1,690.00
0
7,155.00
0
120. 00
150. 00
0

0

0

Hawaii:
AhukinL _____________________________
Hilo __ - -- _______
- -- - -- --______________________
- -- -- -- - -- -- - -- - -- -- Honolulu
KahuluL _______________ _____ • _______
Port Allen ____________________________
Lahaina ______________________________
Mahukona.. ___________________________

10. 00
71. 00
3,921.00
25. 00
10. 00
15. 00
20. 00

0
0
0
0
0
0
0

0
0
10. 00
0
0
0
0

0
0
22.92
0
0
0
0

10.00
71.00
3,953.92
25. 00
10. 00
15. 00
20. 00

TotaL _____________________________ .

4,072.00

0

10.00

22. 92

4,104.92

t
2
3

Includes Port Aracsas, Tex.
Includes Perth Amboy, N. J .
Includes all ports on Puget Sound.


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Federal Reserve Bank of St. Louis

82

PUBLIC HEALTH SERVICE

TABLE

2.-Statement of quarantine services rendered at maritime quarantine
stations during the (isoal year 1935-0ontinued
Inspection Detention
services
services

Station
Puerto Rico:
Aguadilla_____________________________
Arecibo_______________________________
Arroyo __ ---------------------------__
Central Aguirre_______________________
Fajardo_______________________________
Guanica______________________________
Humacao______________ ____ ___________
Mayaguez_ ______________ ___ __________
Ponce______________ __________________
San Juan_____________________________
TotaL____________ __________________

$40. 00
15. 00
25. 00

Special
services

Fumigation
services

Total
charges

50. 00
310. 00
330. 00
5,585.00

0
0
0
0
0
0
0
0
0
0

0
0
0
0
$10. 00
10.00
0
0
60. 00
250. 00

0
0
0
0
0
$7.50
0
0
0
392.12

$40. 00
15. 00
25. 00
0
70. 00
307. 50
50.00
310.00
390 00
6,227.12

6,705.00

0

330. 00

399. 62

7,434.62

0

60. 00

290. 00

1----------1-----1-- ----1--

1=====1=====1=====1=====1==
Virgin Islands:
Christiansted_________________________
40. 00
40.00
0
0
0
Frederiksted________________________ __
808. 00
808. 00
0
0
0
St. Thomas___________________________
3,637.00
98.36
3,735.36
0
0

Total__ _____________________________

1-----1------1-----+-----1-4,485.00

Total, all stations __________________ ., 155,669.18

0

0

511. 00

19,914.50

98.36

4,583.36

49,014.26

225,108.94

MEXICAN BORDER STATIONS
TABLE

3.-Summary of quarantvne transactions on the Mexican border for the
fiscal year 1935

Station

Brownsville, Tex ________
Calexico, Calif. ____ ______
Columbus, N. Mex ______
Del Rio, Tex ____________
Douglas, Ariz __ __________
Eagle Pass, Tex __________
El Paso, Tex.I. __________
Hidalgo, Tex __________ __
Laredo, Tex.2 ____________
Naco, Ariz _______________
Nogales, Ariz __________ __
Presidio, Tex ____________
Rio Grande City, Tex ___
Roma, Tex ______________
.San Ysidro, Calif_ _______
Thayer (Mercedes), Tex_
Zapata, Tex _____________
TotaL ______ - _-_- - 1

2

Number
of persons
from interior
Mexico
inspected

Total
Total
Total
Total
Total
number number
number
Number number
of per-. number
of
perof
perof
sick
of local
of persons
sons
sons
persons
refused
inpassed
inspected sons
vacciadmisdisinspected
without nated
sion
tested treatment
---- ---- --- ---- --- ---

Total
pieces
of
baggage
disinfected
---

1,499
954, 178
955,677
0
16,417
16,417
1,035
1,198
163
232
88,197
87,965
115
1,560
1,445
14,018
545,579
559,597
9,778 4,328, 149 4,337,927
2,068
264,193
266,261
87,856 1,844,927 1,932, 783
30
2,956
2,986
5,448
7,457
12,905
30
45,643
45,673
292
9,025
9,317
2,147
54,822
52,675
2,682
6,756
9,438
42
56,605
56,563
328
9,495
9,823

955,444
0
15,401
0
977
0
87,447
337
1,277
0
552,286
5,788
23,015 4,301,174
264,573
19
1,593 1,918, 731
2,495
0
12,495
0
45,073
64
8,774
0
54,149
3
8,345
0
56,425
13
8,310
0

233
956
221
576
232
1,523
13,736
1,665
14,043
491
410
519
543
673
1,093
167
1,513

0
60
0
0
51
0
2
4
0
0
0
17
0
0
0
0
0

0
0
0
154
0
5,971
1,560
2
1,996
0
0
0
2
4
0
0
0

126,728 8,234,458 8,361, 186

30,832 8,293,376

38,594

134

9,689

- - - - - - - - - - - - - - - - - - - - - - --- - - -

Includes Fort Hancock, Guadalupe Gate, and Ysleta.
Includes Minera and San Ygnacio.


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Federal Reserve Bank of St. Louis

TRANSACTIONS AT
TABLE

Location

NITED STATES AIRPORTS OF ENTRY FOR AIRPLANES FROM FOREIGN PORTS

4.-Summary of transactions at continental and insular stations for the fiscal year 1935
Distance
in miles to
nearest
Public
Health
Service
station

Name of airport

6
Ajo, Ariz ____________________ Municipal Airport__________________________
Akron, Ohio 1________ ___ ________ do.2 _________________________________________________
Albany, N. y _______________ Municipal Field____________________________
10
Bellingbaw, Wash ___________ Graham Airport 2 _______________________________________
Brownsville, Tex ____________ Municipal Airport._________________________
5

Date
designated

Nov.
Apr.
Sept.
Apr.
Jan.

Number of Number of Number of
Number of Nnmberof
aliens in- Number of
persons
airplanes
persons
airplanes inspected
arriving
inspected spected by aliens cerarriving
tified for
Public
by
Public
from
forby
Public
from forHealth
disease
eign ports
Health
Health
eign ports
Service
or places
Service
Service

15, 1929
0
0
0
O
0
0
8, 1929 _______________________________________________________________________ .
28, 1928
0
0
0
0
0
0
18, 1931
1
0
2
0
0
0
8, 1930
441
441
3,793
3,793
535
2

i~:

Buffalo, N. y ________ _______ {BufaYo°Marine-Airpo~t2== ======== ========== ============ ~~; :;
Burlington, Vt.I ______ __ ____ Burlington Municipal Airport 2________________ ___ ______ June 29, 1934 _______________________________________________________________________ _
Calexico, Calif. _____________ Calexico Municipal Airport 2______________ ___ ___________ Jan. 10, 1933
0
0
0
0
O
0

t~r ~ti~~~

8:?it~~~~hi~--~~======== 8:?it~nii~i~~~~~iport2================ ============
Cleveland, Ohio ______ ______ Cleveland Municipal Airport 2__________________________ Sept. 23, 1932
Crosby, N. D ak.1 ___________ Crosby Municipal Airport 2_____________________________ June 28, 1934
Wayne County Airport_____________________
20
Feb. 10, 1931
Detroit, Mich_______________ {~;;:i°tir1i;iJt~~~~~~~~~::================= -------~~--- ~u~~ lt
Douglas, Ariz _______________ Douglas Airport 2_____ _____ ____________ __ ___ _______ _____ Jan. 8, 1930
Duluth Minn
{Duluth Municipal Airport 2_____________________________ Sept. 4, 1931
'
----- -- ------- Duluth Boat Club Seaplane Base 2___________________________ do_______
1½ Mar. 5, 1930
Eagle Pass, Tex _____________ Eagle Pass Airport 2________________________
El Paso, Tex ________________ Municipal Airport__________________________
9
Aug. 23, 1932
Fairbanks, Alaska 1_________ Weeks Municipal Airfield _______________________________ Apr. 1, 1935
Glendale, Calif..____________ Grand Central Air Terminal 3__ ____ ______ ___ ____________ _______________

m~

g~~//~;{ir_

g~;!;.~

t~~g~lcz:~o~te:_ ============= ============ -~~~~0_ ~~~~~Juneau Airport 2____________________________
8
June 18, 1930
Ketchikan Airport 2__ _________ ______ ________ __ _______________ do_______
Meacham Field_ ______ ______________ __ ______
4
Dec. 20, 1927
Laredo Airdrome 2__________________________
3½ Jan. 24, 1930
Malone Airport 2________________________________________ Apr. 18, 1930
Pan American Field________________________
14 Oct. 16, 1928
Miami, Fla_________________ Dinner Key Seaplane Base 2_ _____ _ _____ ____
11 Mar. 7, 1930
{Viking Airport and Seaplane Base 2_________
4 May 16, 1934
7 June 27, 1929
Nogales, Ariz. ______________ Nogales Municipal Airport__________________
Ogdensburg, N. y __________ Ogdensburg Harbor 2 ___________________________________ Mar. 1, 1932
1 No medical officer of Public Health Service on duty.
2 Temporary permission.
O

_~~-~=========
Juneau, Alaska _____________
Ketchikan, Alaska __________
Key West, Fla______________
Laredo, Tex __ ______ ___ ______
Malone, N. y _______________


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

1

2

g

g

g

g

g

g

============ ============ ============ ============ ============ ============

0
0
0
0
O
0
_______________________________________________________________________ _
}
94
0
173
0
0
0
0
0
0
0
0
0
1
0
2
0
0
0
0
0
0
0
0
0
2
2
8
8
0
0
190
·190
1,131
1,131
410
9
______ _____ _ ____ ______________ ___ _______________ _____ _______ -----------257
257
1,237
1,237
217
0

----------ii- ----------ii- ----------ii- ----------ii- ----------ii- -----------o
0
0
8
20
2
3
961
170
115
1

0
0
8
20
0
3
961
170
115
0

0

0
16
50
4
12
18,999
455
217
2

0
0
16
50

0
0

0
0

0

0
0

1

0

0

12
18,999
455
217
0

(J

301
20
16
0

0
0
19

0
0
0

00

~

TABLE

Name of airport

Location

Pembina, N. Dak___________
Plattsburg,
N. y_1
__________
Portal, N . Dak
_______
______
Port Angeles, Wash _________
Port Townsend, Wash______
Put in Bay, Ohio 1__________
Rouses Point, N . y __ __ _____
St. Thomas, Virgin IslandsSan Diego, Calif_ ___________
San Juan, P. R ______ _______
Sault Ste. Marie, Mich _____
Scobey, Mont _______________
Seattle Wash
•
--------------Skagway, Alaska I __ - -- ----Spokane, Wash.I____________
Swanton, Vt.I _______________
Tampa, Fla _________________
Watertown, N. y_1 __________
West Palm Beach, Fla_ _____
Wrangell, Alaska ___________

Distance
in miles to
nearest
Public
Health
Service
station

Fort Pembina Airport 2_____________________
5
2--------------------------- -----------Mobodo
Airport_________________________________________
Portal Airport
2
Port Angeles Airport 2______________________
52
Port Townsend Airport 2____________________
6
Put in Bay Airport 2____________________________________
Rouses Point Seaplane Base 2 ___________________________
St. Thomas Airport 3_______________________ ____________
San Diego Municipal Airport_______________
6
Isla Grande 2____________________________________________
Sault Ste. Marie Airport 2_______________________________
Scobey Airport 2________________________________________
{Boeing 1'q:unicipal Air Field_________________ ____________
Lake Umon_________________________________ ____________
~:f~~ak!;!~ort 2--------------- -----------Spokane Municipal Airport 2____________________________
Missisquoi Airport 2 ____________________________________
International Airport 2______________________
7
Watertown Muncipal Airport 2_________________________
Roosevelt Flying Service Base 2_____________ ____________
Wrangell Seaplane Base 2_______________________________

rn~:~::~

Date
designated

1 No medical officer of Public Health Service on duty.
2 Temporary permission.
a Authorized for use but not officially designated.

~

of Number of Number of Number of
Number of Number
aliens in- Number of
airplanes
persons
persons
airplanes inspected
arriving
inspected spected by aliens cerarriving
by
Public
Public
tified for
by
Public
from
forfrom forHealth
eign ports
Health
Health
disease
eign ports
Service
or places
Service•
Service

Feb. 2, 1930
537
0
537
O
O
O
June
2, 1930
-Jan. 8,
1930
0
0
0
0
0
0
_____ do _______
0
0
0
0
0
0
June 18, 1930
0
0
0
O
O
O
Mar. 12, 1934 _______________________________________________________________________ _
July 14, 1932
0
0
0
0
0
0

_______________

52

52

630

630

0

O

Jan. 24, 1930
358
8
1,445
25
2
O
Jan. 19, 1929
246
246
3,107
3,107
427
1
Aug. 4, 1933
0
0
0
0
0
0
June 2, 1930
0
0
0
0
0
0
Sept. 11, 1928 }
459
0
1' 746
0
0
0
Dec. 27, 1928
_ Nova.;°' 1931 _ ------------ ------------ ------------ ------------ ------------ -----------June 2, 1931 _______ _____ ---------- - - ________________ ____ ____________ __ __ -----------July 18, 1930 ___ __________ _______________________________ ________________ ___________ _
Dec. 1, 1933
64
64
399
399
41
0
June 2, 1930 ____________ ------------ _______________________________________________ _
Mar. 10, 1931
99
99
170
170
12
0
Nov. 30, 1931
0
0
0
0
0
0

TotaL _________ __ _________________________ --------------- ----------- ______ -- -- -- -- -- -- -------- _


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

00

4.-Summary of transactions at continental and insular stations for the fisoal year 1935-Continued

4,081

2,636

34,135

30,249

1,991

31

00
trj

~

a

trj

85

PUBLIC HEALTH SERVICE
CANAL ZONE
TABLE

5.-Quarantine activities of the government of the Canal Zone during the
fiscal year 1935 1
Activities

Balboa

Cristobal

Total

-vessels boarded and passed_____________ ___ ____________ __ _______ __ _
-Vessels grante<l pratique by radio____ __ ______ ____________ ___________

2,777
31

3,392
148

6,169
179

Total number of vessels passed______________ ______ ___________

2,808

3,·540

6,348

1-----1-----1----t=====~=====I=====

:g:: ~:~~:~ ~;1~~~~~~~~~=========================================1-----1i6: g:~ - ----1----l~: ~~~
~g~
1

3
~~:
Total number of crew passed_____ ___ _________________________
155,371
267,216
422,587
t=====I=====~====
·Passengers passed at quarantine____ ________________________ ________
47,827
97,829
145,656
Passengers passed by radio______________ _________ ___ __ _________ ____
2,558
2,428
4,986
2

1-----1------1-----

Total number of passengers passed.-------------------------50,385
100,257
150,642
l=====~=====I=====
,Supplementary sanitary inspections of vessels .. ____________________
562
3, 112
3,674
·vessels fumigated with HCN gas__________________________________
14
34
48
·Box cars fumigated with HCN gas_________________________________
92
43
135
'Fumigation certificates issued to vessels___________________ ____ _____
·neratization exemption certificates issued__________________________
:Rodents recovered after fumigation______________ ________ __ __ ______

14
5
111

34
15
180

48

20
291

.Airplanes inspected and passed_______________________________ _____

127

459

586

-Crew of airplanes inspected and passed_______________ _________ ____
Passengers of airplanes inspected and passed__________ _____________

473
679

1,440
1,643

1,913
2,322

Vessels detained in quarantine__________ _______ ___ ______________ __ _
<Crew detained on board ship for quarantine_____________ ___ ________

0
0

0
0

0
0

1

Senior Surg. C. V. Akin, U.S. Public Health Service, detailed as chief quarantine officer.

MEDICAL INSPECTION OF .ALIENS
'l'ABLE

6.-Alien passengers and seamen inspected and certified at maritime ports
in the United States and possessions during the fiscal yeM 1935

Place

Alien seamen certified 1
Alien passengers certified 1
NumNumber of
ber of
alien
alien
passen- Class A
sea- Class A
men - - - Class Class
gers - - - Class Class
examB
C Total
B
C Total examined
ined
I II
I II
- --- - - - -- -- - - - - - - - - - - -

-

ATLANTIC COAST

Baltimort, Md ___ _________
54
Beaufort, S. c ____________
0
Boston, 1\,fass _____________ 5,123
Brunswick, Ga ___ _________
0
Charleston, S. c ___ __ _____
32
Fitll River, Mass __________
0
Fernandina, Fla __________
0
Fort Monroe, Va.2 ________
461
Georgetown, S. c _________
0
·Gloucester, Mass __________
0
Jacksonville, Fla _____ ___ __
53
Key West, Fla ____________ 5,160
Lewes, DeL _______________
0
Miami, Fla. ______________ 7,287
New Bed.ford, Mass _______
l
New London, Conn _____ __
9
Newport, R. !_ ___________
0
_ ew York, N. Y. (Ellis
Island) ____ --- ----- -- . --- 130,980

0
0
2
0
0
0
0
0
0
0
0
2
0
13
1
0
0

0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
139
0
1
0
0
2
0
0
0
46
0
28
0
0
0

0
0
12
0
0
0
0
0
0
0
0
2
0
1
0
0
0

29

38

5,887

16

0
0
159
0
1
0
0
2
0
0
0
50
0
42
1
0
0

10,097
0
51,917
191
2,696
70
0
9,083
0
417
1,629
1,140
0
8,941
12
0
0

5,970 39,1, 524

0
0
0
0
0

17
0
212
0
1
0
0
4
0
0
0
0
0
0
0
0
0

4
0
43
0
0
0
0
0
0
0
0
0
0
0
1
0
0

69
0
287
0
7
0
0
26
0
0
8
2
0
0
1
0
0

1 139

6

0

146

3
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0

45
0
31
0
6

0
0
22
0
0
7
2

1 Class A-I: Aliens certified for idiocy, imbecility, feeble-mindedness, insanity, epilepsy, chronic alco·holism. 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;tified for diseases or defects of less degree.
2 Includes Norfolk, Va., and Newport News, Va.


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

86

PUBLIC HEALTH SERVICE

6.-.Alien passengers and searrnen inspected and certified at maritime portsin the United, States and possessions diwing the fiscal year 1935-Continued

TABLE

Place

Alien passengers certified
Number of
alien
passen- Class A
gers
Class Class Total
exam- - -B
C
ined
II
I

·-

-

--

Alien seamen certified
Number of
alien
seaClass A
men
Class Class Total
exam- - - - B
C
ined
I
II

-- - - - -- -

-

-- -- --

ATLANTIC COAST-contd.
Perth Amboy, N . L ......
Philadelphia, Pa ..........
Plymouth, Mass ..........
Port Everglades, Fla......
Portland, Maine.- ---·· -·Providence, R. L .........
Savannah, Ga ...... . ... .. .
Searsport, J\,f aine ..... _....
Vineyard Haven, Mass ...
Washington, N. C ...... ..
West Palm Beach, Fla .. _.
Wilmington, N. C ........

2
195
0
522
55

0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0

4

56
0
0
0
24
0

0

--- Total. .... __ ........ 150,021 47 44
--GULF COAST

--

Boca Grande, Fla ........ .
Carrabelle, Fla............
Cedar Keys, Fla ....... . . .
Corpus Christi, Tex ..... ..
Galveston, Tex ........... .
Gulfport, Miss ............
Mobile, Ala ....... ........
New Orleans, La..........
Panama City, Fla .........
Pensacola, Fla ............
Port .Aransas, Tex....... _.
Port St. J oe, Fla ...... . ...
Sabine, Tex .............. .
Tampa, Fla ...............
Total. ... ·-·-···- · ··
P ACTFIC

COAST

Aberdeen, Wash ..........
Angel Island, Calif. (San
Francisco) ..............
Astoria, Oreg ............ .
Eureka, Calif. .. ... . ... .. .
Fort Bragg, Calif. ........
M arshfield, Oreg. (Coos
Bay)_ ........ . ..........
Portland, Oreg ............
San Diego, Calif. .........
San Luis Obispo, Calif. ...
San Pedro, Calif. .........
Santa Barbara, Calif. .....
Seattle, W ash.a ............
South Bend, Wash ........

2
0
0
7
42
0
25
3,035
38
9
0
0
13
316

0
0
0
0
0
0
0
9
0
0
0
0
0
0

--- 9
3,487
----

-

0
0
0
0
0
0
0
1
0
0
0
0
0
0

-

-

l

0
0
0
0
0
0
0
0
0
0
0
0

0
2
0
0
0
0
0
0
0
0
0
0

0
2
0

0
0
0
0
1
0
1
14
0
0
0
0
0
1

0
0
0
0
0
0
0
6
0
2
0
0
0
0

0
0
0
0
1
0
1
30
0
2
0
0
0
1

()

0
0
0
0
0
0
0
0

1, 152
16,101
83
1,041
3,251
G65
1,703
357
7
0
89
0

0
51
0
0
0
0
0
0
0
0
0
0

1
0
0
0
9
7
9
0
0
0
0
0

125

0
0
0
0
0
0
0
3
0
0
0
0
1
0

0
0
0
0
0
0
5
52
0
4
0
0
4
12

0
0
0
0
0
0
4
18
0
0
0
0
0
2

0
0
0

0
0
0

0
0
0
0
0
0
0

1
58
0
0

9
7
9
0
0
0
0
0

24

0
454
11,213
235
3,003
23,366
84
1,081
0
0
7,923
2,785

0

0
0
0
0
1
0
18
0
1
0
0
0
0

0
0
0
0
0
1
9
91
0
5

0
0
5
14

--- - - --- --- - - --- - - - 125
4 77
24
20
17
8
35 50,293
- - - - - - - - - - - - - -- - - - - - - -

0

0

0

0

0

0

636

0

0

0

0

0

7,167
24
0
0

0
0
0
0

3
0
0
0

124
0
0
0

40
0
0
0

167
0
0
0

1,648
1,478
0
0

0
0
0
0

32
7
0
0

2
0
0
0

0
7
0
0

34

0
26

0
3
2
0
3
0
2
0

0
0
4
0
4
0
6
0

0
0

0
0
0
0
3
0
29
0

0
3
11
0
117
0
59
0

864
646
5,956
266
49,178
0
12,227
1, 125

0
0
0
2
1
0
0
0
6 114
0
0
0 17
0
0

0
0
1
0
94
0
2
0

0
0
0
0
5
0
0
0

0
2
2
0
219
0
19
0

882

0
3,687
0
1,964
1

5

0
107
0
22
0

14

0
0

- - - - - - - --- -- - --- - --258
- -290
12
99
17
72
357 74,024
7 172
1
2, 999

----

Philippines:
Cebu .................
1
Davao ................
21
1
Iloilo .. . . . .. _. .. -- .. -. Jolo .... . .... ........ ..
33
Legaspi_ ... . ___ . ... . __
l
Manila...... ... .... . . . 20,477
152
Zamboanga_. _........

-

0
0

0
10

0
0
0
0
0
0
0

0
0
0
0
0
(jg

0

--- - 0 -68
--- - -

Total. .... . .....•... 20,686
3

0

0
4

- - - - - - -- - - - - - - - - - - 243
52
630
6,103
33 6,227 505,166 57 278
--- - - - - --- - ·- --- - - - -

Total .............. . 13,751 10
--INSULAR
Alaska: Ketchikan ........
Hawaii: Honolulu ........

0
3
0
0
0
0
0
0

Includes all ports on Puget Sound.


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

0
33

0
18

0
61

0
34,295

0
0

0
0
0
0
0
25
0

0
0
0
0
0
0
0

0
0
0
0
0
93
0

0
0
0
0
0
95
0

0
0
0
0
0
0
0

--- - - --- --- -

--- - - - -

-

- - - - - - - --- 25
93
95
0
0
--- - - - - --- -

-

0
23
0
0
0
0
0
0
0

0
5

0
2

0
30

0
0
0
0
0
0
0

0
0
0
0
0
0
0

0
0
0
0
0
0
0

--- - - - -

- 0 ---0 - -0 ---0

- --- - - - -

87

PUBLIC HEALTH SERVICE

6.-A.lien passengers and seamen inspected, and certi"fied at maritime ports
in the United States and possessions during the fiscal year 1935-Continued

TABLE

Place

Alien passengers certified
Alien seamen certified
NumNumber of
ber of
alien
alien
passen- Class A
sea- Class A
gers
Class Class Total men - - - Class Class
exam- - - examC
B
B
C Total
ined
ined
I II
I II
-- -- -- --- -- -- --

-

- -

Puerto Rico:
Aguadilla _____________
Arecibo _______________
Arroyo __ -------------Central Aguirre (Jobos) ___ --------- -- --Fajardo.-------------Guanica
_____ __ _______
Humacao _____________
Mayaguez ____________
Ponce._. ____ ____ -----.
San Juan ______________

4
4
0

0
0
0

0
0
0

0
0
0

0
0
0

0
0
0

81
30
28

0
0
0

0
0
0

0
0
0

0
0
0

0
0
0

0
42
56
0
89
30
5,686

0
0
0
0
0
0
0

0
0
0
0
0
0
0

0
0
0
0
0
0
6

0
0
0
0
0
0
1

0
0
0
0
0
0
7

0
114
469
56
548
544
14,526

0
0
0
0
0
0
0

0
0
0
0
0
2
0

0
0
0
0
0
0
1

0
0
0
0
0
0
0

0
0
0
0
0
2
1

---0 -0
5,911
Total, all stations ___ 196,856 66 140
Total. ____________ --

---

TABLE

- - - - - - - --- 6
1
7 16,396
0
- - - - - - -- - - - 6,442

132

6,780 680,269

68

-2
-552

- - -·
1

--0 - -3

--- -- - 372

86

1,078

7.-A.liens inspected and cert·ified, at -i nternational border stat';,ons during
the fiscal y ear 1935

Place

1 Number of
persons
making
permanent
entry
examined

Number of
persons
Total
making Other
tempo- persons ofnumber
persons
rary examined examined
Total
entry
examined

Aliens certified
Class A
I

II

- - - - - - - - -- - - - - - - - -

Class Class
B
C

--- --

MEXICAN BORDER

Ajo, Ariz __________________ __ _
0
Brownsville, Tex _____________
187
Calexico, Calif. ______________
258
Columbus, N . Mex __________
0
Del Rio, Tex ______________ ___
78
Douglas, Ariz _____________ ___
115
Eagle Pass, Tex ___ ___________
240
El Paso, Tex.I _______________ _
302
Hidalgo, Tex _________________
31
Laredo, Tex__________________ 24,252
Naco, Ariz __________________ _
29
Nogales, Ariz ________________
270
Presidio, Tex _________________
2
Rio Grande City, Tex ________
27
Roma, Tex ___ ________________
2
San Ysidro, Calif. ___________
311
Thayer (Mercedes), Tex _____
0
Tucson, Ariz _________________
0
Zapata, Tex __________________
57

0
108
54
37
0
0
0
8,413

Total.. ______ ---------- 26,161
CANADIAN BORDER

Bellingham, Wash ___________
Blaine, Wash _______________ _
Buffalo, N. y ________________
Calais, Maine ___________ : :.~-Chicago, Ill. _________________
Detroit, Mich __ ______________
Duluth, Minn ___________ ____
Eastport, Idaho ______________
Eastport, Maine _____________
Erie, Pa ______________________
Halifax, N. S., Canada _______
Havre, Mont _________________
Houlton, Maine ____ __________
1 Includes

----0
335
23
189
0
1,411
5
163
65
0
275
0
44

1,051
1
2,482
17
0
0
846
0
0
108

2,261
1,891
16,120
1,197
4,113
1,452
3,497
18,065
728
14,564
2,956
4,737
549
520
145
8,281
117
306
163

2,261
2,186
16,432
1,234
4, 191
1,567
::i, 737
26, 780
764
39,867
2,986
7,489
568
547
147
9,438
117
306
328

0
93
73
0
1
95
36
1,977
163
302
214
498
135
29
42
154
19
80
1

13,122

81,662

120,945

3,912

5

0
0
445
-- . 00
1,464
447
206
0
0
232
17

71

3
7
14
12

·o·

0
0
6
l
21
0

0
17
40
0
0
27
3
200
38
28
30
47
16
13
2
22
3
51
0

0
51
1
0
0

24
18
1,515
62
265
58
253
45

0
24
23
0
1
42
14

20
126
7
3
1

191
60
2
112
186
74
6
20
0
8
5
0

537

2,459

768

0
3
12
2
4
32
0
1
0
0
3
0
1

0
26
48

0
42
17
4
1

10

-- ------148

0 1
0
0
0
91
20
783
448
517
102
25
49
- . - . ·5 . · - - 194 - .. 20 -- ·· 3 24
24
16
5
3,608
118
733
625
2,172
5
2
1,720
26
0
1
370
0
62,465
62,530
5
0
0
0
0
267
1
71
578
17
0
0
0
4
120
5
50

26
Fort Hancock, Guadalupe Gate, and Ysleta.


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

0
1
9
0
0
2
1

-------

11

6
475
3
22
0
0
93
0
0

0
0
3

5
0
170
0
0

88

PUBLIC HEALTH SERVICE

TABLE

7.-A..Uens inspected and certified at international border stat-ions during
the fiscal year 1935-0ontinued

Place

Number of
persons
making
permanent
entry
examined

Number of
persons
Total
making Otl;ler
tempo4 persons ofnumber
rary i examined persons Total
examined
entry
examined
--- ---- ---- ---

International Falls, Minn ____
28
Jackman, Maine ___ __________
54
Lewiston, N. y __________ ___ _
17
Malone, N. y ________________
12
Montreal, Canada ____________ 1,951
Newport, Vt _________________
160
Niagara Falls, N. y __ ________
197
Noyes, Minn _________________
4
Ogdensburg, N. y ___ _____ ___
14
Oroville, Wash _______ ________
170
Portal, N. Dak _______________
2
Port Angeles, Wash ____ ______
0
Port Huron, Mich ___________
134
Quebec, Canada _____ -------603
Rouses Point, N. y __________
139
St. Albans, Vt _______________
23
St. John, N. B., Canada __ ___
342
Sault Ste. Marie, Mich _______
0
Scobey, Mont_ ___ ____________
0
Sumas, Wash ________________
21
Sweetgrass,.Mont_ ___________
119
Van Bure'n ,>Maine ___________
26
194
V anceboro, Maine ___________
Vancouver, B. C., Canada ___
0
Victoria, B. C., Canada __ ____
153
w innipeg, Man., Canada __ __ 1,475
Yarmouth, N. S., Canada __ __
0
TotaL _____ ___ --- __ ----

2,978
0
938
3
0
143
319
0
6
0
0
0
196
2,190
0
0
203

274,277
133
22,362
50
1,951
504
1,348
20
20
26,329
35
0
865
3,465
433
62
545
1
14
90
1,671
38
1,190
462
273
5,900
25

36
55
35
12
360
130
45
11
3
0
8
0
149
274
40
16
22
0
0
19
0
1
0
108
56
1,313
22

13,455

391, 173

412,976

3,877

26,577

472,835

533,921

7,789

l

--8,348
---

Total, !\II stations ______ 34,509

TABLE

14
49
1,552
12
980
462
120
444
8

271,271
79
21, 407
35
0
201
. 832
16
0
26,159
33
0
535
672
294
39
0
0
0
20
0
0
16
0
0
3,981
17

Aliens certified
Class A
I

II

Class Class,
B
C

-- -- --- -7
2
3
5
37
2
6
2
0
0
3
0
14
0
8
4
5
0
0
4
0
0
0
7
6
9
1

0
0
0
0
0
0
4
1
0
0
0
0
3
1
2
0
0
0
0
1
0
0
C
9
1
11
3

25
11

19
0
309
16
33
8
2
0
4
0
96
210
25
9
10

0
0
13
0
1
0
82
18
1,083
18

4
42
13
7
14
112
2

0
1
0
1
0
36
63.
5
3
7·
0·
0,
1
0,
0
0,
10
31
210 ·
0-

-- --303- - 94- -2,ll76
804
-- =
-451- -631- -5,135
1, 572 ·

8.-A..Uen seamen inspected and; certified, at mternational border stationsduring the fiscal yea,r 1935
Alien seamen certified
Number o f t - - - - - - - - - - , , - - - - , - - - - - , . - - - alien
Class A

Place

seamen.

examined

1------,-----1

I

Class B

Class C

Total

II

---------------1-----1---- ---- ---- ---- ---Bellingham, Wash___________ __________
Brownsville, Tex_______________________
Buffalo, N . Y ----------- -- - --- --------Chicago, Ill____ ___ _________________ ____
Duluth, Minn___________ _____________ __
Eastport, Maine______ ______ ___________
Erie, Pa________________________________
N. N.
Y -----------------------Lewiston,
Ogdensburg,
y______ ____ ____ ___ __ __
Port Angeles, Wash_____ ____ _________ __
Port Huron, Mich___ ______________ ___ _
TotaL________ ___________________


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

171
9

14,563
432
68
301
187
152
168
79

163

,-----,
16,293

0
0
0
0
0
0
0

0

0
0
3
4
0
0
0
0
0
0
1

10

0

8

90

0
0

0

0
0
65
15
0
0
0
0
0
0

0
0
70
1
0
0
0
0
3
0

0

0•
O•
138
20

0·
0
O•

0

3

o-

11

-----74
172.•

89

PUBLIC HEALTH SERVICE
TABLE

9.-Number and character of the manda.torily ea:cludab-le oonditions certified at United States ports during the fiscal year 1935

'"'"'

~-t:

0 Cl)
l>,a)
.._. A

--,c,
:;:la:,
o,c,
,a
__

~
~

- .....
a)
I>,

o.J:l

;al
H

Alien passengers ___
Alien seamen ______

TABLE

-;·.....

a)

~ 0

A

a:,

I>,
0

A

.§ ~

::::=

0.

