The pathological exhibit from the Medical College of Indiana, the medical department of Purdue University, attracted wide at tention. As part of the Secretary's report there is given herewith reports of the bacteriologist and chemist. REPORT OF THE CHEMICAL LABORATORY FOR THE FIRST CALENDAR QUARTER OF 1906. I herewith submit a report of the work of the Chemical Department of the Laboratory of Hygiene since its establishment to date, together with an outline of proposed work for the coming summer and recommendations for desirable and necessary legislation. Owing to the time spent in equipping the laboratory regular work was not begun until October, when inspectors were sent out and analytical investigations commenced. The laboratory has, therefore, been in active operation for six months. During that time we have analyzed 1,984 samples of food products and 541 of drugs. Of these analyses 2,177 have been reported in full in the November and January bulletins and need no further mention. In the last month we have examined 56 samples of molasses, 31 samples of honey, 40 miscellaneous food samples, 221 samples of drugs, such as sodium phosphate, sulphur, beeswax, etc. Of these unreported food samples 65 per cent. have been pure and 35 per cent. adulterated, and of the drug samples 38 per cent. have been pure and 62 per cent. adulterated. In passing I may observe that all the sulphur samples were adulterated, and that most of the beeswax was paraffin. So that to date the analytical work on foods and drugs has given ust the following results: cers. Much of our time has also been devoted to the sanitary analyses of waters, usually sent in by members of boards of health and health offiWe have examined 272 samples of water and have found 125 supplies polluted and unfit for drinking or domestic purposes. It is evident that the shallow dug well, supplied by surface water, is a menace to the health of the individual and the community. Of 113 shallow well waters analyzed 85, or 75.3 per cent., have been polluted by sewage. Many supplies were actually dangerous. Many others were evidently liable at any time to pass out of the safe class and become foci for the spread of water borne diseases. The driven or deep wells are a much safer source of supply. Our results show that 43.4 per cent. of the wells examined have been contaminated, but the large percentage of polluted supplies is in a great measure due to the fact that well owners call all bored or driven wells deep wells, when the results of our analyses indicate that they really should be classed as shallow or surface water wells. The salary list of the laboratory for the last six months approximates $2,100. The normal running expenses are not over $100 a month. If, by reason of abnormally heavy expenses during the month of October incident to the collecting of 4,000 samples of food products, we set the total expense of the laboratory since it was opened for work at $3,000, 1 of which has been used in the water laboratory, we find that the cost of collection and analysis of each food sample has been 80.6 cents and of each water sample $3.68. If on the other hand we credit the laboratory with the regular fees for the analytical work done, the fees paid the chemists of the Ohio Food Commission for example, it appears that the laboratory has earned: In 301 milk analyses at $2 per sample. A total of... $602 10,485. 2,720 ..$13,807 A practical saving to the State over the cost of operation of $10,807. Outline of Proposed Work.-We have still on hand about two hundred samples of food products collected last fall. These samples will be analyzed and the results reported in an early bulletin. We have on hand several hundred samples of drugs, chiefly tinctures, which are now in process of analysis. We also have before us the examinations of more than 200 samples of patent and proprietary medicine, such as blood remedies, catarrh and cough cures, toilet preparations, etc. This work will soon be completed, and it will then be necessary to collect other samples. The present laboratory force can not afford to leave their analytical work to act as inspectors for more than brief periods, and it will be advisable that a deputy food and drug inspector be employed throughout the summer months. One of the most important branches of food inspection is that of dairy products. And beginning with the month of May we should endeavor to secure from cities and towns samples of milk for analysis. We shall have to rely upon local aid for making the collections, and we have already received assurances of assistance from several health officers. Unfortunately there is no adequate law now on the statutes by which we can punish the sellers of illegal milk, and we shall be forced to conduct prosecutions in local courts under local ordinances. Many analyses of butters have shown that much oleomargarine is being sold as butter throughout the State, and investigation shows that no attention is paid by restaurant keepers and dealers to displaying the signs "Oleomargarine used or sold here." I find that there is on the statutes a law passed in 1882 which is amply sufficient to control the situation if it can be applied. There is some question as to its present legality, however, and I suggest that it be tested in court, that if necessary it may be amended so as to be operative. I think it advisable to make a special study of the quality of the soft drinks so largely consumed in the summer months. Their composition is at least uncertain, and I believe in many cases of positive injury to the consumer. The condition of the public and private water supplies is deplorable. While it may never be possible to eradicate completely the filthy disease producing family wells so situated as to be a cesspool for effluents from the barnyard and sink drains and privy, careful systematic inspection of public supplies is possible, and should be made in the future for the purpose of finding out the condition of the water systems. I have collected from every large town and city statistics of their public water supply, giving source, system of operation, per capita consumption and number of persons supplied. During the summer we should analyze as many of the public supplies as possible and arrange to make systematic inspections several times each year. For the isolated farmhouse well a chemical analysis is usually quite sufficient to determine the quality of the supply, but in order to arrive at a correct valuation of the purity of a public system operated perhaps under changing conditions both the chemical and the bacteriological analyses must be made. It must be remembered that as the work of the laboratory becomes known throughout the State an increasing number of miscellaneous samples of foods, drugs and water is constantly coming in for analysis, and therefore due consideration must be given this routine work, which, while perhaps not of special importance to the public at large, is frequently of great value in impressing the worth of the laboratory upon individual citizens whose support we desire. Suggestions for New Legislation.