A history lab assignment will consist of analysis of an historic health officer’s report from Maryland or the District of Columbia, or another location for morbidity and mortality data on a specific disease. THESE REPORTS ARE AVAILABLE ON CANVAS, IN THE FILES SECTION. YOU DO NOT NEED TO FIND YOUR OWN. You will choose a disease or health issue that has been covered in the reading and/or in class and analyze the report for information on the disease and local or state efforts to combat it. You do not need to read the entire report, just the section that addresses the particular disease or issue. The paper should be a minimum of TWO pages, double-spaced in 12-point type, and proofread.In the paper, you will answer the following questions:a) Which report did you use? (1 point);b) What statistical data does the report provide about the disease – i.e., were cases increasing or decreasing? Where are they concentrated? Which groups are most/least affected? What type of data is missing? (3 points)c) What does the report say about efforts undertaken to combat this issue/disease and their effectiveness? (2 points)d) How does the information in the report add to your knowledge about this disease or public health issue? (3 points)e) How does the data in the report compare to contemporary data on the disease or health issue (Hint: look at U.S. Centers for Disease Control and Prevention website). (2 points)f) Assignment is proofread, with no typos, and uses correct grammar. (2 points)g) References are made to course material and to the report itself. (1 point)
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THE LIBRARY
BGlAr-Oi?
M369
ANNUAL REPORT
of the
State Board of Health
0/
MARYLAND
for ‘ the
1
YEAR ENDING DECEMBER 31, 1912
BALTIMORE:
KING BROTHERS,
2
STATE PRINTERS,
413 E. Lexington Street,
1913
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State Department of Health of Maryland, 1912.
STATE BOARD OF HEALTH.
DR. WM. H. WELCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..President.
DB. MARSHALL L. PRICE . . . . . . . . . ..Secretary and Executive Ofiicer.
DE. JAMES BOSLEY; Commissioner Of Health Of Baltimore (ex Officio).
HON. EDGAR ALLAN POE, Attorney-General of Maryland (ex officio).
DR. NATHAN R. GORTER,
DB. EDGAR A. JONES,
MB. JOHN E. GREINER.
./8»7I’
~
Mamems.?
. .-
BUREAU OF BACTERIOLOGY.
DR- WM. ROYAL STOKES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..Chief.
DB. HARRY W. STONEB . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .Assistant Chief.
L. R. SULLIVAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..Clerk.
WM. A. GrN’rIIER and F. J. ORBAN . . . . . . . . . . . . ..Laboratory Assistants.
BUREAU OF CHEMISTRY.
DB. W. B. l). PENNIMAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..Chief.
DR. WYATT-W. RANDALL . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..Assistant Chief.
M. E. SEIOELL . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .O’lerk.
H. B. DISNEY and C. O. MILLER . . . . . . . . . . . . . . . . . . ..Assistant Chemists.
EDWARD HOPKINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Laboratorp Assistant.
BUREAU
DR. FBEDERIC V. BEITLER . . . . .
T. NIOKLAs M. BAER and E.
B. BETZ . . . . . . . . . . . . . . . . . . . .
OF VITAL STATISTICS
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Chief.
IJAMS . . . . . . . . . . . . . . . . . . . . . . . . . . ..Clerks.
. . . . . . . . . . . . . . . . . . . . . . ..Tabulating Clerk.
BUREAU OF COMMUNIGABLE DISEASES.
DB. 0. W. G. ROHREB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..Chief.
M- MILLEE and J. J. KING . . . . . . . . . . . . . . . . . . . . . . . . .’. . . . . . . . . . . . .Clerks.
BUREAU OF SANITARY ENGINEERING.
MR. ROBERT B. MORSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . ..Chief.
MR. HARRY R. HALL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . …Assistant”‘Chief.
H. A. WALKER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..Clerk.
DLvIsIQN, ,
FOOD. AND Danes.
DR. CHAS. CASPARI. JPZ. 3.9.2 :9. .;. 1 tafc :fwbazaam Dru?)~ Commissioner.
R. W. BATEMAN . . . . . 3.6.3.21; .L’. .;,., 3 :_.,;.:.§ . .1‘. . . 3 .53: . . . . ..Clerk.
JOHN W. ARNOLD and R. H. IlqPIIINs . . . . . . . . . .

. .Inspectors.