...

0,,2:l

:3:s
::, ....
t>
-adi ~~t
A.cl'"'
] 0ooo

0'

·s
CA

0

'Cl

.;;

-~0

.0

0
0

a)

.;;

0

a)

s

l:l
p;l
~
E-<
- - - - - - - - _2__ - -

91
0

58
3

82
0

110
1

78
5

29
0

~S,c,

di

.cl

"O"'::l

a)

~A

0

;:::

~

di

::,

di

.cl

.cl

0

~
A

-::::=~

0
.cl

~
.a

0

~ Q)•;

a)

di

'3

"i:l

1i:i

gi

~ 8gj

-~

A

0

0
00

8

00

204
16

211
143

e,

di O l1l

.cl 0

.cl O 03

s

0

E-<

s...+;i,•-

aldlbL

.............

0

-- - - - - - - -~ - -

114
16

5
90

54
48

252
306

1,288
628

10.-Summa;ry of medical inspection of a.Uens, fiscal year 1935
MARITIME STATIONS

GROUP 1.-A LIEN PASSENGERS NOT EXAMINED ABROAD EXAMINED UPON ARRIVAL

Total
examined

Class

First_ ___________________________________
Second _________ ___ ______________________ 68,987
19,240
Third _____________ --- --- __ ------- ------- 88,118
Stowaways _______________________ -- ____
413
3,335
Warrant cases __--------- --------------TotaL ____________________________ 180,093

Intensively
examined

Certified on arrival

Total
certifled

Passed
A-I

A-II

B

- - --- - -

--- --- -- -857
434
3,680
324
1,663

IO

68,638
18,923
86,176
3£0
3,142

317
292
1,760

3
2
90
7
38

2
16

0
36

C
19
21
76
5
5

11

114

349
317
1,942
23
193

- - --- ---140- -2,494
---- ~---- --64
126
2,824
6,958 177,269

GROUP 11.-ALIEN PASSENGERS EXAMINED ABROAD REEXAMINED ON ARRIVAL

Total
examined

Class

Intensively
examined

Passed
on
arrival

Passed
abroad

--- --First _____________ --- -- -- -- -- - _
Second __ ___________ _________ __
Third __ _____ ---_-_--- --- --- --TotaL __________________

5,872
1,842
9,049

137
83
121

5,659
1,332
6,826

Certified on arrival
(condition noted abroad)
A-I

--- -1
0
0

5,651
1,331
5,825

A-II

Number
certified
- -· - - - - B

--

0
211
0
610
0 3,219

C

1
0
4

----12,807
---------- - -5 --16,763
341
12,817
1
3,946
0 3,940
Certified on arrival
(condition not noted abroad)

Class
A-I
First_____________________________________________
Second ___________________________________________
l'·llird ____ ---- ----------- __________________ __ _____

TotaL ___ ------------------ ----------------


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

213
510
3,223

A-II

B

Number
certified

C

Total
certified

- - - - - - --- - - - - ---1
0
0

0
0
0

6
1
1

------1
0
8

1
0
0

8
1
1

221
511
3,224

1

10

3,956

PUBLIC HEALTH SERVICE
GROUP III.-ALIEN SE.A.MEN EX.A.MINED ON ARRIVAL

Total
examined
Alien crew __ ------------------ __________ 680,083
W orkaways _____________________________
186

IntenCertified
Total
sively
certiexam- Passed
fled
A-I A-II
B
ined
C
--- --- -- -- -- -- -210, 743
36

551
1

68
0

679,007
184

372
0

1,076
2

85
1

---- ---- - - - 68- -552- ------210,779 679,191
1,078
372
86

Total. ____ _____________ ____ ______ _ 680,269

CANADIAN AND MEXICAN BORDER STATIONS
GROUP l.-ALIE'N PASSENGERS NOT EX.A.MINED ABROAD EX.A.MINED ON ARRIVAL

Total
examined

Class

Statistical, making permanent entry
(bona fide immi grants) ________________ 34,378
.Statistical, making temporary entry _____ 24,069
N on3ta tistical, making entry (local
crossers, etc.) ______________ ____________ 469, 129
arrant cases ________ ___ ________ ___ _____
3,032

,r

IntenCertified on arrival
sively Passed
examA-I A-II
B
C
ined
--- --- -- -- -- --

Total
certifled

--

31,555
6,557

32,920
22,371

124
104

34
89

958
1,242

342
263

1,458
1,698

47,780
2,909

465,205
2,401

107
116

317
191

2,616
243

884
81

3,924
631

88,801

522,897

451

631

5,059

1,570

7,711

---- - - - - - - -- -- --- --- --

"rotaL _-- ___ __ ____ _-------------- __ 530,608

GROUP IL-ALIEN PASSENGERS EX.A.MINED A.BROAD REEXAMINED ON ARRIV.A.T.

Total
examined

Class

·-

Statistical, making permanent
entry (bona fide immigrants)_
Statistical, making temporary
entry __ __ __ _____ ___ _____ _____
Nonstatistical. making entry
(local crosser~, etc) __________
Total. _______ ________ -- -·

--

Intensively
examined

Passed
abroad

Certified on arrival
(condition noted abroad)

Passed
on
arrival

A- I

A-II

B

-

--

--

·- - - - - - - - - -

Number
certified
-- --C

132

131

106

104

0

0

26

0

2,508

1,787

2,504

2,477

0

0

4

0

4

f73

673

673

654

0

0

0

0

0

26

---- 2,591
- - - 3,283
- - - 3,235
- - - -0 --- 30- - ---3 313
0
0
30
Certified on arrival
(condition not noted abroad)

Class
A-I

A-II

B

Number
certified

C

- - - - - - - -Statistical,
making
permanent
entry____
(bona
fide-______ ___
_______ _______
_______
immigrants)
Statistical, making temporary entry __________ ____
N onstatistical, making entry (local crossers, etc.)_
TotaL ______ ___ ________ -- - - -- _- ------ - -----


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

0
0
0

0
0
0

0
27
19

2
0
0

Total
certified

---- ---2
27
19

--

28
31
19

------------ -0 --0
2
46
48
78

91

PUBLIC HEALTH SERVICE

TABLE 11,-Distribution, Q,()COrding to class, of applicants for immigration ,v~as

who were medicalvy examif!,ed during the '[i,scai year 1935
Number of applicants Percentage of applicants
Total
in each crass
in each class
number
of ap- 1 - - -- , - - - - , - - - - 1 - - - - - - - - - , - - - plicants
Nonron- immi- Quota NonQuota qubta
exquota , grants
grants
amined

Country and consular office

~!i-

- - - - - - - - - - - - - - - --1-c-- - - -. -..- ,-

- -- - - - - - - - - -

WESTERN HEMISPHERE

-Ouba: Habana __ ____________________ ___ __ __ _

251

,485

3,' 122

6,:646

1,603

639

2,248
1,675
187

1,896
493
978
:653
. 1;638
1803
: 185

992

1,285
322
610
264
2

All countries, Western Hemisphere_ ___ 12,110

3,373

. 585
1,326
. 243
' 172
241
5,451

739

34.0

65.6

.4

27. 5

~8. 4

;J,4. 1

18.1
0
56.8
32. 9
27.1
15. 8
1.0

53.8
100. ff
43: 2
66. 8
72.9
47. 9
99.0

28.1

0
3
0
608
0

1;131

1,606

27. 8

58. 9

108
639
276
66
203
677

0
0
5
0
1
0

84.4
67.4
46. 6
72. 2
54. 2
87.4

15. 6
32.6
5:2. 5
27.8
45.6
11.0

0
0

159
205
313

0
0
0

90. 2
84. 3
90. 2

9. 8
15. 7
9.8

0
0
0

0
0
0
0
0

90. 5
62.3
74. 2
59. 2
61. 6

9. 5

37. 7
25.8
40.S
38. 4

0
0
0
0
0

0
0

56. 6
66. 8

43.4
33.2

0
1
0

30.0
55.0
90. 9

70.0
45.0
9.1

7

61. 3

38. 6

- - - - ~- - - - - - - ---------

•Canada, totaL ___ ----- --- ------------------- 11,371
Montreal_ _____________ __ _______________ _ 3,527
-- ----- ----___
-- _______
-- -- ----_
493
Quebec
Toron.to___
__________
_______--____
________
2,263
Vancouver ______________________________ .
978 .

~f~~f~g------------------------------Yarmouth ______________________________ _

0

0

'.

o.

0
,3

o·

36.3
0

~

EUROPE

Belgium: Antwerp ___ ____ __________________ _
England: London ___ ____ __________________ __
Irish Free State: Dublin __ ____ __ __ ___ __ ____ _
Northern Ireland: Belfast ___ ____________ ____
Scotland:
__ ------ --------~-------Germany, Glasgow
totaL _______
_________
____________ _

693
1,965
524
238
445
6,128

-- --- Berlin _______ _____ ·___ __________________ _ -1,645
1; 486
Hamburg ______ _____________ ________ ____ _ 1,305
1,100
Stuttgart _________________ __________ __ __ _ 3,178
2, 865

- --Holland: Rotterdam ________________ ___ ____ _ - -787
712
1,360
Poland: Warsaw_-- ------------ ------------- 2,182
279

