Less authorized contract liabilities in excess of amounts appropriated under the special appropriations.....

$167,000.00 36, 240.89

331, 710.01 171, 993. 84 949.94

10,055, 622.03

82, 271.86

9, 973, 350. 17

BALANCES OF APPROPRIATIONS SENT TO SURPLUS FUND, JUNE 30, 1915.

On account of special appropriations...

On account of annual appropriations, to wit:

Old building, Bureau of Engraving and Printing, repairs and

alterations, 1914 and 1915..

Operating supplies for public buildings, 1913.

Furniture and repairs of same for public buildings, 1913.

Repairs and preservation of public buildings, 1913.
Mechanical equipment of public buildings, 1913..
Vaults, safes, and locks for public buildings. 1913..
Electrical protection to vaults, public buildings, 1915.

Total......

$223, 147.05

306.47 180, 124.89 30,466.39

267.50 11, 689. 60

101, 223. 21

6, 774.92 6, 676.42 304.84 421.92

561, 403. 21

PUBLIC HEALTH SERVICE.

The Surgeon General summarizes the operations of the service, conducted through its several administrative divisions, as follows:

Division of Scientific Research.

The work conducted under this division showed, as in previous. years, a steady growth, which has been rendered possible by the larger appropriations made available by Congress for public-health investigations.

Constant effort has been exercised to make the work performed not only of scientific value but also of practical usefulness in solving problems of interest to communities and the public generally.

The studies either continued or newly undertaken during the year may be classified under the following general headings: Diseases of man, rural sanitation, school hygiene, industrial sanitation, public health organization and administration, pollution of navigable waters, and disposal of sewage and wastes.

Diseases of man.-Among the diseases studied during the year special attention has been given to hookworm disease, leprosy, malaria, pellagra, rabies, scarlet fever, trachoma, tuberculosis, typhoid fever, and typhus fever.

Malaria.-The investigations of malaria were conducted in most of the Southern States and some of the Northern States, New Orleans being made the headquarters. A special feature of the work was the carrying out of malarial surveys in 36 selected places in different States to advise the local authorities in regard to the eradication and prevention of malaria and suppression of mosquito-breeding places. Among the places where these surveys have been made are Baltimore, Md.; Toledo, Ohio; Mobile, Ala.; Brunswick, Ga.; and Roanoke Rapids, N. C.

Special studies have been made during the year of the possible relation of impounded waters to the prevalence of malaria. As this is a new source of wealth, representing an investment of hundreds of millions of dollars, it is believed that this investigation is of great importance, as it may result in devising remedial measures to prevent the complaints made in some communities against this form of utilizing water power.

Pellagra. Systematic investigations of pellagra were made during the year at Greenfield and Jackson, Miss., Milledgeville and Savannah, Ga., and Spartanburg, S. C., in addition to field studies of the disease in Florida, Louisiana, Texas, and other States. About 200 patients were treated for purposes of study at Savannah and Spartanburg, and over 550 persons included in feeding experiments and kept under observation at Greenfield, Jackson, and Milledgeville institutions. These studies have already thrown light on the nature, treatment, and prevention of pellagra. The results obtained clearly indicate the dietary origin of the disease and render available practical methods for its eradication.

Trachoma. The antitrachoma campaign in the Appalachian region was continued and extended during the year. The very gratifying results obtained through the operation of small trachoma hospitals in the Kentucky mountains has justified the opening of two similar

institutions in Virginia and West Virginia. A total of about 3,000 patients were treated during the year at the three Kentucky hospitals, 1,067 of which were admitted to hospital. Many of these people have thus been relieved of a chronic contagious disease and enabled to earn a livelihood.

Surveys of the prevalence of trachoma were also made in 16 counties of Kentucky, and in Douglas, Ariz., Manatee County, Fla., Tuscaloosa, Ala., and Porto Rico, a total of 29,000 persons having been examined.

Rural sanitation.-An intensive investigation to promote the advancement of rural sanitation was completed in Dorchester County, Md.; Berkeley County, W. Va.; Lawrence County, Ind.; and Union County, Miss., over 20,000 homes having been visited in these districts. A similar study is now being carried on in five other counties in different parts of the United States, namely, Anne Arundel, Md.; Walker, Ala.; Orange, N. C.; Wilson, Kans.; and Dallas, Iowa. Up to the end of the fiscal year about 11,000 residences had been visited in the course of these surveys, data collected, and advice offered when requested in regard to sanitary defects which had been observed. The response met by the officers assigned to this work has been most cordial, and it is believed that these surveys will result in considerable improvement in rural sanitation not only in the localities visited, but also in all others where the methods employed are studied and followed. The facilities to continue this work should be increased.

School hygiene.-Intensive studies of school hygiene were conducted during the year. Sanitary surveys of schools were conducted in Porter County, Ind.; Manatee County, Fla.; Westchester County, N. Y.; and the District of Columbia. A total of 104 schools were inspected during these surveys and over 8,000 school children examined.

Industrial sanitation.-The sanitary studies of the garment workers' trades in New York City were completed during the year, 34 shops having been surveyed and 3,000 employees examined. Studies of lighting conditions in certain departmental buildings in Washington were also begun.

The study of tuberculosis in relation to the industries in Cincinnati, Ohio, was continued, nearly 14,000 persons having been examined and data of importance obtained.