‘WALTEE N. KIBKMAN . . . . . Ekficlsi’rtlelbmmiskzv’
. . .. . . .. .,,, .,._. . .1. . . . . . . 5. . . .1. . .Chief Clerk.
ramp
S. F. GEORGE and E. ROBINSON; . .2 v23.1.3.3.QIL’,3_.€..Secretary’s Clerks.
‘LOUIS L. JUDGE . . . . . . . . . . . . . .§n5.3.6.;3,.;1;-:-‘1..5‘ . . . . . . .Special Agent
A. DUSHANE . . . . . . . . . . . . . . . . . . . . . . . . _ , . . . . . . . . . . . . .Tuberculosis Clerk
JOHN CONWAY and JOHN McLAIN . . . . . . . . . . . . . . ..Multigraphing Clerks.
NORBEBT WILKINSON and D. DISNEY . . . . . . . . . . . . . . . …Assistant Clerks.
B. V. CAVENDER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..Telephone Operator.
ll
General Counsel,
WILLIAM PINKNEY WHY’I‘E, JE.
UM.-2’7
Special Counsel.
H. M . MOCULIOUGH
.
,
Meat Inspector,
CHAELEs N. MrrrEN.
,
1 ’;&.0

‘“‘
f5
RNA
CONTENTS.
List of Officers and Employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ii
Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
iv
Letter of Transmittal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
v
Vital Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1-100
Reports of County and Town Boards of Health . . . . . . . . . . . . . ..
101-131
Reports of Town Health Officers . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
132-148
Sanitary Surveys and Investigations . . . . . . . . . . . . . . . .. =
149203
Cases Examined for Diagnosis. . . . . . . . . . .
.
.
. . . . ..
. . . . . .. 204-213
Report of State Food and Drug Commissioner . . . . . . . . . . . . . . ..
214-225
Report of the Chief of the Bureau of Bacteriology . . . . . . . . ..
226-234
Report of the Chief of the Bureau of Chemistry . . . . . . . ..
235-238
Report of the Chief of the Bureau of Vital Statistics . . . . . . . . ..
239-242
Report of the Acting Chief of the Bureau of Communicable
Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 243-311
Report of the Chief of the Bureau of Sanitary Engineering…
312360
Report of the Inspechh-gggjglb 5_§.1.’.§f.;.;;..;;:1,,n:… »._.
361-366
367
Report of the Chief Ciel-QJZOGjTa.
General Orders. . . .. . . . .
Prosecutions. . . .. . . . . . . . . . . . .
. . . . .. 368-371
,
. . . . . . . 372-373
00
out!
7
1
I
00000
PREFACE
October 31, 1913.
To HIS EXCELLENCY,
PHILLIPS LEE GOLDSBOROUGH,
Governor of Maryland:
SIR:
I have the honor to transmit the report of the State Board
of Health for the year 1912. The contents of the report are
discussed at some length in the Secretary’s letter of transmittal.
The year is a memorable one on account of the legislation
which changed the form of organization to that of a depart—
ment having several bureaus. The advantage of this change
was very soon apparent, and no little significance is attributed
to the fact that three of our bureaus received awards of merit
in the exhibition held in connection with the International Con
gress
on Hygiene i and Demography at Vashington in Septem
ber, 1912.
The recent General Assembly did not pass the legislation
proposed by us for the reorganization of county boards of
health. It seems likely that the State Board of Health will
propose new legislation on somewhat similar lines at the next
session. The movement of public health legislation in recent
years has been strongly toward centralization of authority.
There is now much experience tending to show that local health
administration is more efficient- when under regular supervision
and some direct control of a central authority of the State. The
next step seems to be the employment of a sufficient number
of fairly paid, full time, local health officers. Since it is not
likely that we should be able, within a few years, to secure the
services of well qualified men to the number required, the
change would be somewhat slow, and would present no aspect
of revolution, nor of rapid increase in cost.
The resignation of Dr. Marshall Langton Price as secretary
to the Board was accepted at the January (1913) meeting.
He had been in failing health for several months and presented
his resignation some two months before the date of its accept
ance. The members of the Board, in accepting his resignation,
viii
REPORT OF THE
placed 011 record their sense of appreciation of his valuable
services to the Board and to the State. The Board was fortu
nate in securing as successor to Dr. Price, Dr. John S. Fulton,
who was secretary between the years 1897 and 1907, and had
served most efficiently in this position up to the time of his
withdrawal to undertake the great work of organizing first the
International Congress of Tuberculosis, and following this, the
International Congress of Hygiene and Demography. He
returns to us with an added reputation and experience, which
will increase still further his powers of usefulness in promot—
ing the health of the people of the State.
Most respectfully yours,
WM. H. WELOII,
President.
STATE BOAR!) OF HEALTH.
lX
LETTER OF TRANSMITTAL
October 31, 1913.
To HIS EXCELLENOY,
PHILLIPS LEE GOLDSBOROUGH,
Governor of Maryland.