- - - - - - - - --- --75
822

487

207
266
300

183
187

249
238

141
159

108
79

7,659
1,026
1,006

2,301
565
914

5,358
460
92

All European countries_______ __ _______ 23,868

14,643

9,218

449

~~~:a~~b~~~~~~-~~~~===========
===========_ ·
Sweden,
t otaL ___ ____________ __ _____________
Goteborg ______ ___ _______ _______________ _
Stockholm _____ _________________________ _

- - - - - - --- - - -

72

Italy: Naples _____________________________ __ _ - - - --- - -Czechoslovakia: Prague ____________________ _
Austria: Vienna __ -- ------- -- 0 - - - - - - - - - - - - - - - -

.9
0
.2
0

- - - - - - - --

'

0
0

--0
0
0

. 03

12.-Distribution according to sea: of applicants for immigration visas who
were medically ea:amin,ed and notified, for disabilities during the fiscal year
19.35

TABLE

t

Number of
each sex
examined

Percentaie 'of
each sex '
examined

Percentairn of . Percentage of
males notified · females notified

Female

Class . Class Class Class
A con- B con- A con- B con•
ditions ditions ditions ditions

for-

for-

Country and consular office
Male

Female

Male

- -- - -- - -------1--- - - - - - - - -- - - - - - - - - - - -WESTERN HEMISPHE;RE

Cuqa: Habana ____________ _______ __

60'. 9·

39.1

8. 9

17. 8

5. 5

15. 2

-Canada, totaL____________ _________ 5. 854. 5,517
51. 5
-------Montreal_ _____________________ _ -1,738
49.3·
1,789
Quebec ____ ________ ______ ______ _ · 227
266
46. 0
1,253
l,
010
55.4
Toronto_----------------------Vancouver ________ ______ _______ _
· 43.1
422
556
V{indsor _______________________ _ 1,209
1,039
53.8
Winnipeg ______________________ _
946
729
56. 5
Yarmouth ____ _______ __ ________ _
59
128
31. 6

48. 5

.8

12. 5

.7

~

54. 0
44. 6
56. 9
46. 2
43.5
68. 4

.4
.7
.2
.7
I. 6
0

11.9
6.6
10. 7
19. 7
11. 1
23. 7

0
1.9
.4
.9
.8
0

16.9
6. 6
8.2
21.4
8.4
21.1

48.0

1. 4

12.8

1.0

13.2

Allsphere
countries,
Western
Hemi- _
____________
_________

20980-35-7


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

450

289

-----6,304

--- =

5,806

52. 0

-----------50. 7
12.5
.8
14. 3
.2

- - - --- ------ =

- - - - -- =

92

PUBLIC HEALTH SERVICE

·TABLE 12.-Distribution·, according to sea: of applicants for immigra,tion visas who
were m'e dically ea:ainined and notified; for disabilities during 'the fiscal year

1935-Continued. ·
Percentage of
males notified
for-

Percentage of
each sex .
examined

Number of
each sex
examined

-

Percentage of
females notified
for-

Country and consular office
Male

Female

Male

Female

Class Class Class Class
A con- B con- ·Aeon- B conditions ditions ditions ditions

- - - - - - - - - - - - - - - - - - --- - - EUROPE

Belgium: Antwerp _________________
England: London.---··· ---- -- ----·
Irish Free State: Dublin __________ -·
Northern Ireland: BelfasL----~---Scotland: Glasgow __ -··----·------Germany, total-------------·----:.-Berlin_----- ------·- _________ · __
Harn burg _______ -· ___________ ...
Stuttgart __ ·---·--·------·----··

406
863
165
78
144
2,674

287
1,102
359
160
301
3,454

58.5
43.9
31.2
32. 7
32.3
43.6

41. 5
56.1
67.5
67.2
67.6
56.4

.9
.8
1. 2
0
1. 3
1.0

26.1
4.8
19. 3
19.2
20.1
21. 7

1.3
.2
8
1.8
1. 3
.7

27.5
2. 7
19.5
26.6
18.9
24.8

609
1,317

696
1,861

46.6
41.4

53.4
58.6

1.8
.9

19. 0
22.8

.5
.6

24. 2
20.5

980
134
177
:213

1,202
145
272
274

44.9
48.0
39. 4
43. 7

44.8
55.1
52.0
60.6
56.3

1. 6
.7
1. 6
2.3

20.5
28.3
21.4
26.3

2.3
0
.7
0

24. 6
25.5
19.1
·21.5

102
2,859
439
412

136
4,800
587
594

42.8
37.4
42.6
40.9

57.2
62.6
57.4
59.1

1.9
4.1
1. 6
.2

26.4
15.5
17.8
15. 0

0
6.8
2.0
1. 5

18.3
19.2
21.6
17. 5

9,979

13,889

41.8

58. 2

2. 0

19. 2

2. 7

20.3

- - - --- --- --- --------45. 0
55.0
748
897
.8
35.0
34.0
1.2

------435
352
55. 2
Rotterdam.-----------·--

Holland:
Poland: Warsaw_-··--·----·------Denmark: Copenhagen-----·-··---Norway: Oslo_---·-· -·-·-----·----Sweden, total ___ ·-._._ - ___________ -·

Goteborg _____ ·-·-- _____________
Stockholm __ ._._----· ______ -·- __
ltaly: Nap\es .. --- ---- .. _______ : ____
Czechoslovakia: Prague_- -----,---Austria: Vienna------ ~----·---:··-All European countries.---··-

--= 22. 2 -----.2
1.1
25.5

- - - - - - --- --- --------44.6
55.4
111
·138
2. 7
26.1
24. 6
0

- - - --- --- - - - - - - - - - - - - ---

TABLE 13.-Nu·mb·e r and percentage of quota and nonquota applicants exa;mined
1

who wer~ notified for different classes of disabilities during the fi,scal yearr 1935
Quota

'
.•

Country

)

,,

Total Number notified fornumber
quota
applicants
exam- Class Class
ined
B
A
condi• conditions tions

--- -- --

Nonquota
Percentage of
total examTotal
ined who
number
were notified
nonforquota
appli~nts
Class Class· exam.A
.B
condi- condi- ined
tions tions

Percentage of
examNumber noti- total
ined who
fled forwere
notified
,,.
for-

c :1ass Class Class
A
A
B
condi- cottdi- condi- conditions tions tions tions
Class

.~

- - - - - - - - - - - --- - -

;wi:sTERN _H EMISPHERE

54
30
251
Cuba' --- ---- · -----·---· ·
28
412
3,122
Oan~a---···. _. -·-··--··
------All.countries, Western
Hemisphere _________
466
58
3,373
EUROPE

Belgi'um __ .. _. ___________
England ___ . _____________
Irish Free State_-----·-Northern Ireland __ ..... _
Scotland ........... . .....
GermanY--···········
-··
Holland
___ ·- ____________
Poland __________________
Denmark ____ ._·- ____ . ___
N orwaY-·-·- ·-·-····· --·
Sweden.. ·-· -· ·· . . _..... _
-Italy,__--·····-·-·· ······
Czechoslovakia._._ .. -·-._
Austria._ .. ·- .... -· . . ·- __
AU European countries_

----585
1,326
243
172
24l
5,451
712
1,360
207
266
300
2,301
565
914

6
7
3
3
5
34
4
26
1
3
2
94
12
8

154
53
54
41
51
1,377
163

352
50
48
65
700
140
149

12.0
.9

21. 5
13. 2

485
6,646 .

25
47

68
909

5. 2
.7

14. 0
13. 7

1. 7

13.8

7,131

72

977

1.0

13. 7

1.0
.5
1. 2
1.7
2.0
.6
.5
1. 9
.4
1.1
.6
4. 0
2.1
.8

26. 3
3.9·
22.2
23.8
21. 1
25. 2
22. 8
25.9
24.1
18.8
21. 6
30.4
24.6
16. 3

108
639
276
66
203
677
75
822
72
183
187
5,358
460
92

.2

31

1.8
.4
.7
0
.4
3. 2
1.3 .
2. 2
0
1.0
1. 6
5. 6
1. 5
2.1

28. 7
2.9
17.1
22. 7
· 17. 2
24. 0
32. 0
17.6
34. 7
21. 8
26. 7
10.5
14. 3
19. 5

- -- - --- - -- -- - - - - - - - - - - - - -- - - 3

19

2

47
15
35
163
24
145
25
40
50
670
66
18

0

1
22
1
18
0
2
3
303
7
2

-· - - --- - - -- - - -- -- -208
- -3,397
--14,643
1. 4
23.2
9,218
366 1,348
14. 6
3. 9
) '


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

t·

!

:· PU:S.LIC HEALTH SEB,VIOE

· TABLE 14.-Percentage distripution of total quota. and nonquota applicants of
each sew examined who were not.ified for diff eroot classes of disabiUties during the fiscal year 1935
·
Quota
Country

Male

;

Nonquota
Fei:nale

Male

Female

Class A Class B Class A Class B Class A Class B Class A Class B

--- ---

- -- - - -

--- - - -

WESTERN BEMISPBER:B:

Cuba ___________ ____________
Canada ____ _________________
AllHemishpere
countries,_____________
Western
EUROPE

9.6
1.3

17.8
14.4

1. 7

13.3

1.8

14.6

5.9
.9

13.8
14. 4

1.3

14.4

0
.9
1.3
0
1. 3
3.9
0
1. 7
0
l. 5
3. 3
4. 4
1. 1
3.3

39.1
3.8
20.0
25.0
22. 7
23.9
27. 6
18. 4
50.0
28. 5
27.8
9. 2
12. 2
12.1

~

r;:r;en----------------r-Czechoslovakia _____________
All European countries ___

23.0
12.5

---

Belgium ____________________
England ______ -_------ __ --- Irish .Free State___________ __
Northern Ireland ___________
Scotland.-~~ -- ______ • ________
Germany _______ ____________
Holland ___ _--- ----------- -Poland ____ ___ ________ ___ ___
Denmark ___________________
Norway __• _________________

Austria_---------------- - ---

12.9
.7

4.2
.6

U.4
13.1

.8

===

3.2
0

20.9
2.1
15. 9
21.4
16. 6
24.-1
39. 2
17. 2
22. 2
18. 3
25. 7
14.2
15. 6
23. 7

--- ------ - - - --- --- - - - --1.1
.7
1.1
0
1. 5
•7
.2
1. 6
1.0
1. 7
1. 6
3.4
1. 9
0

24.4
5.4
19.3
16.6
22. 7
25.'6
21.6
21. 3
21.0
17.5
25. 2
28.1
21. 5
i5.3

.8
.3
1. 2
2.5
2. 2
.4
.9
2. 3
0
.6
0
4.5
2.3
1.4

:

29.3
2.9
23.8
27.1
20. 5
24.9
24. 3
30. 7
27.1
19. 7
19. 2
32.0
27. 4
16. 9

=

.4

0
0
2.8
3.9
2. 4
0
.8
0
6.3
1. 7
1. 6

13.2

- -1.- -4.4- - ---- --------5
3. 3
13. 3
1.3
22. 4
15.
23.9
4

15.-Number and percentage of applicants examined wh-0 were notified
and refused visas on medical notification f or different classes of disabilities
dwring the fiscal year 1935

TABLE

Country and consular office

Percentage of
applicants
Nnmber noti- · examined
who
fled forwere notified
for-

Number of
visas refused
for-

Percentage of
applicants
examined who
were refused
visas for-

Class A Class B Class A Class B Class A Class B Class A Class B
condi- condi- condi- condi- condi- condi- condi- conditions
tions
tions
tions
tions
tions
tions
tions
- -- - - - - - - - - - - - - - -

---

WESTERN HEMISPBltRE

Cuba: Habana _________________ i_____
Canada, total. ______ ------ --------- Montreal __________________ _____
Quebec _____
----- -_-- -- -- --______
-_--_-Toronto
• ____________
-Vancouver __________________ ____
Windsor __________ ____________ __
Winnipeg _______________________
Yarmouth __________ _______ _____
All countries, Western Remis-

phere_ ----------------------

56
89

--18

124
1,453

7. 6
.8

16.8
12.8

.2
2
.3
.8
1. 3
0

13. 4
14. 6
6. 6
9. 3
20. 5
9. 9
21. 9

--.5

18
21
0

473
72
150
91
460
166
41

145

1,577

1. 2

8
10
5

185
72
101

1.1
.5
.9

1
28
3

---

1.


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

58
612

7.6
.8

7.8
5. 4

1
28
3
18
21
0

20
10
.4
220
95
22

.2
1. 2
.3
.8
1. 3
0

6.8
4.1
.4
.4
9. 8
5. 7
11.8

13. 0

143

670

1. 2

6.5

26. 6
3. 6
19. 2

8
10
5

81
28
12

1.1
.5
.9

11. 6
]. 4
2. 2

- -- - -- - - - - -- - - - =

EUROPE

Belgium: Antwerp ________ _____ _____
England: London __ __ ___ ___ • ____ __ __
Irish Free State: Dublin _____ _____ __

56
87

- - 16- --- - .5241

- -- - - - - - - - - - - - -

94

PUBLIC HEALTH SERVICE

15.-;--Number and percentage of applicants examined who were notified
and refused. visas on medical notification for different classes of · disabiUties
,d uring the fiscal year 1395-Continued

TABLE

1

l
!

l
Country and !consular office

Number noti•
fled for-

Percentage of
applicants
e,xamined who
were notifi,ed
for-

Number of
visas refused
for-

Percentage of
applicants
examined who
were refused
visas for-

:

Class A Class B Class A Class B Class A Class B Class A Class B
, condi• condi• condi• condi• condi· condi• condi• condi·
tions
tions
tions
tions
tions
tions
tions
tions

- - - --- - - - --- - - - - - - --Northern Ireland: Belfast..••••••... :
Scotland: Glasgow•••.•••.••••••• _._ ·
Germany, total. ••.• ____ •• _. __ • ____ • 1

,3
6
56

........-+--

17
15
24

Berlin ___ ----------------------llamburg
_______________________
Stuttgart. ______________________

56.

14
3
261

1. 2
L3
.8

5.8
.6
4.4

21.8
21.4

16
24

2
25

1.1
.7

.1
.7

23. 7
22.8
26.8
20.0
23. 6

5
44
1
5
5

88
110
20
34
40

.6
2.0
.3
1.1
1.0

11.1
5.0
7.1
7.5
8.1

56
86
1, 540

1. 2
1. 3
.9

23.5
19.3
25.1

285
683

1.1
.7

187
497
75
88
115

.7
2. 0
.3
1.1
1.0

52

.8

3
6

!

- .-.- ------------34.0
234
LO
572
1. 0
16
15.0

.- - - - - - - --- - - - - - - --- - - Rotterdam ________________ : -

'Holland:
Poland: Warsaw_.___________________
Denmark: Copenhagen _____________
Norway: Oslo ___ ------------------Sweden, total. ________ ---- -- ------ __
Goteborg __ _____________________
Stockholm ______________________

5
44
1
5
5

---------3 -----3 ----17
1. 2
25.3
1. 2
63
6.9
2

Italy: Naples _______________________ - 397
19
Czechoslovakia: Prague ____________
Austria: Vienna ____________________
10
All European countries _______

--- --1,370
5.1
206
167

1.8
.9

4,745

2.4

--- --- =
574

21.4

2

23

.8

9.6

17. 8
20.0
16.6

397
19
10

65
37
34

5.1
1.8
.9

3.6
5.3

574

827

2.4

3.5

.- - - - - - - - - - - =

- - - --- - - - =

= 19.9

.8

16.-Percentage distribution :of the total quota and nonquota applicants
notified, for each class of disabilities who were refused msas on medioal
grounds during the fiscal year 1935
·

TABLE

Quota

Number
notified

Country

Nonquota

Number refused visas

Percentage
of notified
cases refused visas

Number
notified

Number refused visas

Percentage
of notified
cases refused .visas

Class Class Class Class Class Class ·Class Class Class Class Class Class
B
A
A
B
A
A
B
A
B
B
B
A

-- -- ---- -- -- -- -- -- -- -WES'l'ERN HEMISPHERE

Cuba _______________ --- -•Canada _______________ --.All countries, Western

Hemisphere ___ ____ ___
EUROPE

Belgium. ________ ________
England_. ___________ ____
Irish Free State __________
Northern Ireland _________
cotland _________________
Oermany
_--------------Holland __________
________
:Poland ___________ _____ ___
Denmark ________________
Norway____________ ______
-Sweden __________ ____ ---Italy _____ ---------- -- ---Czechoslovakia __________
.Austria_----------------All European countries.

68
909

25
47

29 100
407 100

42.6
4t8

72

977

72

436 100

44.6

2
3
2
0
1

31
19
47
15
35
163
24
145
25
40
50
670
66
18

2
3
2
0
1
22
1
18
0
2
3
302
7
2

7
5
5
2
2
12·
4
14
6
9
10
3S
10
2

366 l, 348

364

126

28

54
412

30
28

29
162

100
100

53. 7
39.3

25
47

58

466

58

191

100

41. 0

6
154
7
53
3
54
41
3
51
5
34 1,377
4
163
352
26
1
50
3
48
2
65
94
700
12
140
8
149

6
7
3
3
5
34
4
26
1
3
2
94
12
8

74
23
7
12

1
249
84
96
14
25
30
2;
27
32

100
100
100
100
100
100
100
100
100
100
100
100
100
100

48.0
43.3
12.9
29.2
1-9
18. 0
51. 5
27.3
28.0
52. 0
44. 6
3.8
19.0
21.4

1
18
0
2
3
303
7
2

208 3,397

208

701

100

20.6

30

--

----------

- - - - - - - - - - --- - - - - -- - - - - - -

22

- - - - - - - - - - - - - - - - - - - --


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

100
100
100
0
100
100
100
100
0
100
100
99. 6
100
100

-99.4

22.5
26.3
10.6
13. 3
5. 7
7.3
16.6
9. 7
24. 0
22.2
18.0
5.6
15.0
17.1

-9.3

PUBLIC HEALTH

95

ERVICE

17.-Nmnber and percentage of male and female applicants notified for
class B disabilitieg, who were refused visas on medicai grounds during t!i,e
fiscal year 1935

'rABLE

Country and consular office

Percentage of sp,,plicants notified
Numberofappli- Numberofapplicants refused
were refused
cants notified for visas
for class B who
visas for class B
class B conditions
conditions
conditions
Male

Female

Male

Female

Male

Female

- - - --- --- --- - - -

WESTERN HEMISPHERE

Cuba: Habana._ ---------···-·-················
Canada, total.,---------·······-·····---·-·····
Montreal. ______________ ._·---.•. -- ------ -Quebec ______________________
---------------------------------Toronto
--_------------ Vancouver _____________ ------------------ -Windsor _____________ -- ----------------- --Winnipeg _____________ - _-_--- --. ----- . ----Yarmouth ____________ ----------- -- ---- ----

80
729

44
724

42
338

16
274

52. 5

217
27
83
45
105
14

256
45
67
46
222
61
27

113
9
9
3
136
61
7

128
11
1
1
84
34
15

52.1
33.3
10.8
6. 7
57.1
58.1
50.0

37. 8
55. 7
55. 6

All countries, Western Hemisphere ______

809

768

380

290

47. 0

37.8

Belgium: Antwerp _______ ______ -------------· -England: London _______________ ._. -- ____ -- ____
Irish Free State: Dublin.----------··-------- -·
Northern
Belfast. ___ ----- --- --- --- . -..
Scotland: Ireland:
Glasgow _____________________________
Germany, total---------·······················

106
42
32
15
30
681

79
30
69
41
5C
859

54
18
5
3
2
162

27
10
7
11
1
115

50.9
42.8
15. 6
20.0
7.4
23. 7

34. r
33.3
10.0
26.8
1.7
13.3,

Berlin....•.. ··-----··-···-· •..•...••.•.....
Hamburg .• -···------··-· .••.•.•...........
Stuttgart...• _-····· •.•......•••............

264
116
301

308
169
382

145
2
15

105
0
10

54. 9
1. 7
4. 9

34.0
0
2.6

Holland: Rotterdam.-----·-··········--·······
Poland: Warsaw·······--············-···-·-···
Denmark: Copenhagen __ .• __ ··-- ••.••. ····---·
Norway: Oslo .•• ---··-········--···········-·-·
Sweden, total. _____ •••••••. ··-··--....••.•.•...

97
201
38
38
56

90
296
37
52
59

49
64
13
16
22

39
46
7
18
18

50.5
31.8
34. 2
42.1
39.3

43.3
15.5
18.~
34.6
30.5

Ooteborg ________ .•.•••••... __ .. __ .• ···-····
Stockholm.--··· ··--·-·····················

29
27

34
25

11
11

6
12

37.9
40. 7

17. 6
48.0

Italy: Naples .••.........•.. ·-··-···············
Czechoslovakia: Prague •........ -...•.......•..
Austria: Vienna .• -•...••.•••......•............

446
79
62

924
127
105

47
23
13

18
15
21

10.5
11.8
20. 9

1.~
%9.1
20.0

.A.TI European countries ...................

1,921

2,824

491

353

25.5

12. 6

238

46. 4

36.4
37.S
50.0
24.4.

1.52.Z

EUROPE


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

96

PUBLIC HEALTH SERVICE

18.-Number and percentage of quota and nonquota arppl-icants of each
sea: who were refused visas for mental conditions during the fiscal year 1935

TABLE

--~·~ -

Quota

I

I

Nonquota

Male
Country

~as
Q)=

ss
z
:,o:s

Female

fl

fl

:Oas i:las
.0"'
I

M
a>,c,
~

Q)

Male

. .

~

a)

a)

'"''I:!

.._.'I:!

a>,c,
'"'a>

41 i:l
,o,_

.

d>

,-.,c,

Female

f

i:las

~
a>,c,
'"'a>
Q)i:l
,o._

f

f

:nas 13as
.0 ~

~! §~ .0"'
ss
§-= §.E
~~
:,
:see ii
z
z z P-t z z P-t
P-t
z
z
- - - - - - - - - - - - - - - - - - - - -§.E

S.E
:,

I

.o.S

Q)

.

Q)cp

Q)

Q)

P-t

n

~-

Q)~

WESTERN HEMISPHERE

Cuba ____________________ 178
Canada __________________ 1,942

2
5

1.1
73
.3 1,180

2
13

ern Hemisphere._ 2,120

7

.3 1,253

15

360
555
88
54
66
2,419
388
698
100
114
123
960
266
378

2
2
1
0
1
10
1
8
1
0
0
7
3
0

225
.6
.4
771
1.1
155
118
0
175
1. 5
.4 3,032
.2
324
1.1
662
1.0
107
152
0
177
0
. 7 1,341
1.1
299
0
536

2
1
2
2
4
11
2
13
0
1

Alltries
European
conn-._
____________
6,569

36

.5 8,074

269
2. 7
1.1 2,887

0
16

216
0
.6 3,759

1
13

.II

3,156

16

.5 3,975

14

.4

0
2
1
0
1
9
0
3
0
1
2
9
1
0

62
0
331
.6
201
1. 3
42
0
126
1. 3
422
3.5
28
0
1.1
540
38
0
1.6
120
2.2
97
.5 3,459
288
.5
0
59

2
0
1
0
0
12
1
11
0
0
0
81
3
1

3. 2
0

11
7
5

46
.9
308
.1
75
1.2
24
1.6
77
2.2
255
.4
47
.6
282
2.0
34
0
63
.6
90
0
.8 1,899
2. 3
172
33
.9

61

.7 3,405

29

.8 5,813

112

---- -- -- -- - - - - -- - - -- -- --.3
All countries, West-

EUROPE
Belgium _________________

England _________________
Irish Free State __________
Northern Ireland ________
Scotland _________________
Poland
___________________
iDenmark
~~:~~=-:===============
_______ _________

Norway __________________
Sweden __________________
Italy _____________________
Czechoslovakia ___________
Austria __________________

1. 2

------------------------

0

.4

0
0
2.8
3.5
2.0
0

0
0

2. 3
1.0
1. 7

---- -- -- -- - - -- -- -- -- ----


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Federal Reserve Bank of St. Louis

1. g

97

PUBLIC HEALTH SERVICE
TABLE

19.-Number and character of the mandatorily ea:oludable conditions
n,otified during the fiscal year 1935
WESTERN HEMISPHERE
~
.9

Canada

r:lC!l

...Cl)

.t:J
C!l

Disease or defect

-;;;

~

hi:l

;.;

.t:J

0

::,

0

8
0

i:l

· Total Class A-II _________ ______ _

·si:l

0

§

3

'.5

0
0
0
0
4

0
5
5
0
1

0
0
0
0
0

0
8
0
10

0
0
0
0
0

1
0

1
0

0
0

3
1

0
0

0

0

0

C!l

1
4
1
1
2

0
1
0
1
0

0
0
0
0
0

1
10
14
2
13

1
10
14
2
17

0
1

4
0

0
0

8
2

9

0
0
4
0
0
4

0
5
3
2
0
5

0
0
0
0
0
0

0
6
10
5
1
17

0
16
13 ,
5
37
19

2

- - - - - - - - -55
10
0
6
0
50
------------------=

-- 12- - - 22Total Class A-L _______________ _
5
0

Class A-II
Leprosy _________________________ •• ___ _
Trachoma ________ • ________ •• _. _______ _
Tuberculosis, pulmonary _____________ _
Tuberculosis, other forms __:. __________ _
Ri_ngworm ____________________________ _
Venereal diseases ____ -~ _______________ _

:;

~

p.

'O
i:l

C)

·i

.d

bl)

Cl)

~

O'
i ::,...°' 8 8
::s
8
~
>
- - - - -- - - - - - - - - - - - -

0

Class A-I
Chronic alcoholism ___________________ _
Insanity ______________________________ _
Mentally defective ___________________ _
Epilepsy ___ __ _-----------------------Feeble-mindedness ___________________ _
Constitutional psychopathic inferiority -- --------------------- ----------_
Imbecility
______________________
___ ___

::,

~

::,

...

>

0

C)

Cl)
.t:J
Cl)

0
10
3
0
36
2

0
1
1
1
1
2

0
0
0
0
0
1

.

0
0
2

0
0
0
2
0
1

0

0
4

- 51- - ------ 15- - - 39- - 90
6
6
3
8
0

------Grand total ___________ _____ _____ _ - 56
18
28

-----------18

3

21

0

145

89

EUROPE

~

Disease or defect

]i
Cl)

~

Class A-I
Insanity ____________________
,__ ~- ____
Mentally defective _________________
Epilepsy
___ -----------------------Feeble-mindedne~s
______________ ___
Con:;titutional psychopathic inferi1

I~b~lity __________ ---------- ------

.


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Federal Reserve Bank of St. Louis

~0

;;

I>,

El

.o

3
17
0
10

0
0

4
0

0
0

0
0

0
0

8
2

-

5

-

- -

1
1
0
,3
5
10

-

4

-2

0
0
0
0

0
0
0
0

0
4

-

-

6

0
0
0
0

-0
0
2

..!!?

Cl)

0
6
0

8

:a

'C

~ 0~ · 0p.. Ai:l
r:.'l E Z"'" 00 0
- - - - - - - - 0
2
0
0

2
0
0
0

'C
i:l

C)

0
4
0
0

Total Class A-IL ____________ 2
Grand total __________________

i:l

"'

0
1
0
0

-

..t.l

I>,

'C
i:l

.... '.5.$
... Cl)
bl)
°'i:l .d~
"'00 0 ...

0
1
0
5

Total Class A-L _____________ - 6

Class___
A-II
Ti:achoma _______
: ______ ._ ________
Tt1berculosis, pulmonary ___________
Rmgworm_
-----------------------V,
enereal diseases
_____________ ___ ___

'C
i:l

Cl)
i:l
Cl)
'O
... Cl) ...
Cl)i:l
~

6

-

i:l
Cl)
'O
Cl)
00

3

~

0

I>,
H

.9
o.C:..t.l

"'°'

~

b

~ p,

0

- - -

-

-<

3

11

1
0
0
0

0
1
0
0

1
0
0
0

82
0
22

11

0
6
0
0

0
0

1
0

0
0

1
0

1
0

0
2

0
0

0
0

1
0
0
0

14

-1

54

5

-

4
4
0
0
8

43

1
0
0

-

·o
0
- 0

1

2
0
2
0
0

-

2

3

0
3
0

- - 109 14
- - -

0 275
0
5
1
1
1
3

2
1
0
1

30

a

00,

3
20
0

0
1
0

- - - 40
4 35
- - - 5
7
1
1

°'~
z

6

1
2
0
0

8

-

11

144
0
62

15
4

-236

-

291
22

3
9

- 2 -284 - 4 - 3 -325
2
- 4 - 4 -393 -18 - 9 -561

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 receive reports of outbreaks of diseases dangerous
to the public health and the current prevalence of these diseases,.
both in the United States and in foreign countries, and to disseminate the information to health officers throughout the United States.
MORBIDITY AND MORTALITY REPORTS

Five States (Colorado, Florida, Nebraska, New Mexico, and South
Dakota) were added to the list of States which have met the requirements for admission to the morbidity reporting area. Thirty-seven
States have now met the required standard.
Collaborating and assistant collaborating epidemiologists, appointed as officers of the Public Health Service from the staffs of
State and local health departments, assisted in the collection of
morbidity and mortality reports by collectinO' and forwarding to
the Public Health Service information as to outbreaks and the prevalence of communicable diseases in their respective jurisdictions.
These appointments are made at the nominal salary of $1 per annum.
On June 30, 1935, there were 4,643 collaborating and assistant collaborating epidemiologists on the rolls.
Reports of outbreaks and cases of quarant~nable and other communicable diseases throughout the world were received from officers
of the Public Health Service, American consular officer~, the International Office of Public Health at Paris, the Pan American Sanitary Bureau, the Health Section of the League of Nations, and
other sources. In compliance with the provis10ns of international
sanitary conventions, notice of cases of quarantinable diseases was
given to the International Office of Public Health, the Pan American Sanitary Bureau, and, through the Department of State, to
:foreign governments.
Telegraphic reports of the current prevalence of the principal .
communicable diseases were received weekly from the health officers
of all of the States except Nevada. The data were published in the
Public Health Reports and summaries of the information and comparisons with the data for the preceding year were compiled each
week and promptly sent to State health officers. During epidemics,
the more important information was sent to State health officers by
telegraph.
Monthly reports o:f the numbers of cases of notifiable diseases were
received from State he,a lth officers. These reports show prevalence
by counties. Brief summaries of the totals were published in the
Public Health Reports.
During the fiscal year the annual summary o:f cases o:f notifiable
diseases and deaths from these diseases for the year 1933 was pub98

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Federal Reserve Bank of St. Louis

99

PUBLIC HEALTH SERVICE

lished. At the close of the fiscal year the volume £or 1934 was m
course of preparation.
Reports showi_n g the numbers of cases of the principal communicable diseases and deaths from these diseases were received weekly
from cities of over 10,000 population in the United States. Statistics
from about 140 of these cities in all parts of the country were published each week in the Public Health Reports.
The accompanying tables give a comparison of the numbers of
reported cases of the principal notifiable diseases, with deaths, in the
United States for the calendar years 1932, 1933, and 1934:
CASES

Number of
States'

Disease

Chicken pox ______________
Diphtheria _______________
Influenza ___ ______________
Malaria __________________
Measles __________________
Meningococcus
meningitis ________ ______________
Mumps __________________
Pellagra __________ ________
Pneumonia (all forms) ____
Poliomyelitis _____________
Scarlet fever ______________
Smallpox _________________
Tuberculosis (all forms) __
Tuberculosis (respiratory
. system) ________________
Typhoid fever and paratyphoid fever_ _________
Whooping cough _________

Aggregate population
(in thousands)
1932

1933

1934

Cases per 100,000
population

Cases
1934

1933

1932

1932

1933

1934

- - - - - - - - - - - - -- -- -42
47
47
46
47

108,744
124,307
124,307
117,554
124,307

109,529
125,175
125,175
118,377
125,175

110,188 201,492 223,486 222,898 185. 3 204 0 202.3
125,905 59,784 50,378 43,093 48.1 40.2 34. 2
125,905 -------- ------------- ------ -----119. 069 -------- -------- -------- ------ -----125,905 403,294 396,941 774,822 324.4 317.1 615.4

--------

------

38 110,207 110,959 111,591

40
45
45
42
47
47
47

89,639
104,702
114,063
111,461
124,307
124,307
124,307

90,275
105,412
114,795
112,215
125,175
125, 175
125,175

3,069
2,682
2.8
2,243
2.4
2.0
90,810 98,548 85,031 95,185 109.9 94.2 104.8
106,010
------------------------115,412 -------- ------------112,850
3,682
4,940
7,278
3.3
4.4
6.4
125,905 210,014 210,982 218,573 168.9 168.5 173.6
125,905 11,194
6,460
5,285
9.0
5. 2
4.2
125,905
----

--------

42 114,604 115,407 116,084

------------- ------

------

-------- -------- -------- ------ ------ --------- -------- -------- ------ ----·- ------

47 124,307 125,175 125,905 26,618 23,287 22, 133 21.4 18. 6 17. 6
47 124,307 125,175 125,905 214,310 177,233 259,965 172. 4 141. 6 206.5

DEATHS
reported for
Deaths per 100,000 Cases
each death
population
registered

Deaths
Disease
1932

Chicken pox ___________________________
Diphtheria _____________________________
Influenza _______________________________
Malaria ________________________________
Measles ________________________________
Meningococcus meningitis _____________
Mumps ________________________________
Pellagra ________________________________
Pneumonia (all forms) _________________
Poliomyelitis ___________________________
Scarlet fever ____________________________
Smallpox _______________________________
Tuberculosis (all forms) ________________
Tuber.culosis (respiratory system) ______
'T yphoid fever and paratyphoid fever __
Whooping cough _______________________

94
6,017
37,874
2,682
1,881
1,367
52
4,120
92,955
730
2,568
52
77,222
64, 32~
4,822
6,265

1933

1934

1932

1933

1934

1932

1933

0.1
4.8
30.5
2.3
1. 5
l,2
.1
3.9
81.5
.7
2.1

0.1
3.9
25.5
3.8
1. 7
1. 0

3.6
73.6
.6
2.0

62.1
56.1
3. 9
4. 2

69.0
53.3
3. 5
3.3

0.1 2,144 1,746 1,857
10
3.3
10
10
16.4
3. 7 ------ ------ ---129
214
4.8
183
2
.9
2
2
.1 1,895 1,890 1,670
3.2
83.5 ------ ----7- --·-10
.7
5
1. 9
82
00
86
(1)
252
215
185
56.2
50.8 ------ -----5
6
3.3
6
41
43
36
6. 7

1934

-- - - - - - - - - - - - - -120
128
4,217
4,853
31,908 20,665
4,401
4,463
6,020
2,173
1,001
1,124
45
57
3,781
3,383
84,488 96,426
752
700 .
2,441
2,436
21
35
73,845 70,711
61,467 59,012
4,124
4,380
4,162
7,133

(2)

(2)

(')

------ ------ ------

------ ------ ------

------ ------ -----------

1 In addition to the number of States given, the District of Columbia is also included.
' Less than 0.1 per 100,000 population.

SANITARY LEGISLATION AND COURT DECISIONS

L egislation.-Supplement 111, containing citations to 1931 Stat,e
laws and regulations on public health, was issued during the fiscal
year, this publication having been prepared during the preceding

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100

P U BLIC HEALTH SERVICE

year. · The preparation of citations covering State health laws and
regulations enacted and adopted during the calendar year 1932 was
undertaken, and, also, there were secured copies of public health
ordinances and regulations adopted during 1934 by cities in the
United States of over 10,000 population. This municipal material .is for use in compiling selected ordinances and regulations which, it is
considered, might be helpful to health officials and others interested
in drafting and knowing about municipal health requirements.
0 ourt decisions.-As in prior years, current decisions on public
health matters, handed down by Federal and State courts of last
resort, were abstracted and published in Public Health Reports.
PUBLICATIONS ISSUED BY THE DIVISION

The Public Health Reports, one of the oldest of Government periodical publications, was issued by the Division each week during
the year. It was first printed in 1878 under the title of "Bulletins
of Public Health ", later as "Abstracts of Sanitary Reports ", and
since 1895 it has been issued under the present title. The 52 numbers covering the fiscal year comprised volume 49, part 2, and volume
50, part 1, and contained 1,751 pages of text and tabular ·_ matter,
exclusive of title pages and tables of contents, as compared witij
1,578 pages in the fiscal year 1934, 1,762 pages in 1933, and 3,008
pages in 1932. The reduction of almost 50 percent in size of the
Public HeaJth Reports in recent years as compared . with earlier
years has been necessitated by a reduction in printing funds and
has been secured by suspending . publication of certain statistical
material and "by revising and condensing the text articles as much as
possible. In spite of such economies in space, however, the close of
the fiscal year left on hand unpublished a large number or manuscripts reporting important scientific investigations. Because of inadequate printing funds, permission :was given during the year for the
publication in outside journals of inany reports which . should have
appeared in Public Health Service publications. The 'value of the
Public Health Reports as a ·medium of reporting the results of important current research and of presenting current morbidity statistics to health officers and others concerned was retained to the greatest
extent possible in the face of this handicap in printing. ·
During the year 60 important articles published in the Public
Health Reports were issued in separate form as reprints, providing
more extensive and more economical distribution to persons especially
interested in the particular subjects and permitting the printing of
editions for sale by the Supermtendent of Documents. In recent
years the number of articles reprinted and the number issued of each
have been greatly reduced. In the last fiscal year 50 reprints were
issued. Formerly about 100 articles appearing in the Public Health
Reports each year were issued as separates.
Four supplements to the Public Health Reports· were printed, as
:follows: No. 111, Citations to Public Health Laws and Regulations,
1931 ; No. 112, The Notifiable Diseases-Prevalence in States, 1933;
No. 113, Dilaudid (Dihydromorphinone)-A Review of _the Literature and a Study of its Addictive Properties; and No. 114, Information Regarding Quarantine and Immigration for Ship Surgeons.


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PUBLIC HEALTH SERVICE

101

:N"ew editions of 18 previously issued publications were secured
during the year as the stock became exhausted and the demand. for
them justified · additional printing. About half of these required
some degree of revision in view of increased know ledge of th~ subject. A complete revision was made of Miscellaneous Publication
No. 16, the Public Health Service " Nomenclature of Diseases and
Conditions ", as new terms had become adopted and many of the old
terms had become obsolete because of the progress in medicine and
~urgery.
·
The issuing of a mimeographed semimonthly journal entitled
" Hospital News " was initiated at the beginning of the fiscal year,
with volume 1, no. 1, appearing under the date of July 1, 1934. This
mimeographed periodical contains articles on clinical research, case
histories, accounts of practices, observations, and reports on improvements in methods and new devices in the marine hospi~als and other
institutions served by medical officers of the Public Health Service.
By this means such information is brought currently to the attention
of the personnel engaged in hospital work. The Hospital News,
conducted under the auspices of the Division of Marine Hospitals
and Relief and the Division .of Mental Hygiene, is issued by the
Division of Sanitary Reports and Statistics. It has definitely filled
a long unsupplied need for ·a medium of publication of importan
clinical reports from hospital personnel for record and discussion.
PUBLICATIONS DISTRIBUTED AND EXHIBITS PREPARED

· There were 79 new publications distributed by the Division, as
compared with 76 during the preceding year. A total distriqution
of 230,921 copie.s of :µew public~tions and of editions of pre ously
published documents was made. · Of :_thes~, ( 154,887 were ·sent in
response to individual requests for information ahd 76,034 were distributed to Service mailing lists.
..
There were 24 requests fo'r the loan ·of stereopticon slides; and in
response to these requests, 1,478 slides were lent to universities,
health officers, public health lecturers, officials of the Public Health
Service, and others.
·.
During the past few years the Service has had an appropriation
for the preparation and display of exhibits relating to public health.
Although the funds appropriated during this fiscal year were inadequate, an important exhibit on biologics was prepared and displayed
at the annual meeting of the American Medical Association at Atlantic City, N. J. Other important exhibits of the Service were
displayed at medical and public health meetings in various cities
of the United States. The exhibit material of the Service which
was prepared for the Century of Progress Exposition at Chicago was
returned to Washington at the close of the ex_position. Much of this
material was reconditioned and placed with other exhibits in the
permanent exhibit room of the Public Health Service Building in
WTashhinfgtlol
n. . 1s
. a 1·1st of publ'1cations
.
d'1str1'bu t ed by th e D'1v1S1on
..
e o owmg
during the fiscal year:


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Federal Reserve Bank of St. Louis

102

PUBLIC HEALTH SERVICE
REPRINTS J!'ROM THEl PUBLIQ HEALTH REPORTS

1618. Frequency of health examinations in 9,000 families, based on Nation-wide
periodic canvasses, 1928-31. By Selwyn D. Collins. March 9, 1934.
w~~

.

;l.62.2. I?sittacosis in the United Sta.tes._ Incidence, scientific aspects, and administrative control mea·s ures. By V. M. Hoge. April 6, 1934. 12 pages.
1623. Health services of tomorrow. By Thomas Parran, Jr. April 13, 1934.
·
10 pages.
1624. The standardization of gas. gangrene (perfringens) antitoxin. By Ida A.
Bengtson. April 27, 1934. 5 pages .
.1625. Public Health Service publications. A list of publications issued during
the period July-December 1933. April 20, 1934. 4 pages.
·rn26. Silicosis. By R. R. Sayers. May 18, 1934. 8 pages.
1627. Frequency of eye refractions in 9,000 families, based on Nation-wide
periodic canvasses, 1928-31. By Selwyn D. Collins. June. 1, 1934. 18
pages.
1628. Silicosis among granite quarriers. By J'. J. Bloomfield and Waldemar
C. Dreessen. June 8, 1934. 6 pages.
1629. Court decision holding United States Public Health Service milk ordinance valid. June 8, 1934. 4 pages.
1630. Effect of inhaled marble dust as observed in Vermont marble finishers.
By Waldemar C. Dreessen. June 22, 1934. 9 pages.
:1631. The pellagra-preventive value of green onions, lettuce · leaves, pork shoulder, and peanut meal. By G. A. Wheeler and D. J. Hunt. June 22,
1934. 5 pages.
1632. Table showing the pellagra-preventive value of various foods. By W. H.
Sebren. June 29, 1934. 4 pages.
1633. Effective·ness of filtration in removing from water, and of chlorine in
killing, the causative organism of amebic dysentery. By Bertha Kaplan
Spector, John R. Baylis, and Oscar Gullans. July 6, 1934. 16 pages.
1.634. Time distribution of common colds and its relation to corresponding
weather conditions. By Mary Gover, Lowell J. Reed, and Selwyn D.
Collins. July 13-, 1934. 14 pages.
1635. llectrocution a new aid in the preparation of mosquito mounts. By C. P.
Coogle. July 13, 19-34. 3 pages.
1636. Pulmonary infection in pneumoconiosis. I. A bacteriologic and experimental study. By H. 0. Proske and R. R. Sayers. July 20, 1934.
20 pages.
1637. Milk-sanitation ratings Qf cities. Cities for which milk-sanitation ratings
of 90 percent or more were reported by the State milk-sanitation authorities during the period July 1, 1932, to June 30, 1934. July 27,
1934. 4 pages.
1638. Studies in chemotherapy. I. The action of sodium formaldehyde sulphoxylate in bacterial infections. By Sanford M. Rosenthal. August
3, 1934. 4 pages.
1639. Heart disease among seamen. By H. Arenberg. August 3, 1934. 9 pages.
1640. Effect on the eye of the yellow light of the sodium vapor lamp. By
James E. Ives. August 10, 1934. 9 pages.
1641. Public Health .Service publications. A list of publications issued during
the period January-June 1934. August 10, 1934. 4 pages.
1642. A review of the Federal civil works projects of the Public Health Service.
By C. E. Waller. August 17, 1934. 8 pages.
1643. Tendencies in standards of river and lake cleanliness. By H. W. Streeter.
August 24, 1~34. 12 pages.
.
1644. Recent court decisions on milk control. By James A. Tobey. August
· 24, 1934. 6 pages.
1645. Maximum temperatures and increased death rates in the drought area
in 1934. By Selwyn D. Collins and Mary Gover. August 31, 1934.
4 pages.
·
1646. Child l:J,ealth activities in a State department of health. By Estelia Ford
Warner. September 7, 1934. 5 pages,
·
·
'
1 647. Effect of various amounts of sodium fluoride on the teeth of white -rats.
By H. Trendley Dean, W. H. Sebren, R. P. Breaux, and E. Elvove.
September 14, 19-34. 7 pages; 2 plates.
1648. Mortality rates by occupational class in the United States. By Rollo H.
Britten. September 21, 1934. 11 pages.


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PUBLIC HEALTH" SERVICE

103

1649. Whole-time county health officers, 1934. September 28, 1934. 9 pages.
1650. Some findings of the N. 0. P. H. N. survey of public health nursing of
significance to State health administrators. By Pearl Mclver. September 14, 1934. 10 pages.
1651. Experimental studies of natural purification in polluted waters. No. IX.
Nitrification in sewage mixtures. By Emery J. Theriault and Paul D.
• M.cN.amee. October 5, 1934. 7 pages.
1652. The actual causes of dermatitis · attributed to socks. By Louis Schwartz~
October 5, 1934. 10 pages ; 2 plates.
1653. Sickness among male industrial employees during the second quarter ancT
first . half of. 1934. By Dean K. Brundage. October 19, 1934. 4 pages.
1654. Effectiveness and economy of eounty.health department practice. Brun ·wick-Greensville health administration studies no. 1. Descriptiorl of
study. By Joseph W. Mountin. October 19, 1934. 10 pages.
1655. The Chicago epidemic of amoebic dysentery in 1933. By Herman N.
Bundesen. October 26, 1934. 7 pages.
1656. The relation between housing and health. By Rollo H. Britten. November 2, 1934. 13 pages.
1657. The National Leprosarium, Carville, La. Review of the more important
activities during the fiscal year ended June 30, 19'34. By 0. E. Denney.
November 16, 1934. 8 pages.
1658. Streptococcus bacteriophage. A study of four serological types. By Alice
C. Evans. November 23, 1934. 16 pages.
1659. What every person should know about milk. By Leslie C. Frank. December 14, 1934. 12 pages. .
1660. Further studies on growth and the economic depression. A comparison
of weight and weight increments of elementary-school children in
1921-27 and in 1933-34. By Carroll K Palmer. December 7, 1934.
17 oae:P.R.
1661. Extent of rural health service in the United States, January 1, 1930December 31, 1933. December 7, 1934. 16 pages.
1662. The distribution of immunity against encephalitis virus of the St. Louis
type in the United States as determined by the serum-protection test
in white mice. By J. G. Wooley and Charles Armstrong. December
14, 1934. 11 pages.
1663. Job analysis of a rural sanitation officer. Brunswick-Greensville health
administration studies no. 2. By J. 0. Dean and Joseph W. Mountin.
December 21, 1934. 14 pages.
1664. The official United States and international unit for standardizing gas
gangrene nntitoxin ( vihron septique). By · Ida A. Bengtson. December 28, 1934. 16 pages.
·
1665. Effects of the inhalation of asbestos dust on the lungs of asbestos workers.
By A. J. Lanza, William J. McConnell, and · J. William Fehnel. January 4, 1935. 12 pages.
1666. Milk-sanitation ratings of cities. Cities for which milk-sanitation ratings
of 90 percent or more were reported by the State milk-sanitation authorities during the period January 1, 1933, to December 31, 1934.
February 1, 1935. 4 pages.
1667. Biological products. Establishments licensed for the propagation an rl
sale of viruses, serums, toxins, and ana]oo-ous products. February l ,
1935. 6 pages.
1668. Selected papers on the medical services in the Federal prison system
with special reference to psychiatric problems. Presented at the conference held at Springfield, Mo.. September 13-15, 1934. The role,
organization, and function of psychiatric service in a correctional institution. By R. P. Hagerman, Wilson K. Dyer, and C. C. Limburg.
November 9, 1934. The social viewpoint of psychiatric service in a correctional institution. By Amy N. Stannard. November 9, 1934. The
personality factor in prison discipline. By F. G. Zerbst and D. E.
Singleton. November 16, 1934. Problem neuroses and their management in a correctional institution. By M. J. Pescor. November 16,
1934. The constitutional psychopath as the warden's problem. By
H. C. Hill. November 30, 1004. Psychiatric aspects of job placement.
By J. G. Wilson. December 21, 1934. The educator's viewpoint of
psychiatric _service in a penal institution. By R. A. McGee. January 4,


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Federal Reserve Bank of St. Louis

104

PUBLIO HEALTH SERVICE

The administrator's viewpoint of psychiatric services in a correctional institution. By Joseph W. Sanford. January 18, 1935. The
place of psychiatry .in a coordinated correctional program. By F.
Lovell Bixby. January 25, 1935. Principles of sanitation and hygiene
for a correctional institution. By M. R. King. February 8, 1935. 46
pages.
.
The effects of exposure to dust in two Georgia talc mills and mihes. By
Waldemar C. Dreessen and J. M. DallaValle. February 1, 1935. 13
pages.
Endamoeba histolytica in washings from the hands and finger nails of infected persons. By Bertha Kaplan Spector, Jolin w. Foster, and Nelson
G. Glover. February 8, 1935. · 2 pages.
The family survey as a method of studying rural health problems.
Brunswick-Greensville health administration studies ·no. 3. By Elliott
H. Pennell. February 15, 1935. 14 pages.
Public Health Service publications. .A . list of publications issued during
the period July-December 193"4. February 15, 1935. 3 pages.·
A general view of the causes of illness and death at specific ages. Based
on records for 9,000 families in 18 States visited periodically for 12
months, 1928--31. By Selwyn D. Collins. February 22, 1935. 19 pages.
A comparative study of streptococcal immunity produced in rabbits by
heat-killed cultures, by active bacteriophage, and by inactivated bacteriophage. By Alice C. Evans. February 8, 1935. 17 pages.
The occurrence of infestations with E. histolytica associated with waterborne epidemic diseases. By A. V. Hardy and Bertha Kaplan Spector.
March 8, 1935. 12 pages.
Vadations in physique · and growth of children in different geographic
regions of the United States. Physical measurement studies no. 21.
By Carroll E. Palmer and Selwyn D. Collins. March 8, 1935. 13 pages.
Public health nursing in ·a bicounty · health department. Brunswick-·
Greensville health administration studies no. 4. Prepared by Pearl
Mclver. April 5, 1935. 12 pages.
'
Sickness among niale 'industrial employees during· the final quarter of
1934 and the entire year. By Dean K. Brundage. April 26, 1935.
3 pages.
1935.

1669.
1670.

1671.
1672.
J .673.
1674.
1676.
1677.
1679.

:.-:682.

SUPPLEMENTS

111. Citations to public health laws and regulations, 1931. 1934. 32 pages.
112. The notifiable diseases. Prevalence in States, 1933. 1934. 12 pages.
113. Dilaudid (Dihydromorphinone). A review of the literature and a study
of i~ addictive properties. By M. R. King, C. K. Himmelsbach, and
B. S. Sanders. 1935. 38 pages.
114. Information regarding quarantine and immigration for ship surgeons.
1935, 34 pages.
PUBLIC HEALTH BULLETINS

211. Studies in asphyxia. I. Neuropathology resulting from comparatively
rapid carbon-monoxide asphyxia. II. Neuropathology resulting from
comparatively slow carbon-monoxide asphyxia. III. Neuropathology resulting from comparatively slow carbon-monoxide asphyxia .; reaction
during 16 to 165 days after exposure. IV. Neuropathology resulting from
~omparatively rapid asphyxia at atmospheres deficient in oxygen.
V. Blood chemistry changes resulting from comparatively rapid asphyxia
by atmo~pberes deficient in oxygen. VI. Blood chemistry of dogs after
,comparatively rapid carbon-monoxide asphyxia. By W. P. Yant, John
Chornyak, H. H. Schrenk, F. A. Patty, and R. R. Sayers. August 1934.
'61 pages.
·
2l2. Leprosy. Observations on its epidemiology in Hawaii. By .r • E . Wayson
and Theodore R. Rhea. September 1934. 32 pages.
213. Epidemiological study of' plague in the Hawaiian Islam'ls. By C.R. Eske~'·
October 1934. 70 pages. '
2il.4. Report on the St. Louis o'utb1·eak of encephalitis. .January 1985. 117
pages.


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Federal Reserve Bank of St. Louis

PUBLIC HEALTH SERVICE

105

215. Skin hazards in American industry. Dermatitis in the rubber industry.
By Louis Schwartz. Dermatitis in oil refining. By Louis Schwartz.
Dermatitis in synthetic dye manufacturing. By Louis Schwartz. Dermatitis in candy making. By Louis Schwartz. Dermatitis among silk
throwsters. By Louis Schwartz and Louis Tulipan. Dermatitis in the
manufacture of linseed oil. By Lo;uis Schwartz. Dermatitis due to
perfume. By Louis Schwartz. Dermatitis due to pyrethrum contained
in an insecticide. By Louis Schwartz. October 1934. 54 pages ; 17
plates.
~16. The potential problems of industrial hygiene in a typical industrial area
in the United States. By J. J. Bloomfield, W. Scott Johnson, and R. R.
Sayers. December 1934. 35 pages.
219. A survey of tuberculosis in Louisiana. By L. L. Lumsden. April 1935.
76 pages.
N ATIONAL INSTI'l'UTE· OF HEALTH BULLETINS

163. Key catalog' of parasites reported for carnivora ( cats, dogs, bears, etc.)
with their possible public health importance. By ·c. W. Stiles and Clara
Edith Baker. December 1934. 310 pages .
.164. Experimental studies on cancer. I. The influence of the parenteral administration of certain sugars on the pH of malignant tumors. By
Carl Voegtlin, R. H. Fitch, Herbert Kahler, J. M. Johnson, and J. W.
Thompson. II. The estimation of the hydrogen ion concentration of
tissue in living animals by means of the capillary glass electrode. By
Carl Voegtlin, Herbert Kahler, and R. H. Fitch. III. The influence of
hydrogen· ion concentration upon the reversal of proteolysis in oxygenated extracts of normal and neoplastic tissues. By ;Mary E. Maver,
J. M. Johnson, and Carl Voegtlin. IV: A comparison of the ·growth of
the Jensen rat sarcoma in subcutaneous and intramuscular transplants.
By W. R. Earle and Carl Voegtlin. January 1935. 58 pages; 4 plates.
ANNUAL REPORT

Annual Report of the Surgeon General of the United States Public H~~lth
Service for the fiscal year 1934. 1934. 143 pages.
·
MISCELLAN EOUS PU BLICATIONS

10. Regulations for the sale of viruses, serums, toxins, and analogous products

in the District of Columbia and in interstate traffic. Approved February 25, 1935, to supersede regulations issued March 13, 1004, and
amendments thereto. 1935. 11 pages.
11. Official list of commissioned and other officers of the United States Public
Health Service. Also a li t of all stations of t he Service. January 1,
1935. 61 ptlges.
UNNUMBERED PUBLIOATIO S

Index to Public Health Reports, volume 49, part 1, January- June 1934. 24
pages.
Index to Public H ealth Reports, volume 49, part 2, July- December 1934. 23
pages.
National Negro Health Week program. This pamphlet ls 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. Twenty-first annual observance. March 31 to April 7.
1935. 8 pages.
National Negro Health Week poster. Twenty-first annual observance. 1035.
National Negro Health Week leafl.f't. Twenty-first annual observance. 1935.
2 pages.


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Federal Reserve Bank of St. Louis

DIVISION OF MARINE HOSPITALS AND RELIEF
Asst. Surg. Gen. S. L.

CHRISTI.AN

in charge

Out-patient and hospital treatment was furnished to American
seamen and other legal beneficiaries in 154 ports of the United
States and its possessions. Contracts were maintained with 152
hospitals located chiefly in ports not served by the 25 marine hospitals. At the close of the year, 4,455 patients remained in hospitals,
including 162 insane in St. Elizabeths Hospital and 358 patients at
the National Leper Home.
·
The volume of work which for 137 years has faithfully reflected
the activities of the American merchant marine again showed · ah
increase, for throughout the year the ·marine and contract hospitals
treated a daily average of 482 more patients than they did in the
fiscal year 1934, and this figure would have been still larger but for
the fact that during the month -of June funds became so limited that
it was necessary to reduce the number of in-patients from 4,945 on
June 1, to 4,455 on June 30.
As in the preceding' year, operation of the hospitals was exceedingly difficult on account of inadequate appropriation and personnel,
and toward the close of the year the Public Health Service faced a
very considerable deficit, which was taken care of by using impounded salary funds, transferred from the Bureau of Internal
Revenue, by making drastic reductions in the allotments to the
marine hospitals, and by discontinuing all replacements of equipment between May 15 and June _30, 1935. It was necessary to carry
forward into the new year requisitions totaling approximately $50,000. In the face of greatly advanced costs of commodities of all
sorts, the per diem cost was kept down to the low figure of $3.31.
This per diem cost is 91 cents cheaper than the per diem of 1,016
hospitals which reported their costs to the American Hospital Association, the Catholic Hospital Association of the United States and
Canada, and the American Protestant Hospital Association for the
calendar year 1933, and during that year costs were much lower
than they were for the fiscal year under consideration. In view of
the experiences of 1935 and with basic allotments for 1936 essentially
the same as those for 1935, it is impossible to see how the relief
activities of the Service can continue to function efficiently throughout 1936 upon funds available at the present time.
On July 1, 1934, the Division of Marine Hospitals and Relief,
together with the Division of Mental Hygiene, issued the first number
of Hospital News, a mimeographed pamphlet of about 25 pages devoted to articles of especial interest to personnel engaged in hospital and other clinical work. Forty-nine articles were distributed
during the year, and many compliments were received from Service
officers and others on the subjects dealt with.
In addition to the old-line beneficiaries, the hospitals continued to
furnish medical relief to persons injured in line of duty on Civil
Works Administration projects, for which no reimbursement was
106

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Federal Reserve Bank of St. Louis

107

PUBLIC HEALTH SERVICE

received, and to enrolled members of the Civilian Conservation
Corps and patients of the Veterans' Administration. Each of the
latter two agencies reimbursed the Service at the established rate of
$3.75 per day for in-patient treatment and $1 for each out-patient
treatment.
For a complete statement of relief .furnished at each station and
the customary collateral functions performed by the marine hospitals for the Army; Navy, Civil Service Commission, Steamboat Inspection Service, Coast Guard, Employees' Compensation Commission, Post Office Department, Bureau of Immigration, Coast and
Geodetic Survey, Bureau of Fisheries, Bureau of Lighthouses, Bureau of N arcoticsi.J'eterans' Administration, ··civilian Conservation
Corps, and Civil works Administration, see pages 112 to 116.
CLASSES OF BENEFICIARIES AND AMOUNT AND CHARACTER OF SERVICES
RENDERED

Summary of services by class of beneficio:ry

Hospital days .

Out-patient
treatments

Physical
examinations (not
related to
treatment)

Class of beneficiary

Remarks
Number

---

Percent
of
total
--

American merchant sea- 1,145,469 63. 58
men.
81,322 4.51
Veterans _____ -···-··-····

PerPercent Num- cent
of
of
ber
total
total

Number

--- -- -593,554 51. 57 8,955 10.15 Communicable diseases are re-

1,247

ported to local health officers.

• 11

788

6 --····

13

.89 Patients of the Veterans' Ad-

Lepers _______ -- -- - --·-··--

130,136

7. 22

Coast Guard personneL_.

80,195

4. 45

151,744 13.18 8,966 10.16

Injured Federal employ-

108,700

6. 03

118,473 10. 29 26,469 29.99

Immigrants .. __ - - -- -···- -

25,062

1. 39

10,334

.89

337

.38

Seamen, Engineer Corps
and Army Transport
Service.
Seamen from foreign vessels.
Seamen and keepers,
Lighthouse Service ..
Civilian
Conservation
Corps.
Civil Works Administration.
Alaska cannery workers
leaving United States.
Pilots and other licensees.

48,075

2.67

22,134

1.92

667

. 76

ees.

Civil-service applicants
and employees.
Shipping Board __________
All others entitled to treatment.

. 01


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Federal Reserve Bank of St. Louis

ministration.
National Leper Home, Carville, La.
All medical services and supplies, ashore and afloat.
Patients of the Employees'
Compensation Commission.
Patients of the Bureau of Im•
migration.
Civilian employees on Army
vessels.

6,479

. 36

873

.08

126

. 14 Pay patients •

13,966

. 78

6,054

. 53

142

.16 Medical supplies also furnished

103,638

5. 75

1,903

. 17

443

.50 Patients of the Civilian Con-

35,598

1. 98

12,055

1.05 1,554

1. 76 P atients of the Civil Works

---------- ------

1,070

. 09 4,609

5. 22 Vaccinations and other preven-

7,511

---------- ------ --------- --------------- ------ --------- -----23,128

1. 28

to lighthouse vessels.
servation Corps.
Administration.

8. 51

20,447 23.16
1,461

1.66

231,534 20.12 5,779

6. 55

---------- -- -TotaL-----· ·····-· 1,801, 768 100. 00 1,150, 9 1 JO'.>. 00 88,207 100. 00
20980-35--8

.'

tive measures.
For the Steamboat Inspection
Service.
For the Civil Service Commission.
To determine fitness for sea
duty.
From Bureau of Fisheries,
avy, Mississippi
Army,
R iver Commission, Coast
and Geodetic Survey, etc.

108

PUBLIC HEALTH SERVICE

In addition to the above servire and in accordance with Department Order No. 9, dated September 26, 1934, a commissioned medical officer was detailed to supervise the 10 emergency medical relief
units in the Treasury Department in the District of Columbia; and,
upon request of their respective heads of departments and agencies,
imilar supervision has been extended to the Securities and Exch~nge -Commission, Rt~ral Electrification Administration, Federal
Housing Administration, .Re~onstruction Finan~e Corporation, Natio11a.l Bureau of Standards, . Department of Commerce, Shipping
Board, and the Suburban ,Resettlement Administration.
During the year important new hospital facilities were completed
and occupied at Baltimore, Norfolk, Carville, Chicago, and
Memphis.
DENTAL TREATMENT

Dental services :furnished at marine hospitals and relief stations
by full-time dental officers are shown in the following list:

Number of patients treated________________________________________
Number of individual sittings_______________________________________
X-rays_____________________________________________________________
Prophylactic treatments (hours) ____________________________________
Vincent's stomatitis treatments (hours)______________________________
Pyorrhea treatments ();lours)_______________________________________

!~!~1~f:1;;:========:::::::::=====::::::::::::::=::::::::::::::
Alloy fillings __________'__:_ __ ..., __________ _______ .:_______________________
i~~~ef:/:Yc~~;~;:::::::::::=====~:::::::::::::::::::::::::::::::::

. Silicate cement fillings_______________ _______________________________
Dentures ( full and partial) _____________ . . , ________________________.:___:_
Fracture cases (hours>----~----~------------------------------- ---Number of treatments (out-patient)--------------------------------Number of treatments (in-patient) __________________________________
Total number of treatments _____ .:_ __,_________________________________

174,353
233, 770
39,207
14,406
4,452
4,449
8

t}~;

47, 081

l,~g

20, 554
6, 974
1,463
478,444
199,014
677,458

Of the 174,353 beneficiaries treated, only 25,961 cases were entirely completed. This is· at the rate of 149 completed cases per
1,000 patients.
Although the above i~ . a c~msiderable increase in the actual treatment ' rendered· to benenciaries · over preceding years, it is still far
short of adequate treatment. There is an urgent need for additional
dental officers as well as dental hygienists, dental technicians, and
nurses. Treatments for diseased soft structures of the mouth and
oral prophylaxes required 23,307 hours, which is equal to the fulltime duty of one-sixth of the dental-officer personnel, yet only 107
patients out of each 1,000 received oral prophylaxes.
At marine hospitals and relief stations where full-time dental
officers are on duty, the total cost of all dental treatment, including
salaries, supplies, repairs, and overhead expense, was $303,761.26.
Had it been necessary to pay :for the treatment according to the fee
table by which contract dentists are paid, the total cost would have
been $1,145,769.~9.


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Federal Reserve Bank of St. Louis

109

PUBLIC HEALTH: SERVICE
CON TRACT DENTAL SERVICE

At small stations where the services of a full-time dental officer
are not needed, a local dentist is given an appointment as a contract
dentist and is paid for his services on a fee basis. Owing to increased
costs and inadequate fonds, it was necessary to reduce this class o:f
treatment to a considerable extent. This has worked a very great
hardship on certain beneficiaries, such as Coast Guard personnel,
who are often detailed to small stations considerably distant from
the marine hospitals. During the year 2,858 beneficiaries were given
routine dental treatment by contract dent ists a.t a total cos o-f
$14 721.42, or $5.15 per patient.
.
Senior Dental Surg. C. T. Messner is in charge of dental activitie.
in the field and Bureau.
COAST G uARD .

The average number of Coast Guard beneficiaries on active duty
:and retired was 9,413. Medical services furnished this group in
;recent years are shown in the following ~able:
Numerical strength of Coast Guard and medical
services given
Year

1923 ••
--- ---- ----.
1924
____________
1925 ••• _._ ••• - -··

1926. • •• : ___ ._ ...
1927····· · ·-··· ·-

. 1928. .. ........ . .
. 1929 .. . . ... . . ....
'1930 . . . . .... . ... .
1931 .. . . .. ... .. . .
1932. ......... . . .
1933 . ........... .

_' 1934 •• ••• •.••.••.
1 omi- • •···•·•••••

Number of
Coast
Guard
personnel
4,684

4,896
7,077
9, 839
10,984
12, 462

Hospital
days

41,681
36,504
60,336
71,799
76,564
85,691

12,833

88,870

12,963

90,179
86,829
91,655
106,126
88,896
80,195

13,020
13,189
13, 181
10,401
9,413

Average amount of medical service
per person

Out-patient Physical ex- Hospi tal
days
treatments aminations

32,530
45,857
90,494
125, 226
155,977
137,971
169, 6()7
1()6, 334
187,063
198,800
214, 805
172, 510
151,744

4,207
. 7, 008
13, 394
Ill, 061
18,787
17, 220
17,748
14,882
8, 262
11,481
9, 557
6, 367
8 ,966

8. 9

7. 6
8. 5
7.3
6. 9
6.9
6. 9
6. 9
6. 7
6.9
8.0
8. 5
8. 5

Out-patient Physical extreatments aminations

6. 7
9. 4
12.8

0. 9

12. 7

1. 9
1. 7
1.4
1. 4
1.1

14.2
11.0
13.2

15.1
14. 4
15.1
1'6. 3

16.6
16. 1

1. 5

1.9

.6

.9
.7
.6
.9

Twenty medical and dental officers are assigned exclusively to
·Coast Guard duty, and 103 local physicians under appointment as
Acting assistant surgeons furnish medical and surgical relief and
make physical examinations o:f Coast Guard and Lighthouse Service
personnel at isolated units remote :from any Public Health Service
relief station.
Medical officers have been as igned, as usual, to the cutters on the
·international ice patrol, to those on the cadet practice cruise in South
American waters, and to the Bering Sea patrQL In addition, a medical
,officer is permanently assigned to the,. cutter Itasca, whose base is
Honolulu, T. H. During the year a medical officer and a dental officer were assigned to duty ashore at the headquarters o:f the Bering
ea patrol force, at Unalaska, Alaska, to render relief to the per.sonnel of the 165-foot pat rol boats which had their base at this point


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Federal Reserve Bank of St. Louis

110

Ptr:BUC HEALTH SERVICE

£or the first time. A medical officer and a dental officer are assigned
to the cutter Northland on its annual arctic cruise. This cutter has
a specially appointed sick bay; and in addition to the care of Coast
Guard personnel, the medical and dental officers extend medical, sur:..
gical, and dental relief to Alaskan natives, personnel of other Gov~
ernment departments, and others to whom such relief is not other.wise available.
A full-time medical officer has been assigned to duty on .t he cutter
H aida, with base at Cordova., Alaska. ·Durmg March 1935, 'the H aida
made a special cruise to the Shumagin and Sanak Islands to investigate and render assistance in a reported infantile paralysis epidentjc.
Medical Director A. J. McLaughlin is assigned to duty at · Cmi-st
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, cllissified according to the General Accounting Office Bulletin, is shown
below:
01
0200
0210
0220
0230
0250
0260
0280
03
04
0500
0510
06
07
10
1100
1110
1280
1290 .
1373
1375
1380
2250
3000
3010
3020
3040
3050

Personal services ___ ___ _____________ __ _____________ _______ _ $3,496,350
Janitor and laundry supplies, X-ray films, etc_________________
58,710
Mtdical and hospital supplies_____________________________
270, 220
Scientific and educational supplies_________________________
7, 204
Fuel________________________________________________ ____ __
177,710
Forage ---------------------------------------------------43, 196
P~ovisions------------------------------------------- --~-977,881
Stjndry supplies----------------------------------------·-58,988
Subsistence
and support of persons ( contract hospital care,
etc.)____________________________________________________
347,02'7
Care of animals and vehicles ____________________._________,__
:.102
Telegraph service_________________________________________
1,-138
Telephone service___________________________.____________ ...,__
27,·550
Travel expense _________________________________________ _,__
61,687
Freight________________________________________________ _:__
56,411
Furnishing heat, light, power, and water (service)__________
204, 188
Rent of buildings and offices ________________.____________ ...,__
10, 998
Other rents_______________________________________________
5,229
Repairs and parts, motor vehicles__________________________
5, 180
Repairs and alterations, other equipment_ _______ ,.._________ .
lp,. 867
Laundry service ____________________________________ _:. __ _:_ ___:.' · · 30, 666
Ashes .and garbage removaL ___________________.__ :.. ___ . :. _____ ·: . : 2; -$92
Miscellaneous services ____________________________________.___ . .. . 2; 495
Burials___________________________________________________
23,776
Passenger-carrying vehicles ________________________________ .
' 5, 521
Furniture, furnishings, and fixtures __________ _: _____________ _:._ · · ·95, 793
equipmenL---------------------------------~'---·36, 128
:LScientific
ivestock _____________________________
... .. ·__ .... _ ·-- ___ ·___
504
Other equipment_ ___________________________ _: __________ _'__
10, 315
TotaL _________________________________________ · __ . _ 60,,317 ·26
~


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Federal Reserve Bank of St. Louis

GRQl1_P_

BOS?ITAL

OF
l!OSPITAl-S

I.OCA'l'IO!I
~ltiroorfl
""•+.nn

TOTAL

SAWUES

..,

t 1, q,

~2 . ~0

4 ,4

-~"f',i:-.., ,,._

l.T T

n

C

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Ill
Ohio

'i

4 •

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, ___

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,

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, -

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i'r ...n ... -1.,....

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Y-

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.. .,.

• •v••••" r:..
s--ttle 11••"
••"V
V<ne·--•

~~

2• ,4
4,.
,.' 4•"-

Portland Me
t::~

0

-,g ,.

TAnn
,,.,,

"-' · · - -

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6 MO
, ,,

Kv

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,,_

lJ'

T-·
-· -- ......

v ...... .......

GE?wu.t

• , 0

!.!d..

,. __ _

C1AV~lonA

C

,n

n,

tt---·- ,._
V

'f'

S:llarie a _ _

COST ?ZR PATIENT DU
R3LIEI'
DAYS

-.- '0
1<

• "t:r.

.~
• r.,

l! ln:

4'
,-.

.

0

00

2 .'iO

1

87

1.qs
, o,

0

1

:o
4

~0 .61

W"I
, 'i

, ..,o

,4
46

01

""

41

•4

,o

',
't

l :1
, 14

T

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4,
46

non

1.47

4o

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n

1,.,

,n

nT

',4
...
' 4,
...

1 64

,s

1 71

ho

(,

,o

1 70

lli.

3.33

1.98

.42

J.81

1.56

0

(a_)

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4

c=::J

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5

I

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,

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0

!!i

o•
n T

--- --(

r

.1

go

4,

,

;,

~o .,6

In
In

01
1.77

,

o=

""

o on
O

,

FOOD

o•

=

og
l""
70

,

"

o,

..

~

o,

I

T .-

I

I

Per diem coat for Oeneral lloa;,ital1

'total llel1ef

De¥•

1,463,309
74,476

Port Stanton, ll.11.

Coot

'!Vl!!l!CIJIDSIS
SA!IATOllI1JII
Coat

129,639

Ce.rville, Ia.

2,83

1.56

$4.s11 .s63.37
.62

s

3.31

Per di'!lll coat for all lloapi tale

1.93

I

I

,,

~~

I

$ 367,183.42

.43

I

. 91

i&PllOSAllIUII
Coat

I
1.63

283,985 .36
.36

~$~

.93

. 95

I
w,',« 11/,1,1

ALL

Relief day a for all llo BJ>i tali

1,667,424

Coat

$5,523,032.15

(a) In-patient department of atetion cloaed.

.Average per diem cost of in-patient relief, United States marine hospitals, fis cal year 1935

.......
.......

I-"


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

112

PUBLIC HEALTH SERVICE
CONSOLIDATED AND DETAILED REPORTS

The following tables give consolidated and detailed reports for the
marine hospitals and relief stations:
TABLE 1.-Number of patients treated annuaJly, 1868 to 1935 1
Sick

Fiscal year

Sick

and disabled
patients

Fiscal year

fur-

nished
relief
Prior to reorganization:
1868 __ -------------1869__ -------------1870__ ---------- ---After
reorganization
______
1871_
_____________
1872__ -------------1873 __ -------------1874 __ -------------1875 __ -------------1876 __ ------------- 1877 _--------------1878 __ -------------1879 __ -------------' 1880__ -------------1881__ -------------1882__ -------------1883 ___ ------------1884__ -------------1885 ___ ------------18811_ __ ------------1887 _______ --------1888 __ -------------1889 ___ ------------1890___ -------------

14,256
13,156
13,529
14,356
15,009
16,808
15, 175
18,223 .
20,922
24,860
32,613
36,184
40,195
44,761
41,714
43,822
45,314
48,203
49,518
50,671

1891_ ______ -- _-----1892__ -- ____ -- --- _-1893__ ---- -- _------1894 __ ---------- -- -1895__ -- ---------- __
1896_
--- -- ------ -- --_
1897
_______________

1898_ - - - -- --- --- ---1899. _-- -- -------- -19()() __ --- _---- ---- -1901 _______________
__ -- -- -- _-- ____ __
' 1902
1903_ ----- --- -- _- - -1904 _____ , ---------1!105 ____ -- ---- -- --- _
1906
__ ------ --- - - - -_
1907 ___
___ _________
1908 __ -- -- - - - --- -- - 1909__ ----- ----- ---1910_______ --------1911- --------------1912_______ --------1913 __ --------------

and.disabled
patiell'ts.

Fiscal year

fur-

nished
relief
After reorganizationContinued.

After reorganizationContinued.

11,535
11,356
10,560

Sick

and disabled
patients
furnished
relief

52,992
53,610
53,317
52,803
52,643
53,804
54,477
52,709
55,489
56,355
58,381
56,310
58,573
58,556
57,013
54,363
55, 129
54,301
53,704
51,443
52,209
51,078
50,604

1914 _____ --- __ --- -- _
1915 ________ -- -- -- __
1916 ___ -- --- -- -- -- - 1917 ----- ----- -- -- _1918 ______ --- --- _-- _
1919 __ ---- -- -- -- -- -1920 ____ -- ---- -----1921 __ -- -- -- -------1922 ______ ---- ---- -1923 '--------------1924__ -- -----------1925 __ -- -- ----- -- --1926 _______________
__ -- --------- _--_
1927
1928 _______________
__ -- -- ----- ___ --_
1929
1930 __ --------- -- --1931..
____________
1932 __________ -----1933 ___ -- --- - _____ -1934 __ -------------1935 __________ ------

53, 22655,782
58,357
64, 022·
71,614
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
329, 586-

1 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; 1934, 716, and

1935, 2,448.

2 In this year, and subsequently, the practice of recounting out-patients applying for treatment in morethan 1 calendar month was discontinued.

TABLE

2.-Transactions at United States :Marine h-ospitals an<[; other reUef
stations

Total
number
of patients
treated

PaNumtlents
remainber of
patients Died login
hosp!treated
in hostals
June 30,
pitals
1935

Grand totaL _____________ 332,034

Number of Number
Number patients
of times
of days
furoffice rerelief in nished
lief was
hospitals office furnished
relief

Number of
phys!cal!examinatlons

- - - --- --- - - - --- - - - --49,018

1,163

2,473
1,566
673
426
2,104
1,913
1,785
4,328
837

6,970
2,930
22
22

4,455 1,801,768 283,016 1,150,981

88,267

FIRST-CLA.83 STATIONS

Marine Hospitals
Baltimore, Md _________________ 11,078
Boston, Mass ___________________ 7,939