—The present pure food law, while admirable in its general plan, is wholly useless as a means of bringing violators of the provisions of the law to justice. This is due to the fact that the penalty clause of the law was evidently "written in" by interests opposed to the bill, so that at present offenders must "knowingly sell" "articles injurious to health," thus making it necessary for the board to prove not only knowledge on the part of the seller but also the injurious composition of the goods. The bill should be simply amended so that the penalty clause will read in effect: "All persons violating the provisions of this act shall be for the first offense subject to a fine of $10 and costs; for the second offense subject to a fine of $50 and costs; for the third offense subject to a fine of $100 and costs, and three months in jail." A specific milk law is absolutely necessary. Last fall I endeavored in two cases to secure conviction of persons guilty of selling preserved and watered milk. At Jeffersonville the grand jury refused to indict because it was so evident the offenders could not be convicted under the law, and at Terre Haute the justice of the peace before whom a case of watering was brought released the offenders because it was impossible to prove the vendor knew the milk to be adulterated. The loss of these two cases, one tried under the general food law and the other under the specific milk law, proved how futile it was to attempt to convict an offender under the present food statutes. At the present time the supervision of the State Board of Health over public water supplies is limited and productive of small results. With a water laboratory at its disposal the board should be given control of all public supplies. If a law which has been in successful operation in Massachusetts for some years could be enacted, giving the supervision of all public waters to the board, with authority to grant improvements and extensions after due examination of the conditions, not only would the quality of the present supplies be improved but waste of money and endangered health would be prevented. The disposal of sewage, household and manufacturing wastes is also a problem capable of being efficiently attacked by means of the laboratory, and prompt measures are necessary if we are to conserve the purity of the streams and ponds which are the natural source of water supply. While I realize the limitations placed upon the board in the matter of increasing the salary of the chemist, because the amount to be paid is fixed by statutes, yet I venture to suggest to you for your consideration the following facts: First $1,500 per year is wholly inadequate compensation for the services required of your chemist. Second-He is in charge of two laboratories, food and water, as either department is sufficient to command his undivided attention. The Board of Health of Massachusetts employs two chemists as heads of their food and water laboratories, paying each of them $2,800 per year. Third-He accepted this position with your board with full knowledge of present conditions, yet to do so refused a position as head of the government import laboratories at $2,000 per year, for he received the assurance of your secretary that he would strive to have the salary increased at the earliest opportunity, and had faith that the board would be able to secure the necessary legislation. The work required of the Laboratory of Hygiene is bound to increase rapidly as its availability and value become known, and the expense of operation will thereby become greater. As already suggested, food inspectors are necessary. A food law without inspectors to see that it is enforced is bound to become crippled and to lose its value. While I do not believe in a corps of deputies, I do think that we should have at least one competent man on the road all the time and the funds available for another if he is needed. We also must have funds to conduct prosecutions, for we can not always rely on local prosecutors to convict offenders. It is evident that more money is needed for the successful operation of the laboratory if it is to attain to its fullest usefulness, and I beg to suggest that an increased appropriation of $5,000 be asked of the incoming legislature. REPORT OF THE BACTERIOLOGICAL LABORATORY FOR THE FIRST CALENDAR QUARTER OF 1906. By T. Victor Keene. The Bacteriological Laboratory was put into commission January 1, 1906, although much work had been done previous to the formal opening of the laboratory. Since the laboratory has been opened a great deal of our time and energy has been spent in devising a systematic method of keeping a record of the work done, as well as devising methods of technique. Method of Keeping Records. It was early seen that it would be necessary to devise some method of keeping the records so that they could be readily referred to. All the records are now kept as follows: We have one card containing a full history of the case. This history card gives the clinical history of the case and the record of when the specimen was sent to the laboratory, when it was received, when the report was mailed, and of course the results of the finding. This one card contains full information regarding the case. These cards are kept in consecutive order, each card being given a number. It is very obvious that the persons most liable to refer to this record are the physician in the case and the patient, so we have a cross-index system containing the name of the patient, the nature of the specimen, result of the examination and the file number of the card giving the complete history. This file by patients is kept alphabetically. Each physician of the State who submits for examination a specimen of any variety is given a separate card in our index file of physicians, and on this card we have a record of the date on which we made the examination for him for typhoid fever, diphtheria or tuberculosis. This card also refers back to the card containing the complete history of the case. The index to the physicians and patients is alphabetically arranged. As a further aid in completing our cross-index we have a set of cards giving the name of both the physician and the patient, arranged by counties, so that at any time we can refer to any individual county and in a few seconds know just how much work and what variety of work the laboratory has done for any particular section of the State. This method of keeping the records is an original one. The idea of course is the card system in common use in many lines of business. These records are referred to much oftener than would be supposed. We have on a few occasions had physicians complain that reports had not been sent to them. Reference to the record shows at once the exact date the report was made. We have on two occasions had physicians allege that examinations made in our laboratory gave certain findings, while examinations made by other physicians gave entirely different findings. Referring to our record we are able at a glance to tell just exactly what our findings had been, and in both cases they were exactly similar to the findings reported by other physicians. Letter to Medical Societies.--It has been very obvious for some time that the physicians throughout the State at large did not know about the laboratory. While the health officers of the State have been informed regarding the saine, it seemed to us that they had failed to inform the physicians of their respective communities regarding the laboratory, as it was an almost daily occurrence for physicians from various parts of the State visiting Indianapolis to drop into the laboratory and express great surprise at the existence of the same. Various means of acquainting the profession of the existence of the laboratory, its scope of work, etc., were discussed, and it was finally decided to address a letter to the secretary of every medical society of the State apprising them of the fact that the laboratory was now ready to receive specimens and advising them how to ship the same, etc. We further asked the secretary to bring up the matter before the society and extend to the society an invitation to submit specimens to the laboratory. We have received answers from nearly half of the letters sent out, and nearly all the answers received seemed to show |