SIR:
In accordance with the provisions of Sections 5 and 6 of
Article 43 of the Code of Public General Laws of Maryland,
I transmit herewith the report of the State Department of
Health for the year 1912.
The report begins with the work of the Bureau of Vital
Statistics, and shows that good results may be expected from
the new registration law which became effective on July 1st,
1912. An appreciable improvement is noted, especially in the
registration of births, during the second half year, and at this
writing (October 31st, 1913) we have reason to believe that
the State of Maryland, within a year, will be admitted by the
Census Bureau to the United States Registration Area for
Births. Admission to the Registration Area means that the
Census Bureau believes the registration within the State to
lack no more than 10 per cent. of completeness. To be counted
as a registration State will not, therefore, satisfy the purpose
of the State, as expressed in the registration law. Maryland
has been in the registration area for deaths for the past eight
or nine years, but the mortality is not fully accounted for in
some counties, notably in St. Mary’s and Garrett.
In each of
these counties the local registration offices have been taken
over by the State Board of Health and operated for a time at
the expense of the county. These two counties have thus
incurred expense much in excess of the cost of the proper
operation by their own agents, but both counties relapsed very
rapidly within a short time after the withdrawal of the State.
()ur intervention showed that Garrett and St. Mary’s Counties
did not record, previous to that intervention, more than one
sixth 01′ one-seVenth of the deaths occurring. It is evident that
the registration of both births and deaths, like other public
health undertakings, will fall short of the intention and pur
X
REPORT OF THE
pose of existing laws until the local offices are regularly super
vised by the central sanitary authority of the State. These
memoranda of current gain and loss in population, together
with the reports of current sickness, must be brought to a state
approximating perfection, before it can be claimed that the
other machinery of public hygiene is operated under favorable
conditions or at a high rate of efficiency.
1.
POPULATION.
Since the last report we are able to correct our population
figures by means of the census returns, and so to compute more
reliable rates of mortality than those published for the pre
ceding three or four years. Five counties declined in popula
tion during the decade of 1900-1910—Cecil, Charles, Kent,
Queen Anne’s and Talbot. The colored population declined
in 18 counties.
In Baltimore City, and in the counties of
Baltimore, Caroline, Somerset, Wicomico and Worcester, the
colored population increased. For the Whole State, there was
a loss of colored population. The loss is doubtless due chiefly
to the migration of colored people. The movement is from
the rural districts to the cities, and the State as a whole sus
tains an annual net loss of about 300 colored persons. One
consequence of this loss is apt to be overlooked. The dimin—
ishing proportion of the colored element of population, if it
continues, will cause a diminution of our annual mortality
rates; and some persons may attribute to improved sanitary
conditions those improvements in current mortality which are
wholly or partly due to diminishing numbers in that part of
the population which suffers the higher death rate.
MARYLAND DEATH RATES.
The death rate for all Maryland in 1912 was 15.64 per
1,000 (mortality, 20,597; population, 1,316,806). For Balti
more City, the death rate was 18.37 per 1,000 (mortality,
10,441; population, 568,391). For Maryland, outside of Balti
more, the death rate was 13.57 Per 1,000 (mortality, 10,156;
population, 748,415).
The death ~rate (13.57) is higher than
that for 1911 (13.30), and the latter in turn was higher than
the death rate for 1910 (13.14). Let no one be deceived into
believing that the death rate is as low as 13.57 in any part of
Maryland. It can be said with confidence that the registration
of deaths was incomplete in every county where the apparent
death rate is under 13.57.
STATE BOARD OF HEALTH.
X1
In examining the particulars of mortality, it is pleasant to
record a small drop in the mortality from pulmonary and
laryngeal tuberculosis.
The tuberculosis mortality per 10,000 of population, for
each of the past 6 years, is shown in the following table:
1907 .
1908 .
1909 .
1910 .
1911 .
1912 .
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.17.97
.17/12
.17.68
.17.55
.17.01
1.6.54
The downward tendency should encourage us to believe that
the admirable legislation of 1902 and 1904 is now bearing
fruit. We cannot be over-confident, however, for a doubt
must be reserved on account of those communities which take
no pains to record their losses, and do not concern themselves
about the unnecessary deaths of unimportant citizens, from a
familiar disease like tuberculosis. Since the population of the
State has increased each year, while the absolute mortality
from tuberculosis has decreased, it seems unlikely that we can
be much deluded by the apparent decline. We may indeed
anticipate that when ampler experience is at hand, the decline
will be found to have occurred mostly in those localities where
the laws are best administered, and that the situation in such
localities is much better than that indicated by the tuberculosis
rate for all Maryland. _
The typhoid fever mortality of Maryland is discussed in an
interesting way in the report of the Bureau of Sanitary Engi
neering. This history of typhoid in Maryland continues to be
a reproach to us. We are not found in unfavorable contrast
with a majority of the United States, but we are far behind
certain commonwealths whose advantages in this respect are
mainly those which legislatures can provide.