~~~lY~.
Chicago, 1·a~:::::::::::::::::::
Ill._ ___________________

Cleveland, Ohio ________________
Detroit., Mich __________________
Ellis Island, N. y ___ __ _________
Evansville, Ind _________________


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

4,751
1,548
5,594
6,710
4,197
8,582
1,108

26

81
8,586
90
8

260
106
39
358
183
181
205
383
54

93,750
51,267
19,579
129,639
75,498
61,261
54,019
168,710
24,714

8,605
6,373
4,078
1,122
3,490
4,797
2,412
4,254
271

50,283
38,474
28,593
1,623
22,629
18,970
19,409
11,146
659

2,9~
3,885
1,013

---i:337
1,043
1,017
372
151

113

PUBLIC HEALTH SERVICE
'l'ABLE

2.-Transactions at United States Marine hospitals and other reUe,f

sta:tions--Continued
Total
number
of patients
treated

PaNumtients
ber of
remainpatients Died ingin
hospitreated
in hostals
pitals
June 30,
1935

Number of Number
Number patients
of times
of days
furoffice rerelief in
lief was
hospitals nished
office furnished
relief

Number of
physi- cal examinations

--- - - - --- ---- --- ---- - - FIRST•CL.A.SS STATIONS-Contd.

Marine Hoapital.t-Continued
Fort Stanton, N . Mex __________
Galveston, Tex _________________
Key West, Fla __________________
Louisville, Ky __________________
Memphis, Tenn ________________
Mobile, Ala _____________________
New Orleans, La _______________
New York, N. Y _______________
Norfolk, Va _____________________
Pittsburgh, Pa __________________
Portland, Maine ________________
St. Louis, Mo. __________________
San Francisco, Calif. ___________
Savannah,
Ga___________________
__ ---------------Seattle, Wash
Stapleton, N. y ________________
Vineyard Haven, Mass _________
Contract overflow hospitals _____

1,348
6,363
1,476
1,298
3,934
3,651
11,559
37,654
9,244
2,461
1,638
2,673
16,756
3,959
12,107
11,335

280
102

- -,-

Total ___________ ---- ----- - 179,345
SECOND- AND THIRD-CLASS
STATIONS
Aberdeen, Wash ________________
Albany, N_ y ___________________
Anacortes, Wash ________________
Apalachicola, Fla _______________
Ashtabulii, Ohio ________________
Astoria, Oreg ___________________
Balboa Heights, Canal Zone ____
Bangor, Maine_---------------Beaufort,
N. c _________________
Bellingham, Wash ______________
Biloxi, Miss ____________________
Boothbay Harbor, Maine _______
Brunswick,
___________
-----------~
-Burlington, Ga
Iowa
________
Cairo, Ill. ______________ -_ _______
Calais, Maine ___________________
Cambridge,
MdJ __
-------------Cape May, N.
________________
Charleston, s. c ________________
Chincoteague, Va _______________
Cincinnati, Ohio __________ _. _____
Cordova, Alaska ________________
Corpus
Tex----~------Crisfield,Christi,
Md ___________________
Duluth, Minn __________________
Eastport, Maine____________ __ __
Edenton, N. c _________________
Elizabeth Clty, N. c ___________
El Paso, Tex ____________________
Erie, Pa ________________________
Escanaba, Mich ________________
Eureka, Calif ___________________
Everett, Wash __________________
Fall River, Mass _______________
Gallipolis, Ohio _________________
Gary, Ind ____8.-----------------Georgetown,
o _______________
Gloucester, Mass _______________
Grand Haven, Mich ____________
Green Bay, Wis ________________
Gulfport, Miss __________________
Hancock, Mich _________________
Honolulu, Hawail ____ ---------.
Houston, Tex ___________________
Indiana Harbor, Ind ____________
Jacksonville, Fla ________________


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

=

319
2,068
454
745
1,622
1,260
3,579

17
54
9
12,
18
38
79

4,031
19,392
5,295
4,198
14,141
11,155
33,002
224,776
33,389
3,860
3,725
10,798
65,464
10,314
22,398
29,423
286

1,555
1,680
3,201
14,300
1,975
769
354
1,215
2,388
1,345
5,416
585
9

4,138 1,681,548 135,726

687,433

48,383

675
328
351
153
975
834
757
58
1,469
901
845
44
207
51
1,476
3
219
4,291
1,375
159
299
410
413
1,235
1,098
119
108
615
1,408
1,158
88
472
305
380
369

109
262
20

265

49
49
107
258
136
309
212
25
38

88,529
21,734
25,242
35,425
152,436
54,262
112,241
106,016
8,431
1~ 124

50
114
122

--2~726- -----;;s- -------235
733

553
825
4,119
1,714
3,130
3,423
142
102

15
12
18
91

28
108

50

,4
4

----43,619
1,070

193
1,047
100

1,029
4,295
1,022
553
2,312
2,391
7,980
37,654
6,518
1,728
1,085
1,848
12,637
2,245
8,977
7,912
138

74,476
63,098
16,140
21,016
38,314
45,352
126,275

192
178
30

440

----------------- ---------- ----

I
I

366
184
181
40
332
462
908
45
398
388
582
32
78
43
613
3
92
2,007
804
ii3
138
296
323
753
572
32
33
206
246

404
41
227
176
177
163

79
33
488
224
149
166
72
1,316
1,271
201
1,074

35
19
25
5
13
40
194
12
78
13
3
7

-------- --------1
-----~2-------------3- ---------------

I 261
, 290
139
22
, 223
307
3,336
244
413
80
14
27

1 -----L-2
16

------i- ------2------2- ---------------------- ------------20------i- ------336
1
67

1

56
82

2
1

46

--------2 --------3
-------1
1

'

-----.-3-

------;;- -------- -------58
51
7

560

2

-----io- -------- --------

------i-

-

- 132
209
924
107
1,111
295
32
772

-------- -------- -------- --------·-------- .-------11
2 -------- -------32
1,083
1
15
10
39
17
19

2

200

1

-------- ------i--------------- --------------- --------2
44 -------650
-------- ----------------- --------------56
13 -------2
169
1
17 -------46
10 -------1
58
7
2
127
86
3

54

I

------i- -------------45
2
1
1

-------------i-

91
261
63
252

10
1,393
513
20
494

331
165
156
35
319
422
714
33
320
375
579
25
78
23
546
3
82
1,951
722
63
131
238
272
746
526
32
33

204
214
389
31
188
159
158
119
79
33
475
207
139
159
70
1,189
1,185
198
1,020

229
59
1,410
557
429
358
122
2,823
3,777
324
2,778

------67
129

------69
26

588

20
9
10
1
142
81
4

65
294
20
97
9
13
20
129
9,

------34
189
101
14
18
22
14
3825
90
47
78
21
505
75

·------657

114
TABLE

PUBLIC HEALTH SERVICE
2.-Transactions at United States M(ll1"ine hospitals an<l other relief

stations-Continued
Total
number
. of patients
treated

. ..