In connection with the Commission on Industrial Relations, studies of sickness insurance were prosecuted. At the request of the same commission brief sanitary surveys were made of 10 industries located variously in Illinois, Massachusetts, Michigan, Minnesota, New Jersey, Ohio, and Pennsylvania. In cooperation with the Bureau of Mines the studies of steel plants at Pittsburgh, Pa., and of sanitary conditions in the mining industry in Jasper County, Mo., were continued. Studies were also begun in cooperation with the Massachusetts State Board of Labor and Industries in regard to the effects of various occupations on adolescent persons.

Public health administration. In response to requests from the respective authorities, studies have been made of public health organization and administration in the States of Illinois, Kansas, Minnesota, Washington, and West Virginia, and the cities of Toledo, Ohio; Bowling Green, Ky.; Chicago, Ill.; and Richmond, Ind. In

all these cases detailed reports have been submitted and specific recommendations made for desirable changes. As in previous years, cooperation has been maintained with the Hawaiian and Porto Rican authorities.

Pollution of navigable waters.-The sanitary surveys of interstate and coastal waters have been continued. They included the Ohio River watershed, New Jersey streams, and coastal waters on the North Atlantic seaboard. The studies on the Potomac River have been completed and a report of this investigation prepared. On request, advice in regard to securing safe water supplies was furnished, after careful investigation, to a number of localities in the States of Alabama, Kentucky, and Tennessee.

Sewage disposal.-A number of sewage experimental plants have been operated. It is expected that these studies will eventually result in improved methods of sewage disposal in small communities and aboard trains and steamboats.

Investigations of proposed sewerage systems have been made in various localities in the States of Georgia, Kentucky, and Tennessee and advice rendered.

Industrial wastes.-Progress has been made in the investigations of this branch of the pollution of navigable waters. These studies now comprise tannery wastes, strawboard wastes, cannery wastes, and creamery wastes. The industries studied are located in the States of Indiana, New York, Pennsylvania, and Virginia.

Leprosy investigation station. Studies of leprosy have been continued during the year in Hawaii. The usefulness of the leprosy investigation station has been increased by close cooperation with the Territorial authorities in regard to the study and control of public health problems.

Hygienic Laboratory.-The Hygienic Laboratory remains the center of all the research work of the service. The technical services of this institution are in addition constantly utilized in connection with investigations in the field.

Special laboratory studies have been made during the year of pellagra, rabies, Rocky Mountain spotted fever, pyorrhea alveolaris, scarlet fever, tuberculosis, typhus fever, milk, disinfectants, and sterilization of dental instruments. Work has been done on the standardization of a number of drugs, such as pituitary extract, digitalin, thyroid extract, and the toxicity of various pharmaceutical preparations and of metals occurring in ordinary foods.

One thousand eight hundred and sixty-four antirabic treatments have been sent from the laboratory to State authorities. Studies of rabies have been continued, and 139 heads of animals presumably infected with this disease examined. Seventeen thousand two hundred and forty-eight doses of antityphoid vaccine have been prepared and distributed, chiefly for the use of beneficiaries of the Public Health Service and employees of the Government. Routine examinations of pathological specimens, samples of water and sewage, milk, drugs, etc., have been made in large numbers.

Viruses, serums, etc.-In connection with the enforcement of the law governing the sale of viruses, serums, etc., 46 inspections of establishments have been made and over 3,000 samples of products examined. Forty-one establishments (26 American and 15 foreign) held licenses at the end of the fiscal year.

Educational lectures, etc.-On request of sanitary and civic associations, hundreds of educational lectures have been delivered in practically all sections of the country.

In addition to the scientific bulletins, a number of popular publications have been prepared for use in field investigations and given as wide circulation as practicable.

Division of Foreign and Insular Quarantine.

During the year officers of the Public Health Service have inspected both at domestic and foreign ports 15,363 vessels, of which 3,498 were fumigated, either for the destruction of rats or mosquitoes or on account of the presence on board of one of the quarantinable diseases.

On account of the prevalence of typhus fever in Europe, vigilance in the inspection of arriving immigrants has been greatly increased, and especial attention paid to the destruction of body lice in the clothing of persons from infected districts.

During the year 612,026 passengers and crews were inspected on arriving vessels. On account of the fact that the officers of the Public Health Service engaged in the examination of immigrants endeavor to detect the quarantinable diseases, as well as those diseases which are deportable under the immigration laws, it may be said that during the year 1,771,090 persons have been examined for quarantinable disease.

The infection of plague in Habana, which was discovered on February 22, 1914, has prevailed in that port off and on throughout the year, so that measures in force for the prevention of the introduction of plague from Habana into the United States have been carried out during the year.

On April 1 medical officers of the Public Health Service were detailed for duty in the offices of the American consulates at the ports. of Tampico, Vera Cruz, Tuxpam, Frontera, and Progreso, Mexico, the duty of these officers being to fumigate vessels for the destruction of mosquitoes prior to their departure, and to carry out other restrictions for the protection of the southern ports of the United States against the infection of yellow fever.

On June 1, 1915, as the result of a resolution passed by the city council of Boston, Mass., the mayor of that city was authorized to transfer the quarantine function from local to Federal control. This marks an important step, not only in the development of the national quarantine service, operated by the Public Health Service under this department, but it is important in showing that the public in general have awakened to the necessity for, and economy resulting from, the uniform control of quarantine in the United States by the National Government. The station was opened by the service on that date.

On July 19, 1915, the quarantine station at Galveston, Tex., was formally opened for the boarding and treatment of vessels arriving from foreign ports. This station, the building of which was begun about two years ago, has just been completed.

The department has recently received a very valuable report covering the condition and needs of all of the quarantine stations operated by the Public Health Service, this report having been made jointly by a representive of that service, a representative of the Supervising Architect's Office, and a representative of the United States Navy.