MORBIDITY.
One of the most interesting signs of progress noted by the
present writer, on his return to service in Maryland, is the
much greater volume of information recorded in the Bureau
of Infectious Diseases concerning current morbidity from the
notifiable diseases. One still finds that some physicians are
guilty of unwarrantable delay in making their reports, and
xii
REPORT OF THE
that when brought to Court on charges of neglect, they fre
quently escape on the plea that they failed to make the diag:
nosis with that degree of confidence which amounts to knowl
edge, but it seems unlikely that such physicians will repeatedly
plead infirmity of diagnosis in such cases.
The records improve from year to year, in number, prompt
ness and accuracy.
They are now received in sufficient num
bers to be highly useful in the general study of epidemiology,
but often the information is not received early enough to meet
the cardinal purpose of the law, namely, prompt intervention.
When to the occasional tardiness of practicing physicians one
adds occasional tardiness on the part of local health officers,
it is clear that the operation of the law may be much slower
than is required for the prompt and orderly protection of pub
lic health. We have made, at this time, about as good progress
as can be made in the absence of a centralized control over local
health authorities.
FOOD AND DRUGS.
The report of the Commissioner of Food and Drugs shows
that the laws on this subject are now in full operation. Unus
ual tact and intelligence have been exercised in bringing the
laws to this status. It will be seen that the food laws are more
effectively administered in the counties than in Baltimore City.
The Commissioner calls attention to the great delay encountered
in the office of the State’s Attorney for Baltimore Cit-y. This
is a chronic difficulty of very ltmg duration.
The State’s
Attorney’s oflice is far undermanned, and the results are appar
ent not only in long delays, but sometimes in the preparation
of cases.

The Commissioner calls attention to the need of a sanitary
inspection law. The examinations of places where food is pre
pared at present relate only to the quality of the products.
Establishments may present conditions unfavorable to the health
of employees, or conditions of nuisance to the surrounding
population, but in such situations, the Commissioner cannot
require any amendment beyond such as meet the conditions
under which a marketable food is produced.
SANITARY ENGIN EEK-ING
The addition of a Bureau of Sanitary Engineering has
greatly increased the efficiency of the Department of Health.
In the few months of its existence, this bureau has not only
STATE BOARD or HEALTH.
xiii
done a surprising amount of work, but has given us a view of
future great utility. An examination of the report will show
how very significant is the first half year of its existence.
In concluding this letter, I should record my sense of the
loss to public hygiene, especially in Maryland, which is in
volved in the declining health and consequent retirement
of Dr. Marshall Langton Price, Secretary of the Board
since 1907, and previous to 1907, Medical Assistant to
the Secretary. Dr. Price became the executive officer of
the Board at a critical time, and the results of his five
and threequarters years of service should afford gratifi
cation to him, as they were certainly profitable to the State.
If the progress of the Department of Health in the next five
years is such as should follow the years of Dr. Price’s incum
bency, there is strong probability that the value of his services
may become obscured, and even. by many. forgotten. Such
permanency as a printed record can secure, should include
mention of his services as Secretary to the first Maryland
Tuberculosis Commission; the authorship of the Maryland law
for the registration of tuberculosis, and of the law for the
domestic prophylaxis of tuberculosis; the organization of the
)Iaryland Tuberculosis Exposition in 1904. the first attempt
in America to study the tuberculosis problem in a broad way,
with attendant widespread effect upon the public intelligence.
and leading to a nation-wide adoption of this method of edu
cating the general public in matters of hygiene. These things.
with the great development of the State Department of Health
which occurred between the years 1907 and 1913, should be
indissolubly associated with the name of Dr. Price.
Most respect-fully submitted,
JOHN S. FULTON,
Secretary.
ll
RESOLUTION
(ADOPTED BY STATE BOARD OF HEALTH, JANUARY 16, 1913.)
The State Board of Health in accepting the resignation of
Dr. Marshall L. Price as Secretary and Executive Officer of
the Board, desires to place on record its sincere regret that the
state of his health has compelled his resignation, and its sense
of the great loss suffered by the Board by his retirement from
the responsible office which he has filled with unusual ability,
devotion and satisfaction to the Board and to the public for
nearly six years, having previously served for three years as
medical assistant.
The Board desires to record its high appreciation of the
valuable services which Dr. Price has rendered to the people of
this State in improving the organization and strengthening.
expanding and rendering more efficient the work of the …
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