Num•
ber of
patients
treated
in hos•
pitals

Pa•
tients
remaining in
Died hospi•
tals
June 30,
1935

Num·
ber of Number
Number patients
of times
of days
office refur•
relief in nished
lief was
hospitals office furnished
relief

Num•
ber of
physi•
cal ex•
amina•
tions

--- --- --- ---SECOND· AND THIRD·CLASS
STATIONS-Continued
Juneau, Alaska •..••••.•••••••..
Ketchikan, Alaska••••..••.••••.
La Crosse, Wis •••.•••••••.•••.• .
Lewes, Del. ••.•.•••.•.•.•.•.•••
Los Angeles, Calif. •••••••••.•..
Ludington, Mich •••••••••••••.•
Machias, Maine ..••••.•••.•.••.
Manila, P. L ................... ·
Manistee, Mich ..•...•.••••••••. ·
Manitowac, Wis ..•...•......•..
Marquette, Mich .•.•.•••••..•••
Marshfield, Oreg •...........•••
Menominee, Mich .•.•..••••....
Miami, Fla.....••.•.•.....•.••.
Milwaukee, Wis .......•.•••.•..
Morehead City, N. C .•••••••..
Muskegon, Mich ••........•.••.
Nantucket, Mass •.......•••.•.•
Nashville, Tenn •.••.•.•••••••..
Natchez, Miss ••••••...•••••••••
Newark, N. J. ..••.••••.•.•••..
New Bedford, Mass ••••••...•..
New Bern, N. c .....•.•........
New Haven, Conn ••••.•••••••..
New London, Conn ••••••.•.•.•
Newport, Oreg .••.•.•.•••••••••
Newport, R. L ..............•..
Newport News, Va •••.•.•.•••••
Ogdensburg, N. Y .•.•.•.•••.•.•
Olympia, Wash ...••....•.•••••

=:::
~!ct'~~~h:ki-~~::=====:::=:
Panama City, Fla ...•.....•.•..

Pensacola, Fla .•... •.•.. . .......
Perth Amboy, N. J. .•.••..••..•
Petersburg, Alaska ..•• ..•...•. .
Philadelphia, Pa .••.•..•...•.•.•
Ponce, P. R .. _---····-·········
Port Angeles, Wash .••.••...•..
Port Arthur, Tex ..•...•....••••
Port Huron, Mich •.••.•.•.•.•..
Portland, Oreg ••..•...•••..•••.
Port Townsend, Wash.•••••••••
Providence, R. L ..............
Provincetown, Mass •.•.••...•..

3
-------2
3
-------- -------208
1
-------1,699
6
-------298
-------- -------24 -------- -------- -------2
910
5
83
52
3 -------- -------293
17 -------- -------252
19
-------1 -------121
13
49
2 -------- -------2
1,195
4
335
753
41

1,148
535
18
111
54
642
20
317
381
149
3,150
140
322
310
97
65
148
1,035
255
419
68
215
6,574
140
359

2,000

434
2,078
96
532
281
441
116
Rock Island, Ill .•..•..•....••.• . 5,557
St. Thomas, Virgin Islands •••..
179
San Diego, Calif. •.•••...•.•.•..
623
Sandusky, Ohio •..••.•••...•....
176
San Juan, P. R ...••....•...•••. 1,089
Ban Pedro, Calif. ......•.•••..•• 4,536

lT:g~~~ct.v~a=:::::::=::::::::: .

~ault Ste. Marie, Mich ••••••.•.
eward, Alaska••.•..••••.••..•.
Sheboygan, Wis .••••••••••.••••
Sitka, Alaska .....••••••••.•••..
South Bend, Wash ••.•••..•.•..
~outhport, ~. C .•••..•••.••..••
upenor, Wis .••••••.••.••••••.•
Tacoma, Wash •••• _ •••••••••.•

1,228

326
69
357
62
779
366
298
635
61~o .•••••••.•••••••••.
798
Vicksburg, Miss •.••••..••..••..
682
Washington, D. C ...•.....•..•. 31, 18i

~~~gi,

Wa~h~ngton, D. C., dentf:\l
chn1c ••••......•.••.••••••••..
Washington, N. C •••••••• _•••••
White Stone, Va.••••••••••.••••
Wilmington, ·N. C •......•.•....
Wrangell, Alaska ...... ~.·--··· -


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

1, ~58
296
731
552
159

39
113
5
19
152
9

755
899
125
183
2,496
37

170
120
42
1
8

1,785
16
99
256
26
49
1,478
1,817
292
6
77

2
1

4
1

-------1 ----------------------------1
64 --·------------------1
21
67
14
34
16
55

-------5
18
3
9
20
41
5
22
332
32
40
54
5
226
2
30

573

239
459
96
1
338
1
1
164
1,042
5
-------- •••• 45.
1
1
455
17
-------1
55
1
166
1
275
43
-------- -------128
-------5
3,067
5
1
486
207
1
371
1
18
4
3,217
5
11
-------2
461
-------1

•

1

--------

---------------

--------

--------

······a·
--------

-------- -------- -------- ----------------- -------- ----------------208
23 -------- -------18
5 -------- -------1
130
11 -------2
917
44 -------2
74
9 -------2
117
377
62
69
1
6
16
103
32
17
54
109
15
320

-------27
74
18

3

3
13
3
4

-------3..
-------- --------------- --------

···-··a·

2

-------- --------1
--------2
2
5
1
2

5

-------9

-------- --------------- -------2
1

3

--------

1,300
5,031
467
950
9
129
175
1,442
473
169
377
1,622
70
4,217

.•. 197
•• 721
138

296
640
36
189
1,547
289
24
827
49
276
233
108
47
1,025
1,028
493
17
103
54
578
20
296
314
135
3,116
124
267
319
92
47
145
1,026
235
378
63
193
6,242
108
319
1,946

429
1,852
94
502
281
441
93
5,552
168
579
167
972
4,159
1,166
257

330
1,214
66
559
6,085
470
52
1,395
550
655
815
197
149
3,645
3,015
1,902
22
300
134
1,383
40
564
674
214
4,657
308
473
523
211
84
430
2,326
485
988
111
654
23,212
410
536
6,314
1,003
5,861
597
1,153
808
1,327
158
19,936
246
2,515
276
2,786
10,833
1,972

444

351
46
676
334
281
581
689
667
30,861

130
653
109
979
730
681
1,214
1,781
2,293
66, 791

1,258
269
731
478
141

12,829
481
3,406
1,146
275

68

108
297

24
6

582
4
31
1,091
33
5

64
24
20
157
622
5
11
5
83
49
17
55
13
73
119
10
34
17

43

······•1
46
7
71
12
38

3,4:
47
154
386
1,~~
294
36
9
22
7,135
4
652
14
148
730
94
19
14
109
20
18
8
53
114
132
73
14,344

·······s
13
160
3

115

PUBLIC HEALTH SERVICE
TABLE

2.-Troo.sactions at United States Marine hospitals and other reUef

. stations-Continued .

Total
number
of PB·
tients
treated

:e~~f
.
patients
treated
in_hos•
p1tals

Pa•
tlents
remain·
ing In
Died hospi•
ta1s
June 30,
1935

Num•
ber of
Number patients Number
of times
of days
fur·
office re•
relief in nished
hospitals office lief ;was
furmshed
relief

t1e~f
physi•
cal ex•
amina•
tions

- - - - - - - - - - - - 1 1 - - - - - - - - - - - - - - - - - - - - - - - -FOURTH-CLASS STATIONS

Ashland, Wis•.•••.•.•...•..••..
Bath, Maine............•••..•..
Bay City, Mich ..••.•.•.•.•••..
Bridgeport, Conn •.•..........••
Hartford, Conn .•.......••...•••
Nome, Alaska.••.•....••••.. _•••
Saginaw, Mich __ ··········-·-- ·
Wilmington, DeL ••.•..........

136
·50
148
21

10
3 •••••••• •• ••••••
13
1 ·•·•····
12

2

2

37

12

2

103
15/i
86
102
27
139

126
47
13/i
9

269
259
373
10

110
3
5

8

43

3 ······-- ·······-

10

MISCELLANEOUS

Curtis Bay, Md. (U. S. Coast
Guard)_··- __ -·-····-·--·-···U. S. Coast Guard Academy,
New London , Conn .......... .
St. Elizabeth's Hospital, Washington, D. C-···-·-····· · -·--Special acting assistant surgeons
for Coast _Guard and Light•
h ouse serv1ee ..•.....•.•..•....
U. S. Coast Guard vessels and
bases ... _·-._ •........ __ .•. -·_
Medical relief activities, Treasury Department. .•.......... _
Emergency_ ...•••••.....••.•.••

1,609
2,494

269

179

179

4,576

98

4

3,505

162

58,683

1,609

5,329

125

2,225

8,232

374

4,478

13,045

1,021

12,863

12,863

60,594

979'

33,140
76

33,140
62

129,065
144

120,220 147,290

463,548

39, 88'1

4,455 1,801, 768 283,016 1,150,981

88,267

814

14 ······-· .•..•.••

Total. ................•••. 152,689

5,399

93

Grand totaL .....•....•.. 332,034

49,018

1,163

TABLE

6

317

229

3.-Medical services for various classes of beneficiaries

Beneficiary

Num•
Total ber
of
num- patients
ber treated Died
of
in
patients hospitreated tals

Number Number Num•
Patients
ber
of
of
remain• Number
of
ing
of days patients times
physioffice
in hos•
relief
furnish•
cal
relief
in
ed
pitals
examiwas
June 30, hospitals office
relief furnished nation s
1935

--- --- --- ---- --- ---- --American seamen ............. 165,064
Foreign seamen ..... _. __ • ___ ..
657
Coast Guard .. ·---·-···-----·· 39,165
Bureau of Fisheries .....•.....
66

Army .... _______ .• _-·.··- .....

261

Navy and Marine Corps.••.. _
334
Mississippi River Commis•
9
sion .•.. ····-··-·-······ ....
Engineer Corps and Army
7,136
~ Transport Service ..........
ighthouse Service .....•..••. 2,413
Coast and Geodetic Survey... 1,091
Employ~es: Compensation
Comm1ss10n ••.............. 28,956
Veterans' Administration ..... 2,448
Immigration Service.•••..•... 4,860
Public Health Service officers
and employees •••........... 9,606
Lepers __ ._ ........•••.• _. __ •••
442
Civilian Conservation Corps •• 5,311
Civil Works Administration .. 3,626
Miscellaneous••••••........... 60,589

27,631
311
3,129
8
75
115
2

137,433
346
36,036
58
186
219

593,554
873
151,744
143
741
845

31

7

18

2,607 1,145,469
6,479
7
80,195
211
68
---------------996
4
6
2,061
4
3
748
7
18

-------- ---------


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Federal Reserve Bank of St. Louis

-------386.
56

1,443
423
158

38
22
2

108
33
7

48,075
13,966
4,418

5,693
1,990
933

22, 134
6,054
4,283

66 7
142
349'

4,698
2,339
1,382

15
233
3

243
339
83

108,700
81,322
25,062

24,258
109
3,478

118,473
1,247
10,334

26,469
788
33

892
438
4,250
1,654
70

12
22
20
7
9

40
358
354
52
3

14,323
130,136
103,638
35,598
1,231

8,714
4
1,061
1,972
60,519

60,649
6
1,903
12,055
165,925

2,26 7
1a
443
1, 554
36, 74g.

283,016 1,150,981

88,267

- - --- - - --- -49,018
1,163
'1,455 1,801, 768

Total. .•••.. _.-· .. -. -· -- 332,034

8, 955
126
8,966-

116

PUBLIC . ;HEALTH ·SERVICE

TABLE

4.-Classi fi,cation of ou t -patient t r eat ments .furyi,ishe_d .at Unite<!, States
marine hospitals and other relief stations

,i :a
-g~

,c,
(I)

El

.-

-;;i
=
0
(I)

(I)

Marine hospitals _________ __ _
Other relief stations _________
Special acting assistant surgeons _____________________
Coast
Guard________________
vessels and
bases _____
Medical relief activities,
Treasury Department _____
Emergency _________________

,;,

'cd

=

:i~
<D._,

t~

;a

.!!l

~-c .s

Q

::,

~~
::,

I

Q

lo

-~

"''
="'

I>,

o.S

u
.... C)

i
"'"'
g._,§ -a

~~ : -1>-

li3<D

f'~
(I) . .

.... ~

.Q'

~'O

f~

30

z 8 ~ ~= ~ ~:a ~ ll-1
8
- - --- - -- -- ---- -- --(I)

A

(I)

.c
::,

la:l

00

(I)

1-1

86,127 246,088 40,520 72 301 77,061 82,038 7,416 23,654 124,156 687,433
94,405 21,788 16,357 177 384 70,586 16,853 5,584 . 6,618 19,716 . 252,,468
. ~01 1,028

32

23,'988 15,962 5,444

23

224

92

13,045

5,655 3,166 1,193

3,082

68,826

69,' 465 ------- 27,809 ---- ---- 31,791 ------- ------ -- -·- ------144 ------- ------ ---- ---- ------- ------- ------ ------ -------------

129,065
144

7,,012

5

1,402

81 10,232

416 2,633

--- - - - - - --- --- - TotaL ________________ 281,141 284,039 91,158 304 771 191,072 104,962 18,799 31,689 147,046 1,150,981


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Federal Reserve Bank of St. Louis

DIVISION OF VENEREAL DISEASES
Asst. Surg. Gen. R. A.

VoNDEBLEHR

in charge

The Division of Venereal Diseases continued its studies of the
cause, treatment, and prevention of syphilis and gonorrhea. These
investigations were of a clinical and laboratory nature. Cooperative work with State and local health departments, both in an
advisory capacity and in attempts to stimulate and encourage the
development of local programs was included. The insidious character of the diseases with the control of which this division is concerned
makes it necessary to continue projects over a considerable period
of time. To this extent the present report may be regarded as
a continuation of that of the preceding year.
COOPERATIVE CLINICAL STUDIES

This. project has continued over 6 or 7 years, and a large number
of scientific papers have been prepared during this period. The
work is cooperative, combining cases treated in five of the largest
clinics for the treatment of syphilis in this country, and the guidance
of the directors of these clinics, with the coordinating and statistical
facilities of the Public Health Service.
These studies have been conducted in cooperation also with the
Health Organization of the League of Nations. The latter organization published, during the year, a report on the different systems
of treatment employed both in this country and abroad. It is of
considerable interest to note that the alternating continuous method
for the treatment of early syphilis, advocated by the group of investigators in the United States, was the one which accomplished the
best results.- This report was published in the Quarterly Bulletin
of the Health Organization, League of Nations March 1935.
4- number of scientific papers were prepared hoth on: the treatmei:it ·of eai:ly syphilis and of cardiovascular syphilis. The studies
of early · syphilis have indicated the effectiveness of treatment: and
refµted the contention of certain investigators that modern treatment is · ineffective. The investigations pertaining to the treatment
of cardiovascular syphilis have indicated both the :possibility of prev~n.~ing the development of this serious complication by early adequate treatment and of obtaining symptomatic relief after the condition has. developed.
';.,

COOPERATIVE WORK WITH STATE HEALTH DEPARTMENTS

Upon the request of State health · departments, officers were assigned from time to time to stimulate, organize, and direct programs
against syphilis and gonorrhea within the States. Assistance has
117


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Federal Reserve Bank of St. Louis

118

PUBLIC HEALTH SERVICE

also been given to State and local health departments in their informative and educational campaigns. This assistance, however,
has been mutual, and the States have given material aid in the general program. Reference should be made here especially to the
attempts of many of the State health departments to stimulate
morbidity reports of syphilis and gonorrhea. During the year,
254,551 new cases of syphilis and 161,810 new cases of gonorrhea
were reported to the State health departments. Six hundred and
fifty-six clinics furnished morbidity reports 't o State health departments. These clinics reported 81,590 new cases of syphilis and
50,470 new cases of gonorrhea. They discharged as arrested ~r
cured 60,850 patients and gave a total of 3,338,692 treatments, including 889,310 doses of arsphenamine. The policy of distributing
a monthly statement of morbidity reports on syphilis and gonorrhea
to State and city health officers and others interested in venerealdisease control has been continued. It is believed that the continued
release of this statement and the attendant publicity given to th,e :
morbidity reports will ultimately lead to a real attempt to obtain.
complete reporting.
EDUCATIONAL AND INFORMATIVE ACTIVITIES

This work has been ·coordinated with the activities of State and .
local health departments as far as possible. It includes the distribution of the monthly abstract journal Venereal Disease Informa·- ,
tion, and various reprints pertaining to modern advances in the .
diagnosis and treatment of the venereal diseases to the physicians of:
the United States and to other workers interested in the control of
syphilis and gonorrhea.
.
.
Special articles published in Venereal Disease Information which :
have been reprinted and widely distributed are as follows: Lympho- ,
granuloma Inguinale; What Treatment in Early Syphilis Accomplishes; The Value of Instructing the Syphilis Patient; Trend of
Syphilis and Gonorrhea in the United States; and The Evaluation ,
of Serodiagnostic Tests for Syphilis in the United States. The edu- ·
cational program further embraces the distribution of pamphlets
to citizens upon request, either directly or through State and local
health departments. Four bulletins have been reprinted during the,
year : The Facts About Venereal Diseases; Sex Education in the,
Home; The Problem of Sex Education in Schools; and High Schools
and Sex Education. The distribution of films and the preparation
of exhibits and lectures have also been continued.
·,
Considerable attention has been given the subscription list of
Venereal Disease Information. Leaflets descriptive of this monthly
abstract journal have been distributed on a large scale to physicians.
and other scientific workers. In this distribution the State health
departments have given very useful cooperation. The paid subscription list has more than doubled during the period.
Four thousand two hundred and seventy-six requests for bulletins
and pamphlets were referred to the State departments of health for
the distribution of this material directly to citizens within their.


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Federal Reserve Bank of St. Louis

119

PUBLIC HEALTH SERVICE

boundaries. The Public Health Service distributed to State health
. departments and to organizations and individuals 71,790 pamphlets.
The revision of · such educational pamphlets as have 'become obsolete has been continued. A number have been replaced with more
· modern bulletins.
··
HEALTH SURVEY· IN THE SOUTH

.

In order to determine the permanent Tesults of an intensive program against syphilis, detailed surveys were made during the preceding year in Macon County, Ala., Pitt County, N. C., and
. Albemarle County, Va., to obtain information with regard to the
· health of the individuals included in the original program. These
surveys were analyzed and reported during the present fiscal year.
Based on information from former Negro patients, from the employers of these individuals, from physicians in the areas concerned,
,a nd :from the health officers in these counties there was every indica.· tion that the disability in the treated group had been materially reduced. This project indicated the exGellent results which may be
expected in an intensively developed program against syphilis, even
though it be conducted over a short p~riod of time.
RESEARCH

A fairly well balanced program of inv~tigative and experimental
work has been maintained during the ye'ai-. For syphilis the program included a continua ti on of the study of the carrier problem
with special reference to the possible public health menace of inadequately treated cases with manifestations of involvement of the central nervous system. Two additional steps in the experimental resurvey of the general subject of personal ·prophylaxis in syphilis
were completed and reports submitted for publication. A study designed to contribute additional information in regard to the life
cycle of the syphilis spirochete, utilizing single-cell methods, has also
, been completed.
In gonorrhea an effort to establish more clearly the clinical valu
-of diagnosis by means of the compleIQ.ent fixation test has been well
advanced. Following the Price technique, with a special antigen, an
increasing experience seems to indicate that a high degree of specificity and reliability may be attributed to the method. A determination of the limitations of the technique will be carried out by the
t.esting of suitable groups of patients suffering from other conditions.
. It is hoped also to carry this work into the field of precipitation
· reactions.
·
The :fourth venereal disease, lymphogranuloma inguinale, has assumed an increased clinical and public health importance during
·recent years. A start has been made in the direction of artificially
· cultivating the virus of this disease and ·in studying the use of antigens :Prepared from this virus in the production of diagnostic skin
·_reactions. If successful, further work looking toward the refinement of an antigen suitable for use in a precipitation test will .be
_.attempted.


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Federal Reserve Bank of St. Louis

, PuBiic HEt~LTH

120

,SERVICE

be

' ; There seems to
'a:.· cqnsi'd(ir'~ble· degree of' doubt as to whether
the usually .accepted coric~pt iori ·of the bacferiology of chancroid is
entirely tenable. In the light' of ·more recent advances in bacteriology
a general resurvey of the entire question appears to be desii;-able.,
and preliminary steps in this direction have been taken.
·
••

,

• • •i '

I

~

•

•

•

•

. STUDY OF S;ERODIAGNOSTIC 'l'ESTS FOR SYPHILI~

During. the year the evalli~#on: of serodiagnostic tests for syphilis
_was cqrnplete.d . . This ,prpject, h eld in cooperation with the American Society · of Clinical J,>athplogists and many_ of the clinics and
hospitals of the country, permitted an estimation of the efficiency
of serologic tests for syphilis .a s performed by the serologists · who
originated these tests. FQnd;unental data pertaining to the specificity and sensitivity of the$e· serplogic tests have been published.
For a number of years the .medical profession and public-health
workers have been deeply interested m the relative _value of the
complement fixatio~ ~nd the, precipitation tests for syphilis. O~e
of the pertinent conclusion's'of the committee conducting this work
was that a properly performed and highly sensitive precipitation
test might be ~sed routi~ely ,fo_r excluding- the likelihood of syphilis.
When a negative result 1s obtamed by this method, no further study
of the specimen need be made. The general adoption of this procedure in busy laboratories with. limited budgets will accomplish a
great deal not only in providing _for the efficient diagnosis of syphilis
but also in the saving. of considerable sums of money by eliminating
the necessity for unnecessary serologic tests.
Another recommendation was that the results of all serologic tests
be reported as positive, doubt:ful, or negative. This is in accord
with the recommendations of :the Health Organization of the .League
of Nations which were made. subsequent to the serologic conf(}rences
at Copen~agen :i-nd Monte'Y.1deo. Gen_eraL ado:ptio~ of ~his. system
of reportmg will acce>mpl'isic much m the' s1mphfi.cat10n . of the
diagnosis of syphilis.
..
·
VENEREAL DISEA SE CLINIC,

HOT

SPRINGS,

ARK.

Not only has the number, of new patients admitted to this. clinic
increased during the past, year, but it has -been possible, owing to the
provisions of the Transient , Bureau, .to keep these patients under
treatment for a much longer period of time so that the total rn;unber
of treatments has increased to a greater extent even than the total
number of new admissions. ,As a result., the ..treatment' given the
average patient at the clinic has boon adequate in a much higher p~rcentage of cases than formerly. . The total number of cases o.f venereal disease admitted to the clinic was 8,032. These patients were:
given 198,051 treatment~, including 41,739 doses ·o f the arsphenamines. The staff at this station showed an active interest in research
work and rendered mo_st valuable assistance in several of the projects
of this division.
·
-.
.


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Federal Reserve Bank of St. Louis

121

PUBLIC HEALTH SERVICE

TABLE 1.~Rep<>rt of State departments of heaUh showing . the number of roses
of syphilis andJ gonorrhea reported, the ann,ua.l rates per 1,000 inhabita;n,ts,
the amount of arsphen(llrrtine di.stri b11,t ed, ancZ the laboratMy ea:G1111,,ination.~
made, from July 1, 1934, to June 30, 1935
Numher of cases

Laboratory examinations

Annual

----------1 rate for
State

syphilis
and
Syphia gonor•
rhea
Syphi· Gonor• lis and
per
lis
rhea gonor• 1,000
rhea inhab•
itants 1

Micro• Micro·
Doses of
scopic scopic
arsphena·
exami•
mine dis• Serologic
exami·
nations nations
tributed
tests
for
made
for
Spiro• gono•
chaeta coccus
pallida

------------1--- --- --- --- ---- ---- --- --Total ..•••.•••••••.•••.••• 254,551 161,810 416,361
3. 3 1,393,267 1,973,584
6,497 380,402
---- -1,534
- - - - - --- ---- ---- - - - --Alabama........................ 4,692
6,226
2. 3
23,063
75, ,103
18
12,843
Arizona.........................
520
1, 799
2,319
5.1 --· -···---- ··-·-····· ........•.......
Arkansas....................... 4, 751
2,987
7, 738
4. l
· 41,802
61,369
504
14,047
California.......... ............. 17,488 16, 430 33, 018
5. 5
192, 211
77,895
606
37, 686
Colorado 2 ••••••••••••••••••••••••••••••••• • •••••• • •• • • • ••••••••••••••••••• • ••••••••••••• • ••••••••••
Connepticut. .••••..•••••..•.•.. ;2,593, -1,802! . 4,39,5.
2.7
16,~5
56;266
10
4,758
Delaware .....•••........•..•••• 1,930
383· 2,313
· 0:64,398 .•. ~,684 .•......
746
District of Columbia............ 1,839
1, 428
3, 267
6. 6.
13, 43.5
6, 195
05
6, 021
Florida. ........................ . 5,438
1,043
6,481 ,
4. 1 . •... .. . ..............••.•..•••...••
Georgia..•••••••••••••• ~........ 9, 625
5, 261 14, 886
5. 1
73, 650
98, 758
12
5, 901
Idaho .•...••••••••••••.•.•••••••••.••...............•......••. •·. .••.......
19,943
2, 09u
Illinois ....••.•••••••••••.••••••• 16,170 14,466 30,636
3.9
87,324
98,249
2,636
49,8\1
Indiana......................... · 2, 795
2,056
4,851
1. 5
48, 126
148, 351
7, 373

Io~a............................ : 1,528

l, 972

3,500

1. 4

7,369

1,415

15

2,491

Kansas......................... 1,453
907
2,360
1. 2
10,273
53,618
3,298
Kentucky ••••••.••• _•••••••••••• 2,652
3,712
6,364
2.4
17,909
12,326
347
6,402
Louisiana....................... 2, 150
1, 302
3,452 ·
1. 6
12, 734
28, 393
39
3, 016
Maine .•....••....•••.••••••••.• · 499
518
1,017
1. 3
5,486
12,606
26
3,764
Maryland...................... . 9, 291
2,897 12, 188
7. 3
52, 344
13, 524
49
4, 761
Massachusetts.................. · 4, 813
6, 486 · 11, 299
2. 6
93, 829
126, 296
10, 344
Michigan....................... 6, 782
6, 095 ; 12, 877
2. 5
45, 248
44, 057
39, 682
Minnesota .•.•••••••••• ,.......... 4,172
3, 788
7,960 ·
3.1
11,124
150,566
12,975
Mississippi. •.••••••••••.•••.... 13,290 21,093 34,383
16. 7
46,466
2,915
MlssourL...................... 6,404
3,446
9,850
· 2. 7
17,938
21, 53,5
,·5, 209
Montana •••.••.••••••.••••••••. · 421
476
897
L 7 •••••••..•..••.....•..•.••..... . ....
Nebraska.......................
464
878
1,342 .
1. 0
5,000
27,804
6
4,548
Nevada'····················-·· .••..............••....• .•.· •• ·•.•••..•.....••.........••••....•....
New Hampshire................
196
209 · 405 ,
.9
4,309
11,063 ---·---·
4,100
New Jersey..................... 7, 121 · 3,331 10,452 ,
2. 5
42,668
52,461
374
12,381
New Mexico....................
574
366
940
2. 2 ..•••........• ~ •••....••••........••
1 80: 049 ;
New-York .. _.. ~.....••••••.••••• 62,339' i17,
' 6.1 . 104,073 · 270,865- •••••••• 29,,5.20
North C<irohna ..•..••.•••.••••• · 14,210
4,693 18,903
5. 7
73,032
131,791
206
5,264
North Dakota. .................
180
529
709
1. 0
12,930 ...•••..
1,992
Ohio........ . ...... . ............ . 8,092
3, 142 11, 234
1. 6 a 38, 213
a 30, 248
a 578 3 10,304
Oklahoma .. ..... . . . ... '. ........ 1,995
1,858
3,853
1. 6 .•........ ·········- .••..... ······ -·
Oregon.........................
702
913
1,615
1. 6
5,352
13,228
31
4,315
Pennsylvania................... 4., 296
2,846
7, 142
.7
42,279
82,664 ...... .. 15,374
Rhode Island...................
998
732
1, 730
2. 5
21, 780
16, 997
57
3, 005
South Carolina ••••.• -.......... 3,190
4,340
7,530 '
4. 3 ...••.•.•. ·····-···· ······· - .....••.
South Dakota~ ••..•.•• '. ........ . 89
411
500
.7
6,520 ......•.........
Tennessee ... -. . . .•....•...... . .. ,11, 850
6,333 18,183
6. 8
67,698
52, 754
425
10,052
Texas................... ........ 5,692
1,739
7,431
l_. 2
132,023
9,635
45
3,033
Utah 2 •••••••••••••••••••••••••••'•••••••••••••••••••••••• • ••••••••••••••••••••••••••••••••••••••••••
Vermont. ..•...•...•.••.••.•. .-.• ' 247
375
622
1. 7
1,271
6,601
8
I, 609
1 3,976
Virginia.................. . ..... ; 4,945
3,451
8,396
3. 4 • 13,236 ' 11,927
• 35
Washing ton.................... , 2,235
2, 559
4, 794
3. 0
10, 518
48, 613
198
23, 360
West Virginia"'·················· 3,525
1,731
5,256
2. 9
47,353
11,626
88
2,175
Wisconsin .•.. ~ •.....•. ·• •....•••
315
1, 783
2,098
.7
8,844
9,942
89
8,356
Wyoming 2••• , ••••••••••••••••••••••••••••••••• · · · - · · · · •••••••••••••••••••••• , ••••••••••••• -- ··--·-·

no

1 Excludes chancroid which formerly was included in the annual rates.
2 Not reporting.
a For 11 months.
• For 10 months.


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122

PUBLIC HEALTH

'l'ABLE

ERVICE

2.-Report of 127 correctional and penal ·i nstitutions cooperating with
State departments of health 1

New Syphilis
cases admitted:
______________________________________________________ _
Gonorrhea ___________________________________________ ________ _
Chancroid ____________________________ _________ ______________ _
Total _______________________ ____ _____ ___ ____ ________________ _

7,947
3,859
167
11,973

Cases discharged as arrested or cured ____ ________ __ ______ ________ __===
7,581
Treatments given _______________________________________________ ___ _ 3.58,809
Doses of arsphenamines administered _____________________________ _ 60,802
Serologic tests made-----~----------------------------------------- 58,184
Microscopic examinations for gonococcus ____________ _____ _______ __ __ 19,321
1

Includes 49- prison ca~ps.

TABLE 3.-Report of 656 clinics, furnished through Sta..te health departments,

July· 1, 1934, to June 30, 1935 1
New cases admitted
Cases
Total
dis•
monthly
charged
reports
as
Gonor- Chan- arrested
received Total Syphilis
rhea croid or cured

State

TotaL _______
A:labama _______ _--Arkansas _______ ____
California.--- -----Connecticut_ _______
Delaware 3 _________
District
of Columbia _______________
Gro·gia ____________ .,_
Illinois _____________
Indiana __ __________
Iowa. ______________
Kansas _____________
Kentucky __________
Louisiana __________
Maine _____________
Maryland __________
Massachusetts ______
Michigan ___________
Minnesota __________
Nebraska ___________
ew Hampshire ___ _
N'ew 'J ersey _________
New York __________
North Carolina _____
Ohio•- - -----------Oregon.
____________
Pennsylvania ___ ____
Rhode Island _______
Tennessee __________
Texas _____ ________ _
Virginia•----- -----Washington ________
West Virginia ______
Wisconsin __________
~

Treatments
given

Doses
of arsphenamine
administered

Microscopic
Sero- examilogic nations
tests
for
made gonococcus

- - - --- - - - - - - --- ---- --- - - - --6,462 133,730 81,590 50,470

----4,872
48
14
476
192
30

6,955
11,286
1,526
301

12
3,273
1105
6',096
221 10,906
169, , 4,121
24
688
24
768
228
6,360
12
423
108
818
5,319
440
5,973
52
148
5,595
851
36
48
840
302
58
362:
6,899
1,142
9,233
8,407
465
359
6,343
12
455
6,04.8
630
736
72
527
9,900
1
67
2,192
37
1,623
36
242
3,489
132
1,065

3'.889
4,460
5,765
822

209
l, ·839
4,547
5,701
1,968
345
448
2,607

284
398
3,166
3,007
2,553
426
418
143
4,373
6,632
7,217
3,739
370
3,604
523
6,655
49
1,468
839
2,585
541

1,670

60,850 3,338,692 889,310 663,140

250,094

------------ --- --943
40
910
10,226
65,155 23,063 61,883
2,495
5,473
704
91
1,428
1,342
5,123
2,117
343
319
3,678
139
418
1,932
2,966
2,963
425
416
159
2,511
2,583
1,049
2,125
85
2,424
213
3,087
17
707
783

888
524

------48
------1
6
207
82
36

-----i75

------2
221

------79
------6
------15
18
141
479

------20
------158
1
17
1
16

-------

789
, 5,251
855
118

2 359,002

273,963
55, 161
6,074

266
57,611
4,715
117,769
11,073
330,940
134, 749
1,580
28,577
235
15,680
167
69,768
1,451
6,671
3
232
17,884
2,631
138,917
1,541 ------ ---2,608
206,566
21,674
242
160
24,634
12,498
125
3,443
261,591
289,053
7,949
1,489
101,983
2,096
163, 337
20,488
170
84,334
4,031
512
29,079
3,321
237,144
23
1,867
194
27,978
1,277
45,833
970
74,901
423
57, 781

41,867
64,977
13,580
2,375

61,353
42,465
6,052
945

14,029
33,077
1,411
155

13,435
54,347
81,314
38,507
7,369
5,341
17,252
2,365
5,436
52,146

6,195
27,861
81, 134
15,980
1,415
3,121
11,862
4,465
1,567
13,409

6,921
1,823
42,665
2,997
2,491
2,374
6,338
519
442
4,354

2,185
4,792
608
31,440
35,440
4.3, 731
-27, 018
1,153
17,876
16,997
49,796
121
11,927
23,436
8,854
9,94.2

1,204
3,229
537
12,381
10,112
1,934
9,095
796

-------39,644
4,259
5,000
3,085
46,035
83, 193
63,450
36,652
5,352
39,850
9,338
63, 156
500
13,236
10,518
33,824
8,844

--------------38,117
35,325

-------3, 004
8,809
42
3,976
19,395
2, 097
8,336

1 States which did not report and those which bad no clinics have been omitted from the above table:
They are Arizona, Colorado, Florida, Idaho, Mississippi, Missouri, Montana, Nevada, ew Mexico,
Torth Dakota, Oklahoma, South Carolina, South Dakota, Utah, Vermont, and Wyoming.
2 Includes .159,833 baths given at the U. S. Public Health Servire Clinic, Hot Springs National Park,
Ark.
3 For 6 months.
4 For 11 months.
• For 10 months.


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123

PUBLIC HEALTH SERVICE
TABLE

4.-Report of oooperatwe clinic activities furnished through State health
depmrtments from 1919 to 1935

~cl~: New_cases To~~~f;at-

Year

reporting admitted

1919 ____ --- _______ -- __ ___ --- __ -- -- _-- _________ __ _
1920 ___ ---- ___ _-- ___________ -- -- - - - ___ -- - - -- - - - - 1921 ____ -- ______ _--- -- -- -- _--- __________________ _
1922 ___ ---- _________ _____________ -- ___________ -- _
1923 ____ -- __ -- _____________ -- -- __ -- _____ ____ ___ - - 1924 ___ ----- _--- __ ---- ---- _---- --- -- _ ·------ --- -1925 ___ ----- -- -- -- - -- _---- -- - -- -- --- --- --- ------- 1926 ____ ----- - -- - -- --- --------- -- --- ·- ---- -- ----- 1927 __________________ ----------------- - - ------1928 ______________________ --------- _ - ---------1929 ____ --- _--- -- __ -- ______ -- _-- _-- _____________ -1930 __ __ -- __ - --- - - - - - - -- - - - -- - - - - - - - - - - - - - - - - - - - - 1931 ____ --- __ --- ______ -- -- --- -- ____ -- ___ _______ -1932 ___
·---_---- --- -- ---- ----_
1933
____------ --___ __
-- _---- _---------- _______ -________________
1934 ______ ----------------- --------- ----------1935 ____ --- ____ -- - -- - -- - - - - - - - - - - - - -- - - - - - - - - - - - .-

Iii-

167
383
442
541
513
504
495
416
425
451
445
477
512
533
572
616
656

59,092
126,131
140,748
141,279
119,217
118,023
110,372
100,776
107,688
110,756
120,315
127,978
143,982
150,906
154,302
129,291
133,730

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
2,547,162
2,847,024
2,979,730
3,263,927
3,085,401
3,331,400

Cases dis- Treatc~ar:r~d ments per
rested or new ~ase
cured
admitted
14,278
34,215
55,4'67
60,169
55,503
51,658
47,828
44,329
44,701
49,487
52,136
65,592
57,665
64,645
65,116
55,904
60,850

8.92
12. 50
14.98
14.48
16. 71
18.19
18.92
18. 67
18.24
19.64
17.69
19.90
19. 77
19. 75
21.15
23.86
24. 91

5.-Ann-ual report of the United States Pub Uc H eaith Service clinic at
Hot Springs NaUona.Z Park, Ark., from July 1, 1934, to June 30, 1935 1

TABLE

Total applicants _____________ .14, 946
VenereaL_______________
Nonvenereal ____________
Did not return __________

2

7, 155
7, 112
679

Gonorrhea (new cases) _____ _

2,495

Acute _________________ _
Chronic _______________ _

1,324
1,171

====
Total treatments given _______ 357, 884

Syphilis --------------------

5, 272

New cases______________
Readmitted cases________

4,375
897

Gonorrhea __________________

2,760

New cases-------------Readmitted cases________

2,495
265

Syphilis (new cases) _______ _

4,375

Primary _______________ _
Secondary _____________ _
Tertiary _______________ _
Neuro ________________ _
CongenitaL ____________ _

375
611
3,.133
218
38

1
2

Arsphenamine __________
Heavy metaL ___________
Other intravenous_______
Gonorrhea ______________
Baths __________________

41, 739
105,296
4,243
46,773
159,833

Laboratory examinations ____ 134,031
Complement
fixation
tests _________________
_
Precipitation tests ______ _
Icterus indices _________ _
Darkfields _____________ _
Gonococcus smears _____ _
Urine analyses _________ _
Special ________________ _

31,226
30,048
31,226
504
14,029
26,780
218

From the annual report of the clinic.
The 7,155 patients represent 8,032 cases; 877 patients had both syphilis and gonorrhea.

20980-35--9


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124

PUBLIC HEALTH SERVICE

TABLE 6.-Report of the United States Publio Health Service Clinic at Hot

Springs National Parrk, Ark., from July 1, 1922, to June 30, 1935
t

Number of cases
Number of 1- - - - - - , - - - - - - , - - - - - - 1 Treatments
applicants Total venegiven 1
real diseases Syphilis Gonorrhea

Year

TotaL ••••••••••••••••••••.• -- ••••••

73,610

57,300

35,978

21,322

1,082,398

1922. __ ---···-·-···-----------··-·---·····
1923 ___ ----------·····-····-······-··-·· -1924 ___ --·-------------····-------·-·----1925 ___ --·----·------·--- -------·--·- -- -- •
1926 ___ -·-·- ••••••• ···-------------------1927 __ ----------------------·------------1928 ___ -------- --------------------- --- --1929 ___ ---- · -----------------------------1930. __ ---- ------------ -- ------------ ---- _
1931 ____ --- -------- -- ---- ----- ----- -- ----1932 ___ ------- · --------------------------1933 ___ ---- -- -- ----- ----------- -- -- ------1934 ___ ---------- _-- -- __ ------ _--- -- -----1935 ____ --- -------------- -------- ------- -·

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
14,946

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
8,032

1,182
1,326
1,447
2,011
2,211
2,504
2,626
2,512
2,743
2,776
3,188
2,850
3,330
5,272

593
528
739
771
853
1,178
1,508
1,474
1,698
2,312
2,996
1,635
2,277
2,760

43,830
41,559
50,683
50,608
54,590
58,489
72,466
75,519
79,180
66,246
93,707
73,466
124,004
198,051

1

Baths not included.

TABLE

1.-Sta.tistical summary of activities in the control of venereal diseases
for the fiscal years 1934 and 1935
1935

19341

MEDICAL ACTIVITIES

A, Cases of venereal disease reported to State health departments:
I. Syphilis ____________________________________________ --- . __ -. -.. --. -- -- -II. Gonorrhea ______________ -------------------------------- ------- ---- ---III. Chancroid _____________ ___ _________ ---------------- _______ --- -- --- ---- -

254,551
161,810
3,090

231,129
153,542
1,813

Total _____________ ____________ -- _- ______________ -- ____ -- -- -- -- -- - - -- -- ----

419,451

386,484

B. Doses of arsphenamines distributed by State health departments ___________ _

1,393,267

1,284,009

C. Clinics:
I. Clinics established during the year ____________________________________ _
68
II. Clinics reporting to State health departments _____ ____ _______ ___ _____ __
656
III. Report from clinics:
a. New cases admitted __________ --------------- ___ ____ __ ------ ______ __ -133,730
b. Cases discharged as arrested or cured __________________ _____ ___ _____ __
60,850
c. Treatments given _______________________________ ----------------- ___ _ 3,338,692
d. Doses of arsphenamines administered _______________________________ _
889,310
e. Serologic tests made __ ___ ___ ___________ __ _______ -- _------------------663,140
!. Microscopic examinations for gonococcus ____________________________ _
250,094

97
616
129,293
55,905
3,085,401
828,945
553,646
213,115

EDUCATIONAL ACTIVITIES

A. Pamphlets:
I. Requests for pamphlets received by the Public Health Service ________ _
II. Pamphlets distributed:
a.
By the Public Health Service to State health departments and others_
b. By State health departments ________________________________________ _
Tota}. _______________________________________________________________ _
III. Venereal disease pamphlets issued by the 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 ______ _________ ______ _

10,206

12,227

71,790
583,836

75,372
385,743

655,626
5

461,115
9

2,021
100
261

21,530
91
208

1 Data for 1934 were changed from previously published figures because of the receipt of additional
reports.
2 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.

W.ALTER

L.

TREADWAY

in charge

The year ending June 30, 1935, marks the fifth full 12 months'
activities o:f the Division o:£ Mental Hygiene. The functions o:£ the
Division continued unchanged during the year. They comprised:
studies o:£ the nature and treatment o:£ drug addiction and the dissemination o:£ information U:tJOn the subject; studies o:£ the abusive useso:£ narcotic drugs; admimstrative functions incident to the establishment and operation o:£ the narcotic :farms; the supervising and
:furnishing o:£ medical and psychiatric services :for the Federal penal
and correctional system; studies and investigations o:£ the causes,
prevalence, and means for the prevention and treatment o:£ mental
and nervous diseases; and cooperation with other agencies interested
in the various phases o:f work with which the Division is concerned.
STUDIES OF THE NATURE AND TREATMENT OF DRUG ADDICTION

Studies o:£ the nature and treatment o:f drug addiction were continued at the United States Penitentiary Annex, Fort Leavenworth,
Kans., during the first half o:£ the year. Experimental investigations
were conducted on the value of certain substitutes for morphine, and
studies were completed on the :following: Isocodeine, pseudocodeine,
dihydrodesoxymorphine-D, and dilaudid ( dihydromorphinone). All
o:f these substitutes were found to have addictive properties similar
to morphine. It was also found that they have a cross-tolerance and
alleviate withdrawal symptoms in a manner similar to that of
morphine.
Considerable progress was made in the study o:£ the role of carbohydrate metabolism during the phase o:£ addiction and withdrawal.
The value o:£ the intravenous administration o:£ glucose solution dur:.
ing the period o:f abstinence and the disturbance of the sympathetico~
adrenal mechanism were studied. These investigations are incomplete
and plans have been made for their continuation.
A process for manufacturing dihydrodesoxymorphine-D was patented by Dr. Lyndon F. Small, consultant in alkaloid chemistry to
the Public Health Service, and its custody lodged, ex officio, with the
Secretary of the Treasury.
•
Further studies o:£ the addiction liability of this new substance
were carried out among cancer patients, in cooperation with the
State Department o:£ Health o:f Massachusetts, under the immediate
supervision o:£ Asst. Surg. C. K. Himmelsbach. The results of these
studies indicate that the substance in question has very limited clinical value and exceedingly dangerous addicting properties, and recom'mendations have been made that it not be manufactured or distributed in the United States.
Arrangements were made :for Dr. Small to apply :for parents
governing the manufacture o:£ 9 products derived :from morphine
125


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126

PUBLIC HEALTH SERVICE

which give promise of scientific value. The custody of the patents
is to be lodged with the Secretary of the Treasury.
DissEMI'.NATION OF INFORMATION

Further information concerning the incidence and other :factors
in drug addiction were collected during the year. Several articles
relating to the work of the Division were published, including
"Dilaudid (Dihydromorphinone )-A Review of the Literature and
a Study of Its Addictive Properties" and" Dedication ·and Opening
of the Lexington Narcotic Farm." Advisory assistance was rendered
various agencies, including representatives of local political jurisdictions with reference to the drug addiction problem.
STUDIES OF ABUSIVE

uSES AND THE MEDICINAL AND SCIENTIFIC NEEDS

Investigations relative to the addiction liability of dihydrodesoxymorphine-D with special reference to its use in inoperable cancer
offered opportunity for observations as to the indispensable uses of
opiates in the management of cancer. These observations indicate
that a very much smaller quantity of opium alkaloids is required for
the control of cancer pain than is ordinarily supposed. In some instances the pain of cancer may be controlled by the use of such substances as aspirin, and the use of codeine plays a very important part
in the control of pain in many cases.
Studies on the addiction liability of dihydrodesoxymorphine-D
suggest that addiction in the human being becomes a greater liability
when opiates are adminfatered at regular and stated intervals instead
of being used when and if necessary to control actual pain.
They also indicate that the indispensable use of opium alkaloids
in the treatment of chronic tuberculosis may be very much less than
that ordinarily used.
These studies point the way to the possibility of and need for an
informative memorandum based upon first-hand knowledge of the
indispensable uses of the opium alkaloids in the practice of medicine,
with the possibility of reducing the frequency with which these drugs
are used ill-advisedly.
NARCOTIC FARMS

The first United States Narcotic Farm, at Lexington, Ky., was
formally dedicated and opened by the Surgeon General on the afternoon of May 25, 1935. It was opened for inspection by the general
public on the day or dedication and on the following Sunday, Monday, and Tuesday, after which it was closed to visits by the general
public. During the 4 days in which it was opened to general inspection, 17,341 persons visited the institution, many of whom came long
distances by motor from adjoining States. Three thousand four
hundred and eighty visitors attended the dedication and opening
exercises.
Admissions were accepted on and after May 29, 1935. Arrangements were made for the transfer of some 300 addict prisoners from
the Federal prison system; to accept cases placed on probation by


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FACADE OF THE BUILDINGS OF THE LEXINGTON NARCOTIC FARM , SHOWING THE MAIN ENTRANCE .


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AIRPLANE VIEW OF THE LEXINGTON NARCOTIC FARM .


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THE FARM COMPRISES ABOUT 1 , 050 ACRES OF LAND .

PUBLIC HEALTH SERVICE

127

courts having jurisdiction, one conditi•on of such probation being
that the probationers voluntarily submit themselves to confinement
and treatment in a narcotic farm; and to accept a limited number
of persons voluntarily seeking treatment. On June 30, 1935, there
were under care at the Lexington Narcotic Farm a total of 280
inmates.
The institution at Lexington, Ky., is for men only, 1,000 beds being
provided, although it is contemplated that facilities will be developed
for women addicts in the near future, as an adjunct to those facilities already provided :for men.
·
Senior -Surg. Lawrence Kolb was assigned to duty as medical officer in charge of the United States Narcotic Farm, Lexington, Ky.,
on October 1, 1934, preparatory to equipping and opening the institution, and the professional, subprofessional, and technical staff were
recruited and placed on duty before the opening for the reception
of admissions.
The institution at Fort Worth, Tex., is in process of being developed. The preliminary plans have been approved, and it is anticipated that the contract for the necessary buildings will be accepted
some time during the autumn of 1935.
Preliminary contracts for beginning work at the above-mentioned
institution were approved by the Procurement Division on October
13, 1934, and ground was broken with appropriate ceremonies for
the beginning of grading and other preliminary construction work.
The institution at Lexington is designed primarily for the care
of the more intractable type of person, largely the prisoner group.
For that reason the custodial :features have been emphasized. The
institution at Fort Worth will be more open in character, being
designed as a cottage type, and the custodial :features will be less
emphasized than those at Lexington. Experiences have indicated
that there are certain groups of addicts who require that greater
emphasis be placed on custodial care, while others may be benefited
by a more liberal policy. The institution at Fort Worth, therefore,
will be supplemental to that at Lexington.
The inception 0£ the institution at Lexington is an ex:pression on
the part of the United States Government that restrictive laws
governing commerce in narcotics are not the only measures to be
applied as a possible solution of the medico-social problem of drug
addiction. The presence in American communities 0£ persons who
are addicted to the use of narcotic drugs constitutes an ultimate
market for smuggled or contraband drugs and tends to menace the
legal supply of such drugs originally destined for medical or scientific purposes. Public policies, therefore, which have for their
object the regulation and control of the production and distribution
of narcotic drugs are proportionately as effective as those which
undertake to control, segregate, or cure the drug addict population
of a community.
The dedication and opening of this institution at Lexington, Ky.,
represents a change in the policy of the United States toward the
so-called " drug-addiction problem." No person will be eligible


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128

PUBLIC HEALTH SERVICE

for treatment or confinement in the institution unless he is an addict
as defined in the law authorizing these narcotic farms, and then only
if he complies with the regulations governing admissions.
MEDICAL AND PSYCHIATRIC SERVICES IN FEDERAL PENAL AND
CORRECTION AL INSTITUTIONS

The Service continued the work of supervising and furnishing
the medical and psychiatric services for the Federal penal and correctional system, and the Attorney General requested the Public
Health Service to extend the psychiatric service to all Federal
-eourts.
A 3-day conference of medical officers and others in the prison
-service was held at the United States Hospital for Defective D elinquents, Springfield, Mo., on September 13, 14, and 15, 1934. A total
of 51 persons attended this meeting, consisting of the chief medical
officers, psychiatrists, psychologists, wardens, superintendents, and
educational directors of the various penal institutions, and administrative officials of the Bureau of Prisons and the Public Health
Service.
At the close of the fiscal year 1935, the Service was operating 16
medical units in connection with the various institutions under the
control of the Department of Justice, one unit, that at the Federal
Correctional Camp, Fort Eustis, Va., having been discontinued on
October 15, 1934.
During the course of the year the inmate population of the various
institutions increased as follows:

Penal institution

Number of Number of Number of lncre~se
inmates on inmates on inmates on on June 3o,
1935 • over
June 30,
Dec. 31,
June 30
0,
1934
1934
1935 '

Jut1if

Alcatraz ______________________ __ _____________________ _
338
Alderson__________ _______ ___ _______ _______
Atlanta __________ _______ ---- ------ -------1,992
Chillicothe________ _____ _________ ___ _______
862
El Reno_____________________ __ ___________
616
Fort Eustis_______________________________
172
Fort Leavenworth________________________
1,495
La Tuna__________________________________
469
Leavenworth __ - -------------------------2,466
Lewisburg__________ ______ ________________
1,195
843
McNeil_______________ _______ ______ _______
Milan ____________________ ---------------233
New Orleans______________________________
262
New York____________ _____ __ __ _________ __
120
Petersburg________________________________
278
Springfield________________________________
395
Tucson____________________________ __ _____
118
TotaL ____________ - ___ ___________ __ _
1

11,854

212
356
2,148
950
867

(1)

1,649
525
2,431
1,225
786
309
392
142
460
446
219
13, 117

242
469
2,515
1,458
730

------------

(2)

242
131
523
596
114

1,570
505
2,828
1,312
907
543
517
144
601
505
213

75
36
362
117
64
310
255
24
323
110
95

15,059

3,205

Percent
increase

-----------38. 8

26. 3
69.1
18. 5

-----------5.0

7. 7
14. 7
9.8
7.6
133.0
97.3
20. 0
116. 2
27.8
80.5
27. 0

Discontinued Oct. 15, 1934.
172.

2 Decrease,

A progressive program of classification and rehabilitation of prisoners has been carried on in the larger penal institutions, in which the
medical service has taken an active part, members of the medical staff
serving as members of the disciplinary boards and classification committees. Through this means each prisoner has been given treatment


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Federal Reserve Bank of St. Louis

PUBLIC HEALTH SERVICE

129

for his physical and mental disorders and has had the benefit of medical, psychiatric, and psychological supervision in his work assignments and solution of his adjustment problems, thereby placing him
jn his proper status at the institution and enabling the medical department to carry on a more extensive rehabilitative program. Periodical
sanitary inspections were made by the medical staffs at the various
institutions, resulting in greatly improved sanitary conditions.
At the United States Penitentiary, Atlanta, Ga., a plan was put
foto effect which gives promise of yielding better results than those
obtained with a general "sick line." It consisted of dividing the
prison population of 2,500 men among 5 physicians so that each was
responsible for the medical care of a definite group of about 500 men.
'"~h_is permitte_d a ~uch close~ relationship be~ween p~t~ent. and phys1cian appro:.inmatmg that enJoyed by the family physician m private
life. It gives promise of solving many administrative difficulties associated with the so-called morning" sick call or line" of a correctional
institution.
The medical staff at the United States Penitentiary Annex, Fort
Leavenworth, Kans., assisted the classification committee in selecting
315 narcotic drug addicts from among the inmate population at that
institution for transfer to the United States Narcotic Farm, Lexington, Ky. Those with serious criminal records, or incorrigibles, were
not chosen, ]?reference being given to those whose medical, criminal,
and sociological histories indicated the best possibilities £or a cure for
drug addiction.
Passed Asst. Surg. 0. C. Williams took over the direction of the
medical activities at the United States Penitentiary, Leavenworth,
Kans., on August 17, 1934. Spinal anesthesias for opeTations below
the diaphragm and a vertin anesthesias for the extraction of teeth and
other operations have been found from past experience at this institution to be the most satisfactory for prison use where the professional
personnel is limited and where a large majority of the help throughout the hospital is necessarily of inmates. A total of 678 spinal
anesthesias and 70 avertin anesthesias has been given, and all have
been entirely satisfactory.
During the first 9 months of the fiscal year 1935, a paper X-ray
chest film was made on each new admission to the United States Industrial Reformatory, Chillicothe, Ohio. One thousand films were
made and analyzed and compared with the results of primary physical
examinations, and when indicated, with celluloid films of the same
cases. An analysis of the results obtained from the paper films indicated that the additional expense involved in carrying out this procedure was not justified, and the use of paper chest films routinely
was discontinued. The hospital at the above-mentioned institution
was approved by the American College of Surgeons and placed on
the accredited list in April 1935. The population of this institution
has almost doubled in the last year. However, the medical unit has
been able to render adequate service in spite of the additional burden.
The results of efforts at rehabilitation at the United States Penitentiary, McNeil Island, have been gratifying. Of all admissions during
the fiscal year 1935, 32.3 percent were admitted to the hospital for
medical and surgical treatment which might assist in the rehabilita-

•

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PUBLIC HEALTH SERVICE

tion of the inmate. Of these, 79 percent were success:fully treated and
relieved of conditions which had been a handicap to them on the
outside.
The program of medical rehabilitation at the United States Penitentiary., Lewisburg, Pa., has been extended and systematized so that
it is now extremely rare for a prisoner to leave the institution with
even minor remediable defects uncorrected. As a result of this program the surgical operations increased 28 percent during the year,
while the average daily population was only 10 percent higher. At
least 60 percent was of a constructive and rehabilitative nature. An
intensive campaign to study and more adequately treat the psychoneurotic patients resulted in a decided decrease in the number of
patients reporting sick at times other than the morning "sick call."
Of the 713 men discharged from this institution during the year,
95 percent showed improvement in physical and mental condition
as compared with their condition upon admission.
In addition to the medical services rendered by the Public Health
Service unit at the United States Detention Farm, La Tuna, Tex.,
the chief medical officer at that institution made 241 visits to the El
Paso County jail £or the purpose of furnishing medical service to
the Federal prisoners confined there, treating a total of 1,680
prisoners.
Some changes occurred in the administrative staff of the United
States Hospital for Defective Delinquents, Springfield, Mo., during
the year. Senior Surg. Lawrence Kolb, superintendent and chief
medical officer, was transferred to the United States Narcotic Farm,
Lexington, Ky., and was succeeded by Surg. L. M. Rogers. In
February 1935, Surgeon Rogers was relieved from duty because of
illness and Surg. Marion R. King was assigned for duty there as
superintendent and chief medical officer.
The medical staff at this institution has been heavily taxed
throughout the year due to insufficient personnel. Provisions have
been made, however, to correct this situation during the coming
fiscal year. In spite of the excessive amount of work, all officers
and employees have responded loyally to the exigency and the sick
have received adequate care and attention at all times. More than
half of the inmates of this hospital are afflicted with mental disease.
At the end of the fiscal year there were 151 insane, 75 chronic
infirm, and 60 tuberculous patients. In addition, 219 prisoners,
comprising a prison camp service, were confined at this institution.
Since its opening on September 30, 1933, 290 insane persons have
been admitted to the hospital. The records of 102 of these patients
have been closed, owing to transfer, recovery, discharge, or death.
Of these 102 patients, 52.9 percent were improved, 10.7 percent died,
and 8.8 percent recovered.
An outline containing directions and information for medical
aftercare of indigent and mental patients in the various States
was prepared during the year and has proved of value for reference
purposes in the disposition of chronic infirm, tuberculous, and mental
patients at the time of release.
A request was received from the Attorney General for the Public
Health Service to provide medical services for the Federal Prison


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Federal Reserve Bank of St. Louis

PUBLIC HEALTH SERVICE

131

Camp No. 8, Montgomery, Ala., on June 13, 1935. Arrangements
were made to furnish this service beginning with the new fiscal year.
During the year the following articles were published in connection with the work in the Federal penal and correctional institutions: "Selected Papers on the Medical Services in The Federal
Prison System, with Special Reference to Psychiatric Problems",
" Methods to Detect Malingering in Pulmonary Tuberculosis ", " The
Surgical Eradication of Pyorrhea", "Nonoperative Relief of Foot
Pain"," The Injection Treatment of Hemorrhoids-with a Resume
of 115 Cases", and "Collection of Specimens of Blood for Serologic
Tests for Syphilis."
An indication of the scope of the medical services rendered the
Federal penal and correctional system by the Public Health Service
may be obtained from the following: During the fiscal year 1935
there were furnished 300,774.4 hospital relief days and 672,916 outpatient relief days.
STUDIES AND INVESTIGATIONS ON THE CAusEs, _PREvALENCE, AND MEANS
FOR THE PREVENTION AND . TREATMENT OF NERVOUS AND MENTAL
DISEASES

Upon the request of the Governor, a survey of mental health
administration of the State of Washington was made. The field
of mental health administration in that State would appear to embrace the following activities: (1) The formulation of a policy
respecting the qualifications and training of medical and technical
personnel, both special and general, required to meet the problems
of mental illness within the State; (2) regulations governing the.
practice of psychiatry; (3) regulations governing the qualifications
and appointment of commissions for the detection and certification
of mental diseases and defects; ( 4) regulations governing the operation of facilities for the diagnosis, treatment, and care of persons
with mental diseases or mental defects, and for inebriates and problem children; ( 5) regulations governing the rendering of expert
testimony in alleged mental disease; ( 6) regulations governing the
mental examination of offenders against the law and the disposition
of mentally disordered and mentally defective delinquents; (7) the
formulation and supervision of those measures and policies governing the treatment, care, disposition, and general supervision of
mentally disordered members of the population, including regulations governing a system of interchange of mental patients with jurisdictions having responsibility for their care; (8) the development
and supervision of facilities and agencies for out-patient and inpatient treatment, and the supervision of mentally disordered persons
in the population, including the insane, mentally defective, epileptic,
and problem situations manifesting symptoms of mental ill health;
and (9) taking stock of the material with which mental health
administration is called upon to deal, so that comparisons may be
made from time to time of the conditions under which mental disea~;es are found, and when they occur, and including an analysis of
the omissions and commissions attributed to a given public policy.
Such inquiries, which are largely of a statistical nature, should relate not only to professional successes or failures but also to the
economic questions involved. The effectual fulfillment of such a

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Federal Reserve Bank of St. Louis

132

PUBLIC HEALTH SERVICE

policy for mental health administrat ion in the State of Washington
involves the developmen t of a department , division, or special governmental agency charged specifically with carrying it into effect,
and the appointmen t of a competent, reliable, and experienced physician with such necessary deputies and assistants as may be required
for achieving the aims and objectives of the administrat ive policies
outlined above.
A lecture course in mental hygiene was conducted for a class of
Public Health Service officers assigned to the National Institute of
Health for training.

•


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Federal Reserve Bank of St. Louis

DIVISION OF PERSONNEL AND ACCOUNTS
Asst. Surg. Gen. W. F.

DRAP ER,

in charge

The Personnel and Accounts Division supervises all operations of
the Service relating to personnel, finances, and the maintenance of
property records. The organization of the Division has remained
unchanged during the year. Through a personnel section, a finance
section, and a property-record section, all matters relating to appointments, separations, and other changes in status of personnel,
estimates of appropriations, allotments, and encumbrances, records
of expenditures, including administrative audit, and all records of
nonexpendable property are administered under the supervision of
the Assistant Surgeon General in charge of the Division.
Because· of the increase in the capacity of the marine hospitals
there is urgent need of additional funds with which to provide medical officers and other classes of personnel essential for hospital operation. For the past few years, in order to keep within the appropriations it has been necessary to assign medical internes to duties which
should be performed by more experienced doctors. A similar shortage of medical and other personnel exists also at the quarantine stations. A number of complaints have been received from Members
of Congress and representatives of employees unions to the effect
that the compensation of employees at the marine hospitals and quarantine stations is not commensurate with that of similar positions
elsewhere in the Government service. In most instances the complaints are fully warranted.
PERSONNEL
COMMISSIONED OFFICERS

On July 1, 1934, the regular corps consisted of the Surgeon General ; 8 assistant surgeons general ; 49 medical directors, 1 pharmacologist director; 37 senior surgeons, 1 senior dental surgeon, 1 senior
sanitary engineer, 81 surgeons, 13 dental surgeons, and 15 sanitary
engineers, 97 passed assistant surgeons, 16 passed assistant dental
surgeons~ 5 passed assistant sanitary engineers, 1 passed assistant
pharmacist, 21 assistant surgeons, 12 assistant dental surgeons 1
assistant sanitary engineer, and 10 assistant pharmacists-a total of
370 officers. Of this number, 16 medical directors, 12 senior surgeons,
14 surgeons, 3 passed assistant surgeons, and 3 assistant pharmacists
were on waiting orders. During the fiscal year the following changes
occurred in the several grades : 2 assistant surgeons general reverted
to the grade of medical director and 1 senior surgeon and 1 passed
assistant surgeon were assigned to duty in the Bureau as assistant
surgeons general; 1 medical director, 1 surgeon, 1 passed assistant
surgeon and 1 assistant dental surgeon were placed on waiting orders
status; 2 medical directors and 3 senior surgeons on waiting orders
1

,

133

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134

PUBLIC HEALTH SERVICE

status died during the year and 1 assistant dental surgeon was separated from the corps because of inability to qualify for the next
higher grade ; 2 senior surgeons were promoted to the grade of medical director, 12 surgeons were promoted to the grade of senior
·s urgeon, 2 passed assistant surgeons were promoted to the grade of
surgeon, 6 assistant surgeons were promoted to the grade of passed
assistant surgeon, and 7 assistant dental surgeons were promoted to
the grade of passed assistant dental surgeon; 16 doctors were ap_pointed to the corps in the grade of assistant surgeon· and 2 dentists
were appointed to the corps in the grade of assistant dental surgeon.
On July 1, 1935, after these changes had occurred, the regular
corps consisted of the Surgeon General, 8 Assistant Surgeons General, 51 medical directors, 1 pharmacologist director, 43 senior surgeons, 1 senior dental surgeon, 1 senior sanitary engineer, 71 surgeons,
13 dental surgeons, 15 sanitary engineers, 100 passed assistant surgeons, 23 passed assistant dental surgeons, 5 passed assistant sanitary
engineers, and 1 passed assistant pharmacist, 31 assistant surgeons,
6 assistant dental surgeons, 1 assistant sanitary engineer, and 10
assistant pharmacists-a total of 382 officers. Of this number 15
medical directors, 9 senior surgeons, 15 surgeons, 4 passed assistant
surgeons, 1 assistant dental surgeon, and 3 assistant pharmacists
were on waiting orders. .
. At the close of the fiscal year 1935, 6 senior surgeons, 1 surgeon,
and 1 passed assistant surgeon 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;
1 medical director was on duty as director of the public health
district, New York, N. Y. ; 1 senior surgeon, 1 surgeon, and 2 passed
assistant surgeons were serving on detail to the United .States Employee's Compensation Commission; 2 medical directors were assigned as assistants to the Director, Pan American Sanitary Bureau,
Washington, D. C. ; 4 senior surgeons, 1 surgeon, 1 dental surgeon,
1 passed assistant surgeon, 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 serving ( 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, 1 surgeon, 1 dental
surgeon, 3 passed assistant surgeons, and 2 passed assistant dental
surgeons were serving on detail with the United States Coast Guard;
in connection with mental hygiene activities, 1 senior surgeon, 1
surgeon, 4 passed assistant surgeons, and 4 assistant surgeons were
assigned for duty at various penal and correctional insit itutions, and
1 senior surgeon, 1 surgeon, 3 passed assistant surgeons, 1 passed
assistant dental surgeon, 1 assistant surgeon, and 1 assistant pharmacist were assigned to duty at the United States Narcotic Farm,
Lexington, Ky.
RESERVE OFFICERS

On July 1, 1934, the reserve commissioned officers on active duty
numbered 37, consisting of 4 surgeons, 1 dental surgeon, 10 passed
assistant surgeons, 11 assistant surgeons, and 11 assistant dental
surgeons.

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Federal Reserve Bank of St. Louis

PUBLIC HEALTH SERVICE

135

On July 1, 1935, the number of reserve officers on active duty was
64, consisting of 4 surgeons, 1 dental surgeon, 10 passed assistant
surgeons, 1 passed assistant dental urgeon, 37 assistant surgeons, and
11 assistant dental surgeons.
ACTING ASSISTANT SURGEONS

On July 1, 1934, there were 695 acting assistant surgeons in the
Public Health Service, and by July 1, 1935, this number had mcreased to 707.
Of the 707 acting assistant surgeons, 98 were on duty at marine.
hospitals; 433 were engaged in immigration, 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 in-vestigations of public health and rural sanitation; 113 were on detail
with the United States Coast Guard; 1 was serving with the Bureau
of Mines by detail ; 20 were serving at various penal and corredionali
institutions; and 32 were engaged in antivenereal disease activities
as part-time employees at nominal compensation. Eleven of the
thirty-two acting assistant surgeons engaged in antivenereal disease
activities held appointments as collaborating epidemiologists.
ATTENDING SPECIALISTS

On July 1, 1934, there were 481 attending specialists in the Service, and during the year this number increased to 520, of which
number 270 were consultants to marine hospitals, while 42 were
available for call at second- and third-class relief stations; 26 were
engaged in antivenereal disease activitie.s; 65 were serving at various
penal and correctional institutions; and 117 were consultants in
connection with quarantine, immigration, and scientific research
activities.
INTERNES

On July 1, 1934, there were 118 medical and dental internes in the
service; on July 1, 1935, there were 129. Internes are appointed for
temporary per10ds o.f 1 year for duty at marine hospitals and stations where mental hygiene activities are being conducted.
PHARMACISTS AND ADMINISTRATIVE ASSISTANTS

On July 1, 1934, there were 14 pharmacists and 34 administrative
assistants in the Public Health Service. During the year 1 pharmacist was retired under provision.s o:f the act of May 29, 1930; an
addition of 10 was made in the administrative corps and one in that
corps was demoted to clerk. The total corps at the end of the fiscal
years was 13 pharmacists (9 chief and 4 junior) and 43 administrative a.ssi.stants (12 first class, 7 second class, 10 third class, and 14
fourth class) .
NURSES, DIETITIANS, AND RECONSTRUCTION AIDES

On July 1, 1934, there were on duty in the Public Health Service
498 nurses, 27 dietitians, 31 reconstruction aides, 4 social workers,
and 35 guard attendants. On July 1, 1935, there were on duty 560

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Federal Reserve Bank of St. Louis

136

PUBLIC HEALTH SERVICE

nurses, 31 dietitians, 31 reconstruction aides, 4 social workers, and
67 guard attendants, distributed as follows: Hospital Di visionnurses 517, dietitians 30, reconstruction aides 28, social workers 4;
Mental Hygiene Division-nurses 35, reconstruction aides 3, dietitians 1, guard attendants 67; Domestic Quarantine Division-nurses
5; Foreign Quarantine Division-nurses 3. There were 34 resignations, the smallest numher ever reported. These positions were filled
with new appointees. Since the last report, the First United State,s
Narcotic Farm at Lexington, Ky., has been opened with 10 nurses,
1 dietitian, 1 reconstruction aide, and 30 o-uard attendants. One
nurse was detailed to the office of Industrial Hygiene for 2 months
in connection with the study of mercurial poisoning among fur cutters. Nurses have been detailed for .short periods to the marine
hospitals by the State emergency relief associations in various States.
CONTRACT DENTAL SURGEONS

On July 1, 1934, there were 52 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 1935, this number had increased to
54; 8 were at marine hospitals, 34 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 decreased from 4;t374 to 4,643. 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 33 to 44. These appointees are on
duty in the different States.
NATION AL 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 63 members, of whom 19 were
commissioned medical officers, 29 other research workers, and 15 consulting experts. The staff was assisted by 19 technicians and 78
other subordinates, making a total of 160. Of this total, 142 were
on full-time schedule.
PROPERTY RECORDS

The property return section has accounted for all property of the
Service, and 328 property returns were audited d-µring the year. A
total of $10,430.91 was turned in to "Miscellaneous receipts" from
sales of property. Surplus property not desired by any other Government department was sold for $2,837.14, unserviceable property

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Federal Reserve Bank of St. Louis

PUBLIC HEALTH SERVICE

137

£or $1,483.26, hides £or $338.16, and unserviceable boats and boat
property for $6,110.51. Property surplus to the Public Health Service valued at $64,248.21 was transferred to other Government departments. Of this amount, $46,176.20 was from Perry Point. Surplus
property of other Government departments valued at $2,038.01 has
beoo. received by the Public Health Service. Property valued at
$70,879.33 has been transferred from Service stations where it was
surplus to stations where it could be used. By the exchange value
on old typewriters and adding machines turned in on the purchase
price of new machines, $902.43 was saved.
Accou'.NTS

SECTION

The Accounts Section of the Division of Personnel and Accounts
conducts all bookkeeping and accounting in connection with the
expenditure of Public Health Service appropriations. This includes
also accounts of miscellaneous collections, allotments, records of encumbrances, cost accounting, and the administrative audit. A statement of appropriations, expenditures, and balances, with miscellaneous receipts, is published as an appendix to this report.
PERSONNEL STATEMENT

The accompanying tabular statement shows the personnel of the
Service as of July 1, 1935. Of the 10,985 employees shown in the
table, 4,643 listed as collaborating epidemiologists and assistant collaborating epidemiologists, receive only nominal compensation.
They are mainly officers or employees of State and local health organizations who collaborate in the collection of morbidity statistics by
furnishing the figures collected by those organizations relating to
cases of communicable 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.


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Federal Reserve Bank of St. Louis

Consolidated personnel report as of July 1, 1935

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Marine hospitals:
Baltimore, Md _____________________________________ -----1 ------ _____ _
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Boston, Mass______________________________________ ______
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Carville, N.
Chicago, Ill._______________________________________ ______
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Cleveland, Ohio___________________ __ ______________ _ ____ __
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Detroit, Mich______________________________________ ______ ______ ______
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Evansville, Ind ___ ___ _______ _____________ ______ ____ ______ ____ __ ______ ______
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Fort Stanton, N. Mex________ ___ _________ _______ _____ ________ _____ ___ ______
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1 _____ _
Hudson Street, N. y_______________________________ ______
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1
Key West, Fla ________________________________________ __________________________ _
Louisville, Ky________ ____ __________ _______ __ ___ ___ ____ _________________ ___
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Memphis, Tenn_________ ____ _____ _____ _____ ____ ____ ____ __ ______ ______
Mobile, Ala________________________________________ ___ ___ ______ ______
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New Orleans, La___ ____ ________ ____________________ ______ ______ ______ ______
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Pittsburgh, Pa- --- --------- ---------- --- -------- -- ______ __ ____ ______ ___ __ _
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St. Louis, Mo___ __ _____ __ __ __ ___ ___ _____ ______ _____ ____ __ ______ ______
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San Francisco, CaliL__________________________ __ __ ____ __
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Savannah, Ga______________________________________ ______ ______ __ ____
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Seattle, Wash_________________________ _____________ ______ ______ ____ __
1 Clerical.


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Federal Reserve Bank of St. Louis

3

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Relief stations:
3 ______ ______
2
3
3 ______ ------ ------ -----2
18
Second class ________________________________________ -----33
10
1 ------ -----Third class _________________________________________ ------ ------ __________________ ------ ____________ ------ ------ ------ ------ 146
9
24 ------ ------ -----Total relief stations _____ ____ ___ ___ _______________ ------ ____________________________________________________________________________________ ------ ___________ _

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Foreign quarantine division:
Quarantine stations:
Baltimore, Md ______________________________ _______ ------ ------ ------ ______
1 ------ ______ ------ ------ ------ ------ -----2 ------ ------ ------ ------ --- --Boston, Mass ______________________________________ ------ ______ ______
2 ________________________ ------ ------ ------ -----1 ------ ------ ------ ------ -----Ellis Island (also immigration) _____________________ -----3 ______
1 ______
1 ____________ ------ --- - -- ------ -----15 ------ ------ ------ ------ -----El Paso, Tex ___________ __ _______ ____ __ _____________ ------ _____ _________ __________ ------ ____________ ------ ------ ------ -----2 ------ - ----- ------ ------ -----Fort Monroe, Va ________ __ _________________________ -----1 ___ __ __________________________________ __ ___ __ _____________________ ____________________________ _
Galveston, Tex ____________ _________________________ ------ ------ -----1 ______ ------ ------ ------ ------ ------ ------ -----3 ------ ----- - ------ - ----- -----Honolulu, T. H ____________________________________ -----1 ______ ______ ______
1
1 ______ ------ ---- -- ------ -- -- -12 ------ -- --- - ------ ------ -----Laredo, Tex ________________________________________ ------ ------ ________ -_________ ------ ____________ ------ ------ ------ -----5 ------ ------ ------ ------ -----Marcus Hook, Pa __________________________________ -----1 __________________ -----1 ______ ------ ------ ------ -----2 ------ ------ ------ ------ -----New Orleans, La ___ ___ ________ __ _______ __ __________ ------ ------ ______
1 ______
1 ____________ ------ ------ ------ -----4 ______ ------ ------ ------ -----Rosebank, N. y ______________________ _______ ______ -----1 ______ ______ ______
3 __________________ ------ ------ -----5
1 ------ ------ ------ --- -- 1
1 ______ ______ ______ ______ ______ ______
3 ______ ------ ------ ------ -----San Francisco, Calif. (also immigration) __________________ ------ _____ _ ______
San Juan, P. R ___________________________ _________ ------ ------ ------ ______
1 ------ ------ ------ ------ ------ ------ -----2 ------ ------ ------ ------ -----Foreign ports ______________________________________ -----2 __ __ __ ______
5
11 ____________ ------ ------ ______ -----34
2 ------ ------ ------ -----All other stations ____________ __ _____________________ ---- -3 ______
4
4
7 ____________ ------ ------ ______ ------ 178 -- ---- ------ ------ -----2
Total quarantine and immigration _______________________________________________ _______________ ____________________________________________________________ _
Domestic quarantine division:
Interstate ________________________________________ ______ ------ ------ ______ ______
5
2
Trachoma ______________________________________________ ------ ------ ______ ______
1 -----Rural sanitation (regular) ______________________________ -----1 ___ ___
1
2 ______
Civil Works Administration project_ _______________ ------ ______ ______ ______ ______ ______
1
3 -----All other stations ___________ ____ _______ _________________ .::.::..=.=.::.::..=.=______

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_________________________________ _______________ ------ ------ ------ ------

__________________
______ ______ ______
______ ______ ______
1 ______ ------

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5
4
______ ______
2
3
____ __ ______ ______ ______
________________________

______ ------ ------ -----____________ ------ -----______ ______
94 _____ _
------ ______ ----.- ------

Total all activities ________ ___ _________________________ ------ ------ ____________________________________________________________________________________ ------ _____ _
Scientific research division:
4 ______
1
7
7 ______ ______ ______ ______ ______ ______
1
6 _______________________ _
National Institute of Health ___________________________ -----1 ______
2 __________________________________ - ____________________________________ _
Leprosy investigations_________________________________ ______ ______ ______
2
2
1 _______________________________________________________________________ _
Malaria investigations___________________________________________________
Nutrition studies_______________________________________ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______
1 _____ _ _________________ _
Stream pollution_____________ ____ ______________________ ______ ______ ______ ______
2
1 ______ ______ ______ ______ ______ ______ ___ ___
4 _______________________ _
Industrial hygiene and sanitation______________________ ______ ______ ______
1 ______
2
2 ______ ______ ______ ______ ______
1
34 _______________________ _
Child hygiene ____________________________________________________________ -----1 ------ ____________ ------ ------ ______ ______ ______
8 ------ ______ ------ _____ _
Statistical Office_____________________________________________________________________________________________________________________
8 _______________________ _
2 ______
2
6
4
1 ______ ------ ------ ______ ______
1
39 _______________________ _
All other stations_______________________________________ ___ ___
Total all activities ___ _________________________________ ------ ------ ______ ------ ------ ------ ------ ------ ------ ------ ________ __ ________ ------ _______________________ _


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Federal Reserve Bank of St. Louis

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Consolidated personnel report as of July 1, 1935-Continued

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Sanitary reports and statistics_________________________________________________________________________________________________________________ __ _________________ _____ _
Division of venereal diseases ______________________________________________________ _

1 ---- -- ------ ------ ------ ------

Division of mental hygiene:
Alderson, W. Va ______________________________________________________________________________________________________________ _
3
Atlanta, Ga______________ _____________ _________________ ______ ______ ______ ______ ______ ______ ______ ______ ____ __ ______ ______
1
2
Chillicothe, Ohio____________________ ___________________ ______ ______ ______ ______ ______ ______ ______ __ __ __ ______ ___ ___
Fort Leavenworth, Kans_______________________________ ______ ______ ______ ______ ______
2
1 ______ ______ ______ ______
1
1
1 ______ ______ ______ ______
1
Leavenworth, Kans____________________________________ ______ ______ ______ ______ ______
Petersburg, Va________________________________________________________________________________________________________________ _
1
1 _____ _
McNeil Island, Wash ______ ___________________________________________ ___ --~--- ______ ______ ______ ______ ______
2
2
6
4 ______ ______ ______ ______
8
All other stations_______________________________________ ______ ______ ______

32

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3 - ----- ------ ------ -----6
4 ------ -----5
1 ------ -----1
3 ------ ------

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3 ------ -----6

1 ------ -----7 ------ ------

---1---t---1--- --- - - - --- --- - - - --- --- --- - - - --- - - - - - - --- --Total all activities __________________________________________________________________________________________________
_____________________________________________ _

-=cl---t---1===1====1===1===1== _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Miscellaneous:
Detailed to other offices________________________________
Coast Guard___________________________________________
~~iivhi:ithi-.gi~ir\~¥f ply station) ____________________
Waiting orders_________________________________________
All others______________________________________________

______
______
-----______
______

2 ______
5
1 ______ _____ _

3
2

3
1 ______ ______ _____ _ ______
2
1 _____________________________ _
5 ______ ______ ______ ______
2
3 113
4
6 _________________ _
----i- ------ ------ ------ ------ ____ 1_ ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ -----15 ______
9
15
4
4 ________________________________________________________________ __
1 ______
1
4
4
1 __ ____ ______ ______ ______ ______
1
3 _______________________ _

Total miscellaneous ____________________________________________________ ---- -- ------ ____________ ----- - ------ ------ ______ ------ ------ ------ ______ ____________ -----Grand totaL. _______________________________________ _
52
45
99
129
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Federal Reserve Bank of St. Louis

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FIELD

Hospital division:
Marine
hospitals:
Baltimore,
Md ________________________________________ _
Boston, Mass____________________________ ________ ______
1
1
Buffalo, N. y ____________________________ -------- ________________ __
Carville, La_____________________________ _ ________ ______
1
1
Chicago, Ill______________________________ ________ ______
2 _____ _
Cleveland, Ohio__________________________ ________ ______ ______
1
Detroit, Mich____________________________ ________ ______
1
1
2
1
Ellis Island, N. y________________________ ________ ______
Evansville, Ind _________ _________________ _______________ __________ _
Fort Stanton, N. Mex _____________________________________________ _
Galveston, Tex___________________________ ________ ______
1
1
Hudson Street, N. Y _____________________ ________ ______ ______
1
Key West, Fla ____________________________________________________ _
Louisville, Ky ____ ________________________________________ ________ _
I
Memphis, Tenn__________________________ ________ ______ ______
Mobile, Ala______________________________ ________ ______
1
1
New Orleans, La_________________________ ________ ______
1
1
1
Norfolk, Va______ _______________________ ________ ______ ___ ___
Pittsburgh, Pa.__________________________ ________ ______ ______
1
1
1
Portland, Maine_________________________ ________ ______
St. Louie;, Mo _______________________________________________ _ _____ _
San Francisco, Calif._____________________ ________ ______
1 _____ _
1
Savannah, Ga____________________________ ________ ______ ______
Seattle, Wash____________________________ ________ ______
2
I
Stapleton, Staten Island, N. y ___________ ________ ______
2
1
Vineyard Haven, Mass ____________________________________________ _

32
18

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4
3 -----1
1 -----1 ------ ------

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26
2 ------ ------ ------ -----22 ·----- ------ ------ ------ ------ -----1
27
2 ------ ----·- ------ -----2
55
4 -----1 ------ -----9

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19
6

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7
11
15
45
29

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2 ----·- ------ ------ ----------61 -----______ -----1- -----1 ___
____-----____ _

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1 ------ ------ -----1 ------ ------ ------ -----2 ------ ------ ------ -----3 ------ ------ ------ ------

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17

87
62
18
262
77
64
62
186
31
114
54
41
19
27
38
51
140
103
19
25
31
148

8
3
3
5
12
4
8
8

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1

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101

Total hospitals _______________________________________ ------ ------ ------ ------ ------ ------ -- ---- ------ ------ ------ -------- ------


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Federal Reserve Bank of St. Louis

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35
27

26
34
14
10
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17
16
47
33
16
20

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271
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117
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281
154
120
127
292
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108
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48
216
50
154
167
10

72
273
79
103
201
14

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Hospital division-Continued.
Relier stations:
Second class __________ _______ _____________ -------- -- ---1 -----20
1 ------ -----1 ______ ______
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Total relief stations __ __________________ --- ----------- -------- ---------------------------------------- _________________________ _
===l===l===l====t===l===t=== === 1~=~ 1=~=--- 1- - - =

Foreign quarantine division:
Quarantine stations:
1 ______ ______ ______ ____ __ ______ ______
1 _____ _
Baltimore, Md___________________________ ________ ______
1 ____________ ------ ______ ______ ______
2
2
1
Boston, Mass ____________________________ ------- -- ----Ellis Island (also immigration)___________ ________ ___ ___ ______ ______ ______ ______ ______ ______ ______ ______ ______
2
El Paso, Tex _____________________________ ----- --- ------ ______ ------ ______ ------ ______ ______ ______ ______ ______
1
Fort Monroe, Va _________________________ --- ----- ------ ______ ______ ______ __ ____ ______ ______ ______
2
2
1
1 ___ ___ ______ ______ ______ ______ ______
1
3
1
Galveston, Tex___________________________ ________ ______
Honolulu, T. H__________________________ ________ ______ ______ ___ ___ ______ ______ ______ ______ ______
2 ______
1
Laredo, Tex _______________________________________________________________________________________________________ _
Marcus Hook, Pa________________________ ________ ______
1
2 ______ ______ ______ ______
2
2
1
New Orleans, La_________________________ ________ ______
1 ______ ______ ______ ______ ______ ______
4
4
3
Rosebank, N. y _____________________ __ ___ ________ ______
3 ______ ______ ______ ______ ______ ___ ___
6
6
7
1 ______
1 ______ ______ ______ ______
4
2
2
San Franrisco, Calif. (also immigration)__ ________ ______
San Juan, P. R ________________________________________ -·--·· ______ ______ ______ ____ __ ______ ______
1 ______
2
Foreign ports______________________________________________________________________________________ ____ ______
3
All other stations_________________________ ________ ______
4
1
2 ______ ______ ______ ______
15
16
14

=

17
18
9
11

15
11
24
16
20
17
83
39
24
20
211
Total quarantine and immigration ____________________________________________________________________________________________ _

=

254

=

64

3
3
20
2

24
11
12

1

20

4
15
5

20

10
5
3

17
27
16
28
29
105
49
27

54

23

4
6

198

263

333

671

7
10

64

318

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31
14
21
21
42
21
32
35
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Domestic quarantine division:
Interstate _____________ ________ _______________ ----··-- -·-·-- ________________________ ----·· _______________________ _
Trachoma __ --·-•------- ---------------------- ________ ---·-- ______ ______
5 ______ ____________ ··-·-- -----· _____ _


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

6

58 -- ----

1 -------- ------

6

71
16

25
94

29

34 -------94 -------34 --------

- - - - - - - - - - - - - - - - - - - ---1---t---1---1--- - - - - - - - - - - - - Total all activities __________________________________________________________________________________ ------ ------ -------- ------ -----31
249
218 ------

26
3
5

142
5
13

7
40
9
8
55

13
11
6
11
78

1

168
8
18
1
20
51
15
19

133

Total all activities ______________________________________________ ------ ------ ------ ------ ------ ---- -- ------ ------ -------- ------ -----154
433
279 -----1===ci===1===========1==~==1=========
4,643 _________ ___ _________________________________ __________ __________ _
4,645
2 ------ ------ -- 4,645 -----Division of venereal diseases ______________________________________________________________________ _
4
61
19
80
80
14 -----1 ------ -----l===!==I== = = = = = = = = = = = = = = =
Division of mental hygiene:
.Alderson, W. Va_____________________________ ________ ______ ______ ______
5 ______ ______ ______ ______ ______ ______
1 __ ___________ _
6
12
6
14
4
18
~
----2- -----10
6
16
6
15
9
6
17
t~;:ne!~~rh:~~hi{s~~~~:::::::::::::::::::::
_____ __
11
Petersburg, Va_______________________________ ::::::::
________ ::::::
______ ______ ::::::
______ ______ ::::::
______ ======
______ ::::::
______ ::::::
______ ::::::
__ ____ ::::::
______ ::::::
______
3 _____
3
8
5
McNeil Island, Wash________________________ ________ ______
1 ______
2 _______________________________________________________ _
3
11
8
.All other stations_____________________________ ________ ______
5
2
21
4
1 ______ ______ ______ ______
14
209 _____ _
256
340
84

Sanitary reports and statistics____________________

~~i~fl:t~~-oiiio--==:::::::::::::::::::::::::: :::::::: ::::::

~

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: :::::: :::::: :::::: :::::: :::::: :::::: ::::::-~

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Total all activities ______________________________________________ ------ ------ ------ ---- -- ------ ------ ------ ------ -------- ------ -----437
147
290 -----===1~=-=-t===t===t===1=== - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - Miscellaneous:
Detailed to other offices __________________________________________ ------ ------ ------ ------ ------ ------ ------ ------ -------- ------ -----17
17
Coast Guard_________________________________ ________ ______ ______ ___ ___
1 _______________________________________________________ _
136
1
137
Perry Point, Md. (supply station)___________ ________ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______
4
5 _____ _
1
9
10
1 ______ ______ ______ ______ __ ____ ______ ______ ______
3 _____________ _
Public health districts________________________ ________ ______
1
4
5
47
Waiting orders _______________________________ -------- ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ -------- ---- -- -----47
.All others ________________________________________________________ ------ ------ ------ ------ ------ ------ ------ ------ -------- ------ -----15
15
Total miscellaneous________________________ ________ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ________ ______ ______ __ 217
231
14 -----=====---,---,----->----<---=======
Grand total________________________________ 4,643
31
43
20
586
37
4
40
10
36
38
321
3,000
183
1,869
9, 116 ------ 10,985

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Federal Reserve Bank of St. Louis

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CHIEF CLERK'S OFFICE
DANIEL MASTERSON,

Chief Clerk

DEPART MENTAL PERSONNEL

On July 1, 1934, the civilian :force on duty in the Administration
Building consisted o:f 181 employees, of whom 162 were paid from
the appropriation " Salaries, Office of the Surgeon General ", 10
:from the appropriation "Expenses, Division of Venereal Diseases",
and 9 from the appropriation "Expenses, Division of Mental
Hygiene." In the course of the year 3 new employees were added,
chargeable to the appropriation "Expenses, Division of Mental
Hygiene", making a total of 184 positions in the Bureau at the close
of the fiscal year.
During the year 9 employees resigned, 3 died, and 1 was retired
on account of physical disability. Thirteen vacancies were filled by
original appointment, 4 by transfer of employees from other Government agencies, and 1 by transfer from the Public Health Service.
field service.
Only 4 administrative promotions were possible, and these were
in the Division of Mental Hygiene. Increases in grade or salary
were given to nine employees by advancements to positions left
vacant by the resignation, death, or retirement of the incumbents.
The average salary at the beginning of the fiscal year was $1,898,
but had fallen to $1,890 at the close of the year.
Sick leave averaged 9.3 days per employee, as compared with S.4
days for the preceding year. Largely as a result of reduced annual
leave allowance, a considerable number of employees found it necessary to take leave without pay, a circumstance that worked hardship
in some instances.
There were 2,032 visits to the emergency room maintained in the
Administration Building, in 260 of which there was attendance by
a physician.
Three deaths occurred among the personnel. Miss Lucy Minnigerode, who had been Superintendent of Nurses since 1919, died on
March 24, 1935. Miss Blanche E. Bogard, senior clerk in the dental
section of the Hospital Division since 1920, died on January 6, 1935.
Miss Ethel Clark, assistant clerk in the Division of Personnel and
Accounts, died December 4, 1934, after a service in this Bureau since
April 30, 1920. Mr. Jennings B. Phillips, assistant clerk in the
Chief Clerk's Office, retired on June 30, 1935, on account of physical
disability after a Government serviqe 0£ nearly 17 years.
PRINTING AND BINDING

Prior to the fiscal year 1933 the annual allotment to the Public
Health Service for printing and binding had been $93,000, which
sum was far :from being adequate for the reasonable printing and
binding requirements of the Service considered essential to the most
144

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PUBLIC HEALTH SERVICE

145

effective performance of its authorized and required work. However, in 1933, because of a decreased appropriation for the Treasury
Department, this allotment was drastically cut to $50,000, with resulting serious impairment to the health work of the Service. While
this allotment has now been increased to $58,000 for the fiscal year
1936, it cannot be too strongly urged that the fund be restored to
its -former figure at the earliest practicable date. A further enlargement beyond that amount could easily be justified by the needs
involved. Reasonable printing expenditures for disseminating the
results of researches and investigations and other useful health information authorized by law is one of the best means of achieving the
greatest results from the progress being made in sanitary science
and of promoting general health in our country. In the meantime,
constant attention is being given in this office to the most economical
utilization of the funds available.
OFFICE QUARTERS

During the fiscal_year the new Administration Building at Nineteenth Street and Constitution Avenue was improved by the completion of the handsome marble terrace surrounding the structure,
by the grading and landscaping of the grounds and approaches, by
the painting of the interior, and by the installation of new cork
floors to replace defective mastic tile flooring originally provided.
The auditorium in this building has proved very useful for numerous gatherings connected with the work of the Public Health Service,
and in addition has been frequently used by other departments and
agencies of the Government.
The comprehensive Public Health Service exhibit shown at the
Century of Progress exhibition at Chicago was returned to Washington and has been utilized, with other exhibit material, to equip
a very interesting exhibit room in the administration building, where
the public may view many instructive features of disease-prevention
work.
PUBLIC HEALTH SERVICE LIBRARY

The library added to its shelves 258 volumes and approximately
200 pamphlets, its collection now numbering 13,851 bound volumes
and 7,450 pamphlets. Journals to the number of about 250 are being
received regularly and circulated to Service personnel interested
therein. Many of these journals are subsequently bound and form
valuable reference material.
Visitors to the library, and requests received by letter, telephone,
and person, showed a constant increase throughout the year, and
there is pressing need for an increase in the library staff, which now
consists of but three persons.
EMPLOYEE ACTIVITIES

During the year a credit union was organized by the personnel
on duty in the administration building under the recently enacted
Federal credit-union law. This union, like many others of its kind,


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146

PUBLIC HEALTH SERVICE

is proving very successful, as it provides its members, to a considerable extent, with their own banking facilities. Besides furnishing
a convenient and profitable method of regular savings, it affords
also a source of credit of decided practical value.
The Public Health Service Relief Association, which was organjzed in 1929, has continued to progress, and proyides the means of
giving immediate and substantial aid to employees who may be
confronted with unexpected emergencies. This association has been
notably successful and has accumulated a :fund of considerable size.


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Federal Reserve Bank of St. Louis

APPENDIX
FINANCIAL STATEMENT

The following is a statement of expenditures from appropriations
of the Public Health Service for the fiscal year 1935 :
Obligations

Appropri-

Appropriation

ated and
received
from other
sources

OutLiquidated standing

Incurred

Unobligated

balance

---Salaries, Office of Surgeon General. .•.....•.•.
Pay, etc., commissioned officers..•.....•......
Pay of acting assistant surgeons••....•.••..•..
Pay of other employees ....•....••••.•••••••••
Freight, transportation, etc ............•......
Maintenance, National Institute of Health ..••
Books ......... ......... ..... ......... ........

Pay of personnel and maintenance of hospitals.
Quarantine Service ....................... .....
Preventing the spread of epidemic diseases....
Preventing the spread of epidemic diseases,
1935-36. . ...... ... ........... ... ...... ...•..•

I

$293,080
1,594,342
289,111
948,737
25,190
50,000
450
6,041,079
322, 150
209,123

$291,777
1,576,729
275,924
936,331
24,737
49,055
448
6,041,079
306,733
205,003

$291,777
1,575,385
274,224
935,175
22,749
46,752
426
6,012,818
299,548
200,059

$1,344
1,700
1,156
1,988
2,303
22
28,261
7,185
4,944

8,000

1,515
229,184
34,686
25,267
41,141
62,106
387,992
986

1,399
225,295
33,937
25,175
41,113
60,054
378,806
863

116
3,889
749
92
28
2,052
9,186
123

6,485
4,089
1, 128
144
443
149
5,192
14

47,135

42,338

4,797

17,865

Field Investigations of public health ........•.
233,273
Inter~tate Quaranti_ne ~ervice.••••••..........
35,814
Studies of rural samtat10n..............•.•....
25,411
Control of biologic products .................. .
41,584
Expenses, Division of Venereal Diseases .••...
Expenses, Division of Mental Hygiene ..•..... 2
Educational exhibits......................... .
1,000
Working-capital fund, narcotic farm, Lexing•
ton, Ky......................... ......... __
65,000
Payment to officers and employees in foreign
countries due to appreciation of foreign cur•
49,100
rency ······--···········--··········-···-···
Total •. ·--·-········-················--· a10,687,883

3~~: i~i-

46,668

43,320

10,584,496

10,511,213

$1,303
17,613
13,187
12, 40
453
945
2

15,417
4,120

___

3,348 ,__
73, 283

2,432

103, 387

1 Includes $693,485 reimbursement for care and treatment of beneficiaries of the Veterans' Administration
and Civilian Conservation Corps and $25,234 miscellaneous reimbursement.
1 $65,000 transferred to working-capital fund, narcotic farm.
a Statement does not include expenditure of $7,490 from trust funds.

FUNDS TRANSFERRED FROM OTHER DEPARTMENTS

Expenditures from allotments of funds from other bureaus and
offices for direct expenditure during the fiscal year 1935 were as
follows:
Balance

Appropriation title

;fg~ ~~l

Allotted

Expended

year
Veterans' Administration: Working fund......................................
$304,899
Department of Justice: Medical and hospital service, penal
Institutions.-········ ......... . ······-··· ............••.....•.••. ·······-···- 1 432,478
Public Works Administration: National Industrial Recovery......
$459,748 .••.........
Civil Works Administration: Working fund.-··········-··········
37,795 •.•.........
Federal Emergency Relief Administration: Working fund-·-······............ 1,000,000
Public Works Administration: Working fund-.....................
75 .•..•...... .
Total.._.-· .....•........•...••.•...•...•••.•••..••....... -..
1

497,618

1, 737, 377

$304,899
432,297
459,748
37,795
943,533
75
2,178,347

This amount includes $14,000 transferred under acts of Mar. 29, 1934, and Feb. 13, 1935.

147


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PUBLIC HEALTH SERVICE
MISCELLANEOUS RECEIPTS-COVERED INTO THE TREASURY

The revenue derived from operations 0£ the Public Health Service
during the fiscal year 1935, and covered into the Treasury as miscellaneous receipts, were as follows:
Amount

Source
General
fund receipts:
Quarantine
charges ______________________________ __ ____________ _______________________ _
Hospitalization charges and expenses ______________ ____ __________________________ _____ _
Sale of subsistence _________________ ------------------- ----------- -- ----------------- __
Sale of occupational-therapy products ________ _________ ___ ___ ___ ___ __________________ _
Sale of obsolete, condemned, and unserviceable equipment ___________________________ _
Rents ________ ----- -- ---- -- --- ----- ---- ------ ---- ---- -- ---------- -- ---- ---- -- ---- -----Reimbursement for Government property lost or damaged ___________________________ _
Commissions on telephone pay stations installed in service buildings _________________ _
Sale of refuse, garbage, and other byproducts _________________________________________ _
Sale of livestock and livestock products _______ _______________________ . ---- ------------Other revenues ____________ ------------ ______ -- -- -- -- __ ---- -- _-------- --------- ---- ---TotaL _______________________________________ _____ ___________ ___________ ____________ _
Trust-fund receipts:
Sale of effects
deceased
patients _______ ------------- · -----------------·-·-----------Inmates'
fundsof____
. _______________________________________________________
. ___ .. _____ .
Grand total. ___________ ------------------------·.··-- ·- · __ · -----------·--·-· .• _____ _

$218, 534. 52
35,979.39
11,328.01
561. 94
9,312.14
2,417.00
398.45
1,257.10
1,241.60
377. 90
235. 21
281,643.26
955. 76
1,363.78
283,962.80

QUARANTINE SERVIOE--EXPENDITURES BY STATIONS:

Name of station

Pay of officers and em- Maintenance
ployees

Total

CONTINENTAL QUARANTINE STATIONS

Baltimore, Md_______________________________________________

$30,479.69

$9,754.26
5,880.47
65.00
Boston, Mass ________________________________________________
37,720.41
20,594. 96
2,853.84
325. 72
10. 00
2,196.58
Cape Fear (Southport), N. c_ ------------------------------7,834.98
8,549.96
Charleston, S. 0 .. -----·--·-----------------·---------------23,149.04
Columbia River (Astoria), Oreg______________________________
3,644.48
3,194.20
Corpus Christi, Tex________ ________________ ____ ______________
1,997.50
60.92
Del Rio, Tex_______________________ ______________ _____ __ _____
4,579.45
1,033.86
1,021.58
2,867.64
Eureka, Calif_ ______ ··---·--------- ___________________________ . ___________ _
12. 00
Galveston, Tex_______________________________________________
22,407.92
7,839.26
Gulfport, Miss_ _____ _______________________________ __________
3,815. 55
429. 95
Hidalgo, Tex______ ___________________________________________
4,267.56
506. 37
Key West, Fla________________________________________ __ _____
1,708. 29 _____________ _
Laredo, Tex________________ ________________ ___ _______________
19,745. 00
2,081.66
Marcus Hook, Pa____________________________________________
40,102.27
12,659.72
643. 16
6,166.02
15,777.16
Newport, R. I _________________________________ ___ ________________________ _
35. 00
New York (Rosebank), N. y ________________________________
145,534.31
68,498.76
Nogales, Ariz________________________________________________
2,483.16
1,618. 78
Norfolk (Fort Monroe), Va__________________________________
30,652.59
7,088.46
Pensacola, Fla_____________ _________________________________ _
11, 687. 69
• 1,596.96
Perth Amboy, N. J._________________________________________
1,366.58
900. 00
Portland, Maine_____________________________________________
10,751.00
2,357.71
Portland, Oreg_______________________________________________
1,413.01
112. 48
Port Townsend, Wash_____ __________________________________
11,486.70
2,539.68
Presidio, Tex___________________________ _____________________
3,641.87
745.19
Providence, R. r __________________________________________________________ _
95. 00
Rio Grande, Tex_____________________________________________
2,255.30
125. 80
Roma, Tex___________________________________________________
3,681.00
616. 60
Sabine, Tex__________________________________________________
11,688.47
1,147.09
St. Andrews (Panama City), Fla _______________ ___________________________ _
100. 00
St. Johns River (Jacksonville), Fla__ ________ __ _______________
8,500. 18
1,263.16
San Diego (Point Loma), Calif.._________________________ ____
10,937.61
4,138.24

~~i:lt~~:t:. f..~~~~il~-~!~================================== t m: ~~
~mrffI.~t:ir~~============================================= ____ 1i: m: ~:.
~f~:s~~~~~~~========================== ========== ======== ==

~g: :~z: :~

~i~~it:!~rs~~i:~=============================================

~~: m: !i .


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Federal Reserve Bank of St. Louis

$40,233.95
22,869.60
1,206.25
58,315.37
15,503.18
1,671.20
10.00
10,031.56
31,699.00
6,838.68
2,058.42
5,613.31
11,487.46
25,257. 10
12. 00
30,247.18
4,245.50
4,773.93
1,708.29
21,826.66
52,761.99
2,161.96
27,056.18
60,764.78
35. 00
214,033.07
4,101.94
37,741.05
13,284.65
2,266.58
13, 108. 71
1,525.49
14,026.38
4,387.06
95. 00
2,381.10
4,297.60
12,835.56
100. 00
9,763.34
15,075.85

•

149

PUBLIC HEALTH SERVICE
QUARANTINE SERVICE--EXPENDITURES BY STATIONS-continued

Name of station

Pay of officers and em- Maintenance
ployees

Total

CONTINENTAL QUARANTINE STATIONS-continued

San Francisco, Calif.._______________________ _________________
San Pedro (Los Angeles), Calif..____________ _________________

$43,010.93
19,882.51

~::ft~~a~a~:________________________________________________
~~t ~~
Tampa, Fla________________________________________ __________
11, 210. 49
Vineyard Haven, Mass. ___ ---------------------------------- __ _______ ____ _
Ysleta, Tex. __ ----------------------------------------------- _____________ _
Zapata, Tex__________________________________________________
1,862.16
Freight and miscellaneous ______________________________________ ___________ _
Travel of medical directors within districts ___________________ --------------

rn:

Total, continental quarantine stations_____ _____________
..

INSULAR QUARANTINE STATIONS

Hawa1L____________________________________ __________________
Philippine Islands___________________________________________
Puerto Rico__________________________________________________
Virgin Islands_____________ ___________________________________

$19,970. 83
3,673. 31
4,601.96
1,040.14
3,995.83
20.00
21. 70
360. 00
49,822.67
1. 28

$62,981.76
23,555.82
17,627. 77
11,143.27
15,206.32
20. 00
21. 70
2,222.16
49,822.67
1. 28

689,003. 76
281,010.92
970,014.68
l= = = = =:l= = = = ==I= = = = =
29,448.78
13,840.56
22,265.38
10,960.64

11,855.85

-------------11,248. 90
2,617.33

41,304.63
13,840.56
33,514.28
13, 577. 97

1------1------1------

102,237. «
25,722.08
76,515.36
l=====-1======1=====
Grand total, all stations________________________________
1,072,252.12
765,519.12
306,733.00

Total, insular quarantine stations______________________


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Federal Reserve Bank of St. Louis


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Federal Reserve Bank of St. Louis

INDEX
A

Pag6

Accounts section, report oL ____________________________ _____ ________ _ 137
Acting assistant surgeons, number on duty ___________________________ _ 135
Administration building, new,________________________________________ _ 145
Aides. (See Nurses, dietitians, and reconstruction aides.)
Air-pollution studies________ . ----------------------.----------- ________ _
Airports of entry :
Inspections at_ _________________________________________________ 3-4, 74
Summary of transactions at______________________________________ 83-84
Aliens:
Medical inspection of_ ______________________________ _________ 4-5, 78-79
Summary of medical inspection of,________________________________ 85-97
Amoebic dysentery, studies of_ _______ ____ __________ ..: _________________ 10, 49
Anemias, experimental research on___ _______________________ _________
52
Appendix (financial statement) ____________ ______ _________ __________ 147-149
Atlanta, Ga., medical services furnished the United States Penitentiary
at----------------------------------------------------------------129
Attending specialists, number on duty_______________ ________________ __
135

B
Bacterial variants and mutants, studies, of____________________________
48
Bacteriophage, reports on ____________________________________________ 1
48
Beneficiaries, marine hospital, summary of services by class of_ ________, 107
Bichloride of mercury poisoning, study of______________ _______________
51
Bills of health, opposition to abolition of_ ______________________________ 76-77
Biochemical studies _______________ _ ·--------------------------------- 22-24
Biological effects of radiation, studies of_ ____________________________ 20-21 ·
Biologic products_____________________________________________________
49
Studies for the control of ____,____________________________________
10
Birth rate· for the United States___________ ________________ ___________
2
Buildings, new :
Administration ------------------------------------------------ -- 145
Hospital_____________ ___________ __ ________ ______________________
108
National Institute of Health------------.-------------------------47
Quarantine__________________________ _______ ________________ _____
74
C

Canada, reciprocity with, in sanitary-control work_____________________
65
Canadian and Mexican border stations, summary of aliens examined at
( see also Mexican border stations)--------------------------------90
Canal Zone, summary of quarantine activities at_ ________ _____________
85
Cancer:
Control of pain by drugs_ ___________________ _______________ ______
126
Investigations of------------------------------------ -- 6-7, 10, 20-24, 51
Chart, average per diem cost of inpatient relief, marine hospitals (see
a~o Tables)__________________________________________ _____ ______ __ 111
Chemistry, report of division of ______________________________________ 52-53
Chemotherapy of pneumococcus infection_____________________________
51
Chief clerk's office, report ··of_ ______________________________________ 144-146
Child hygiene, investigations of_ ______________________________________ 33-34
151


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152

INDEX

Children :
Page
Dental examinations of_ _______,__________________________________
8
Growth and development of, studies on___________________________ 7-8
Chillicothe, Ohio, medical services furnished the United States Industrial
Reformatory at____________________________________________________
129
Cholera:
Prevalence of__________________________________________________ 1, 2, 73
Vaccination against______________________________________________
74
Coast Guard beneficiaries, medical relief furnished to ________________ 109-110
Commissioned officers, number on duty _______________________________ 133-134
Conference of the Surgeon General with the State and Territorial health
72
officers-----------------------------------------------------------Consular
Regulations, amendment of _________________________________ _
4
Con tract dental service______________________________________________ _ 109
Contract dental surgeons, number on duty ___________________________ _ 136
Cooperation of Public Healt b Service with other agencies,______________ _ 12-17
Current prevalence of disease, reviews of___________________________ _:_
45
Cytological studies__________________________________________________ _
24

D
Death rate:
Publication of note on___________________________________________
45
United States_______________________________ ,-------------------2
Defective vision, adult, prevalence of_________________________________
45
Dengue fever, prevalence of___________________________________________
3
Dental examinations, children________________________________________
8
Dental health surveY--,----------------------------------------------34
Dental service, contract------------.-----------------------·-----_______ 109
Dental treatment a.t marine hospitals and relief stations----------,---- 108
Dermatitis. (See Dermatoses investigations.)
Dermatoses investigations_____________________________________________
~5
Dietitians. (See Nurses, dietitians, and reconstruction aides.)
Diphtheria death rate _____ ··-----------------------------------------2
Diseases:
Contagious and infectious, prevention of the spread of in interstate traffic___________________________________________________ 5-6
Current prevalence of, reviews____________________________________
45
From abroad, prevention of tbe introduction oL___________________ 3-4
Nervous and mental, causes, prevalence, and means for the p,revention and treatm.ent of_ ____________________________________ 131-1~_2
Notifiable, summary of number of cases compared with number
of dea tbs ___________ ---,---------------------------------------99
Venereal. (See Venereal diseases.)
Domestic quarantine, report of division o:1:----------------------------- 54-72
Drug addiction :
Dissemination of information relating to------- -,------------------ 126
Studies of the niature a.nd treatment of_ _______________________ 125-126
Dust studies _________________________________________________________ 36-37
Dysentery, bacillary, studies of_______________________________________
49

E
Educational activities relaiti.ng to the venereal diseases _______________ 118-119
El Paso, Tex., quarantine a ctivities at________________________________
77
Employees:
Activities oL------------~--------------------------·----------- 145-146
Supervision over medical relief rendered to__________________ 10-11, 108
Encephalitis, studies oL-------------------------.------------------ 9, 47-48
Engineering activities:
Public Health, cooperative _______________________________________ _ 70-72
Statistical compilations of_________ -----------------------------.-65
Epidemiological studies _______________________________________________ _
36
Epidemiologists, number on duty _______ ---------------,---------------- 136
Exhibits prepared---------·---------------,-------------------------- 101, 145


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Federal Reserve Bank of St. Louis

INDEX

153

F
Federal Emergency Relief .Administration, field supervision of medical
relief measures_____________________________________________________
7_0
Federal penal and . correctional institutions, medical and psychiatric
services in--------------------------------------------------.-- 12, 128-12-1
Financial statement, tabular___________________________________,_____ 147-149
Floating equipment, construction oL__________________________________
75
Foreign and insular quarantine and immigration., report of division oL __ 73-97
Fort Worth, Tex., development of narcotic farm at_ ________,____________ 1...:7
Fumigation and inspection cf vessels ______________________________ 3-4, 73-74
Fumigation studies---------------------------------.-----------------74
Funds transferred from other departments, tabular statement___________
147
G

Ground squirrels.

(See Rodents.)

H
Hawaii, plague-control mea:mres in_--------....------------------------- 57-60
Health conditions:
United States___________________________________________________ _
2-3
World----------------------~---------------,--------------------- 1-2
Health organizations, local, surveys oL ______________________________ _
72
Heart disease, studies oL---------------------.-------------------- 7, 24-2-5
Hot Springs, Ark., venereal disease clinic at_ ________________________ _ 120

I
lllumination studies--------------------,------------------------------ 37-3_8
Immigrants. (See Aliens.)
Industri,a l hygiene and sanitation, studies oL _____________________ 8, 36-39
Industrial poisons, studies of_______ ___________________________________
38
Industrial workers, studies of sickness among__________________________
38
Infantile paralysis. ( See Poliomyelitis.)
Infant mortality rate________________________________________________
2
Influenza, prevalence of _______________________________________________ 1,45
Inpatient relief, chart showing average per diem cost oL_______________ 111
Inspection of vessels. (See Fumigation and inspection of vessels.)
International Sanitary Convention for Aerial Navigation, ratification of_ 4, 75-76
Internes, number on duty_____________________________________________ 135
Interstate quarantine. (See Domestic quarantine.)
Interstate traffic, prevention of the spread of contagious and infectious
diseases in _____________________________________________________ 5-6,54-66
Introduction of diseases from abroad, prevention oL____________________ 3-4
Investigations (see also Studies) :
Cancer ___________________________________________________ 6-7,20--24,51
Child hygiene ____________________________________________________ 33-34
Dermatoses______________________________________________________
35
Leprosy _________________________________________________________ 7,49
Malaria _________________________________________________________ 27-29
Milk --------------------- ' ----------------------------------- 9, 39-41
Pellagra controL_________________________________________________
7
Psittacosis_______________________________________________________
30
Public-health
problems ------------------------------------------- 42-45
6-10
Statistical
_______________________________________________________
Stream
45-47
Venerealpollution
diseases------------------------------------------------________________________________________________ 11-12

L
Laboratory, Public Health Service, in California, activities at__________
56
La Tuna, Tex., medical services furnished the United States Detention
Farm at__________________________________________________________ 130
Leavenworth, Kans., medical services furnished the United States Penitentiary at________________________________________________________ 129
Legislation, sanitary, and court decisions _____________________________ 99-100
Leprosy, investigations of_ ___________ __ ______________ __ _:_ ________ 7, 25-27, 49


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154

INDEX
Page

Lewisburg, Pa., medical services furnished the United States Penitentiary
at_________________________________________________________________ 130
Lexington, Ky., narcotic farm at_ ___________________________________ 126-128
Library, Public Health Service__________ _____________________________ 145

M
Malaria:
Control measures _________________________________ ______ _ 5,68-69,78-79
Investigations of---------------------------------------------- 7, 27-29
Malignant growths. (See Cancer investigations.)
Marine hospitals :
Average per diem cost of inpatient relief, chart showing____________ 111
Beneficiaries, summary of services by class of______________________ 107
Coast Guard beneficiaries ______________________________________ 109-110
New buildings ___________________________________________ _______ 11,108
Operating costs__________________________________________________ 110
19
Recommendations for____________________________________________
Reports, consolidated and detailed______________________________ 112-116
Marine hospitals and other relief stations, beneficiaries treated at_ _____ 10-11
Marine hospitals and relief, report of division of_ ______ __ _____________ 106-116
Maritime quarantine, recommendations for____________________________
18
Maritime quarantine stations, summary of transactions at_ _______ 79-82, 89-90
McNeil Island, medical services furnished the United States Penitentiary
at. - ----------------------- -~- - ------------------- ------ ---------- 129-130
3
Measles, prevalence of--------------- ---- ---------------------------Medical and psychiatric care of Federal prisoners on narcotic farms_____
12
psychiatric services in Federal penal
and correctional
insti-128--131
Medical
tutionsand
____________________________________
__ ____________
___ _____
Medical examination of aliens. (See Medical inspection of aliens.)
Medical inspection of aliens ______________________________________ 4-5, 78-79
Summary of _____________________________________________________ 85-97
Medical relief units, Treasury Department, supervision oL _________ 10-11, 108
Mental hygiene, report of division of_ _______________________________ 125-132
Mexican border stations, summary of quarantine transactions at (see
a.lso Canadian and Mexican border stations>-----------------------82
Midwifery, studies of_ ________________________________________ ______ 8, 33-34
Milk investigations _________________________ --------- - - ------------- 9, 39-41
Miscellaneous receipts, tabular statement of__________________________ 148
Morbidity and mortality reports ______________________________________ 98-99
Morbidity studies____________________________________________________
45
Mortality trends and the depression, study of_ ________________________ 44-45
8
Mottled enamel, studies of ( see also Dental studies)-------------- -----

N

Narcotic farms:
Development of__________________________________________________
12
Operation of _______ ___ _____ ____ __ ______________________________ 126-128
National Institute of Health:
New building___________ _________________________________________
47
Number on duty ____ ___ -- ---·- -------------- ------------ ----------136
Publications issued by____________________________________________
53
Report of--------------------------- ----------------------- ----- 47-53
Negro health work__________________________________________________
5
Nervous system, pharmacology of_____________________________________
52
Notifiable diseases, cases of compared with deaths, summary of________
99
Nurses, dietitians, and reconstruction aides, number on duty _________ 135-136
Nutrition studies ____________________________________________________ 29'--30

0
Operating costs of marine hospitals ________________ _____________ -------

110

p
Pacific Coast States, plague-control measures in ______________________ 54-57
Pathology and bacteriology, report oL ___________________________ _____ 47-50
Pathology, diagnostic service_________________________________________
49


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Federal Reserve Bank of St. Louis

INDEX

Pellagra:
Control
measures-------------------------~-~--------------------Death rate
_____________________________________________________ _

155
Page

7
3

Personnel ( see also Personnel and accounts) :
Activities of -------------------------------------------------- 145-146
Departmental______________________________________ ___________
144
Recommendations for____________________________________________
19
Supervision over medical relief furnished to ____________________ 10--11, 108
Tabular statement of __________________________________________ 137-143
Personnel and accounts, report of division oL _____________________ ___ 133-143
Pharmacists and administrative aiSSistants, number on duty_____________
135
Pharmacology, report of division of_ _________________________________ 51-52
Plague:
.
Control measures ______________________________________________
5, 54-60
Laboratory, Public Health Service________________________________
5_6
Prevalence of _______________________________________________ 1, 3, 55, 73
Pneumococcus infection, chemotherapy of_______________________ ______
51
Poliomyelitis:
Prevalence of-------------------------------------~-------------- 2-3.
Studies OL----,------------------------'---------------------- 8, 9, 36, 4&
Printing and binding_______________________________________ _______ 144-145Property records section, report of __________________________________ 136-137
Prophylactic and therapeutic studies__________________________________
50,
Psittacosis :
Investigations of_________________________________________________
30
Measures taken against ________________________________________ __ 61-62
Publications issued and distributed __________________ 53, 100-105, 106, 118-119
Public health :
Engineering activities _________________________________________ 6, 70-72
Methods, studies oL ___________________________________________ 9, 41-42
Problems, investigations of_______________________________________ 6-10
Public Health Service :
Cooperation with other agencies ____________________________ 12-17, 70-72
Laboratory in California_________________________________________
56
Library_________________ ___________ __________ _____ ___ ____________
145
Q

Quarantine laws, violations oL______________________________ _________
74
Quarantine service, expenditures by stations, tabular statement oL ____ 148--149
Quarantine stations, construction of___________________________________
74
Quarantine transactions at:
Airports of entry, summary of ____________________________________ 83-84
Canadian and Mexican border stations, summary of aliens examined -------------------------------------------------------90
Canal Zone, summary of____ __ ____________________________________
85
Maritime stations, tabular statement of _________________ ________ 79-82
Mexican border stations, summary of________________________ ______
82

R
Railway sanitation _______ _____ --------------------------------------- 64, 66.
Rats. ( See Rodents. )
Recommendations for:
Marine hospitals------------------------------------------------19
Maritime quarantine --------------------------------------------18Personnel________________ ________________ ___ _____________________
19·
Scientific research________________________________________________
17
State and local health work __________________________________ ;_ ____ 17-18
Venereal disease problem_______________________________________
19
Reconstruction aides. (See Nurses, dietitians, and reconstruction aides.)
75
Reedy Island quarantine station, inspection of vessels at_______________
Relapsing fever, studies of ____________________________________________ 32, 48
Reports:
Marine hospitals, consolidated and detailed ______________________ 112-116
Morbidity and mortality ____________________________ __ ______ ____ 98--99
Personnel _______________________________________ _______________ 137-143
Research program, venereal diseases (see also Studies) ______________ 119-120
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Reserve officers, number on duty ____________________________________ 134-135
Respiratory studies___________________________________________________
45
Rocky Mountain spotted fever :
Prevalence of ____________________________________________________ 7,47
Studies of _______________________________________________________ 30-32
Vaccine, production oL__________________________________________
7
Rodents:
Control
measures
------------------------------------------------ 54-60
Plague-infected
___________________________________________________
3,73
Ruralhealthwork ___________________________ _________ '-<=------------ 5,67-68

s
:San Francisco, Calif., Public Health Service laboratory at______________
56
,Sanitary-control work of Public Health Service with Federal agencies ____ 70-72
Sanitary legislation and court decisions______________________________ 99-100
Sanitary reports and statistics, report of division of_ __________________ 98-105
Sanitation projects, community________________________________________
69
Sanitation, rural. (See Rural health work.)
Scientific research:
Recommendations for_____________________________________________
17
Report of division of _________________________________ ____________ 20-53
Sewage treatment, studies of__________________________________________
9
Shellfish sanitation __________________________ ___________________ _ 6, 64-65, 66
Sickness and the depression, studies oL ___ :.____________________________ 9, 43
Skin diseases. (See Dermatoses.)
Sleeping sickness. ( See Encephalitis.)
Smallpox:
Prevalence of ___________________________________________________ 2,3,73
Studies of_______________________________________________________
45
Vaccination against--------------~-------------------------------- 57,74
Spotted fever, prevalence oL__________________________________________
9
Springfield, Mo., medical services furnished the United States Hospital
for Defective Delinquents at________________________________________
130
Squirrels. ( See Rodents.)
State and local health work, recommendations for ______________________ 17-18
State and Territorial health officers, conference of the Surgeon General
with--------------------------------------------------------------72
Sta ti stica 1 compilations, engineering___________________________________
65
Statistical investigations ______________________________________________ 42-45
Stream polJution investigations ______________________________________ 6, 45-47
Stream sanitation, cooperative work with States relative to____________
65
Studies (see also Investigations and Research) :
Air pollution_____________________________________________________
37
Amoehic dysentery _______________________________________________ 10, 40
Bacterial variants and mutants___________________________________
48
Bichloride of mercury poisoning___________________________________
51
Biochemical ______________________________________________________ 22-24
Biological effects of radiation _____________________________________ 20--21
Biologic products, control of______________________________________
10
Cancer___________________________________________________________
10
Children's development------------------------------------------7-8
Cytological------------------------------------------------------24
Dental ___________________________________________________________ 34-35
Drug_____________________________________________________________
addiction ------------------------------------------------- 125-126
Dust
36--37
Dysentery, bacillary______________________________________________
49
Encephalitis ___________________________________________________ 9, 47-48
Epidemiology_____________________________________________________
36
Fumigation-----------------------------------------------------74
Heart disease _________________________________________________ 7,24-25
Illumination _____________________________________________________ 37-38
Industrial hygiene and sanitation ________________________________ 8, 36--39
Industrial poisons________________________________________________
38
Leprosy __________________________________________________________ 25---27
Malaria control__________________________________________________
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Studies-Continued.
Page
Midwifery practice____________________________________________ _ 8,33-34
Morbidity________________________________________________________
45
Mortality trends and the depression_______________________________ 44-45
Mottled enameL--------------------------------------------:,..---8
Nervous and mental diseases, causes, prevalence, and means for the
prevention and treatment oL ___________________________ _______ 131-132
Nutrition __________________________________ ___ ___________________ 29-30
Poliomyelitis ______________________ ___ __ __ ____________________ 8, 9, 36, 48
Prophylactic and therapeutic_____________________________________
50
Public-health methods------------------------------------------ 9, 41-42
Relapsing fever -------------------------------------------------- 32, 48
Respiratory______________________________________________________
45
Rocky Mountain spotted fever _____________________________________ 30-32
Serodiagnostic tests for syphilis___________________________________
120
Sewage treatment-----------------------------------------------9
Sickness among industrial workers________________________________
38
Sickness and the depression _______________________________________ 9,43
Smallpox_________________________________________________________
45
Stream pollution_________________________________________________
6
Tick-host anemia_________________________________________________
33
Trachoma_______________________________________________________ _
49
Tularaemia__________________________________________ ____ ________
32
Venereal disease, cooperative clinicaL_____________________________
117
Surveys:
Health, in the South______________________________________________
119
Local health organizations~--------------------------------------72

T
Tables ( see also Chart) :
Airports of entry, United States, transactions at_ ___________________ 83-84
Canadian and Mexican border stations, aliens examined at ( see also
Mexican border stations)_______________________________________
90
Canal Zone, quarantine activities at_______________________________
85
Classes of beneficiaries and amount and character of services rendered --------------------------------·- ----------------------- · 107
Coast Guard beneficiaries_________________________________________
109
Dental treatment rendered by marine hospitals and relief stations__
108
Financial statement ________________________, ___________________ 147-149
Funds transferred from other departments_________________________
147
Marine hospital transactions ____________________________________ 112--116
Maritime quarantine stations, transactions at_ _______________ 79-82, 89-90
Medical inspection of aliens_______________________________________ 85-97
Mexican border stations, quarantine transactions at (see also Canadian and Mexican border stations)______________________________
82
Miscellaneous receipts covered into the Treasury-------------------148
Notifiable diseases, cases of compared with deaths__________________
99
Personnelreport________________________________________________ 138--143
Quarantine service, expenditures by stations ____________________ 148--149
Trachoma, dispensary and hospital relief__________________________
61
Venereal disease reports________________________________________ 121-124
Water-supply supervision and other sanitary-control work ____ 62, 63, 64, 66
Tick-host anemia, studies of__________________________________________
33
Trachoma:
Control work ___________________________________________________ 5,60--61
Studies of_______________________________________________________
49
Tuberculosis death rate------------,----------------------------------2
Tularaemia :
Prevalence of ____________________________________________________ 9,48
Studies of_______________________________________________________
32
Typhoid fever :
Death rate_______________________________________________________
2
Prevalence of _______________________ ·---------------------------64
Typhus fever :
Control of_______________________________________________________
62
Prevalence of ___________________________________________________ 2, 9, 47


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u
United States, health conditions in ___________________________________ _

Pag~
2--3

V

Vaccination against smallpox and cholera ______________________________ 57, 74
7
Vaccine, Rocky Mountain spotted fever, production of__________________
Venereal diseases :
Clinical studies of ( see also Research>---------------------------- 117
Clinic, Hot Springs, Ark____________________________________ ______ 120
Control measures ________ _____ __ -------------------------.-------- 117-118
Educational and informative activities relating tO---------------- llS-119
Health survey in the South________________________________ _______ 119
Prevalence of___________________________________________________ 12,118
Prevention and control of_________________________________________ 11-12
19
Problems, recommendations for___________________________________
Publications issued relating to __________________________________ llS-119
Report of division of ___________________________________________ 117-124
Research program .o f (see also Studies)------------------------ 119-120
Serodiagnostic tests for syphilis, study of__________________________ 120
Tabular statements relating to __________________________________ 121-124
Vessels:
Fumigation and inspection of__________________________________ 3-4, 73-74
Supervision of water supplies on _____________________________ 63---64, 66,

w
Water, drinking and culinary, certification of_________________________
5-6
Water supplies:
Reciprocity with Canada_________________________________________
65
Supervision of on interstate carriers _______ .;.__________________ 6~. 66
Work-relief projects, Emergency Relief Administration, cooperation on__ 68-00
World health conditiOllS-----------------------------~---- -----------1-2
y
Yellow fever, prevalence of______ _______ _______________________________

2, 73

z
Zoology, report of division of___________________ .:_______________________

0


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