in very many cases in impairment of vision, makes this a question of very serious consideration and one that demands the attention of the state health authorities. Dr. Clark states that he could obtain no definite information as to how long this disease has existed in the region surveyed. It is a not uncommon belief that the disease was introduced by foreigners, as it is known to prevail very extensively in those parts of southern Europe from which many of our immigrants come. It is the opinion of Dr. Clark, however, that the disease in West Virginia is of very long standing, as he was told by some of the residents that their grand-fathers "had been blind by reason of 'granulated lids.'"

It is believed that before this disease can be eradicated or materially diminished, special hospitals will have to be erected or houses rented where the cases can be scientifically treated. Already the state board has had an application for the establishment of such an hospital in Wyoming county from the active health officer of that county, Dr. H. E. Stiltner. Were means available for this purpose, the secretary believes that skilled assistance may be received from the U. S. Public Health Service. Already he has received a partial promise from that department that an experienced surgeon with one or more nurses may, at some future time, be furnished by the government, if one or more hospitals are provided and the expenses of conducting them be guaranteed. When we consider the enormous economic loss attending the wide prevalence of this disease, it becomes a matter of the greatest importance to institute some means whereby the spread of the disease will be prevented and as many cases as possible be cured. The recommendations of Surgeon Clark, who has had very wide experience in the investigation of trachoma in the different states, may with propriety be here presented.

"1. Systematic examinations for trachoma should be made of all school children of the state.

"2. All children suffering from active trachoma should be excluded from school under medical supervision, until pronounced in condition to return without danger to others.

"3. The expense of such medical supervision of school children should be borne by the state whenever necessary.

"4. A school nurse should be employed wherever practicable, whose duty it would be to visit the homes of children debarred from school by reason of trachoma, and put into practice, under the physicians direction, the principles of control of the disease from the standpoint of the individual and the public.

"5. A campaign of education should be instituted in infected territory, through talks to school children and the distribution of printed information relative to the dangers and prevention of trachoma.

"6. A free hospital of inexpensive construction for the treatment of trachoma should be located at a point near the junction of Logan, Mingo, McDowell and Wyoming counties.

7. The co-operation of the mining companies should be secured in order that a systematic examination of all miners may be made by

"8. A systematic effort should be made to improve the sanitary conditions of rural schools, to the end that the dangers of school infectious may be lessened."

Before closing this reference to the prevalence of trachoma in this state, the State Board of Health and its secretary desire hereby to acknowledge their indebtedness to the U. S. Public Health Service, not only for sending Surgeon Clark to make this investigation, but also for aid extended in many other ways, and especially for the very valuable work done in Berkeley county, of which more detailed statements will appear in our next published report.

SCHOOL OF INSTRUCTION FOR HEALTH OFFICERS.

In the amended health law of 1913, it was provided that "it shall be the duty of every county or municipal health officer to meet with the State Board of Health or its representatives at least once a year, due notice having been given, at such time and place as such State Board of Health may designate, to attend a School of Instruction for the purpose of familarizing such officers with their duties in the interest of public health. In pursuance of the object here stated, the board held its first School of Instruction in the assembly room of Hotel Chancellor, Parkersburg on November 28, 1913. The members of the board present were the following: Drs. J. L. Pyle, S. L. Jepson, W. W. Golden, J. H. Shipper, J. E. Robins, J. A. Rusmisell, H. M. Rymer, W. J. Davidson, H. A. Barbee, H. A. Brandebury and D. D. Lind. The following health officers were present: Drs. R. H. Boise, Sistersville; C. L. Boyers, Ellenboro; C. E. Clay and W. T. Henshaw, Martinsburg; H. W. Daniel, Elkins; W. C. Etzler, Wheeling; U. S. T. Ferrell, Cairo; John Folk, Bridgeport; J. B. Grove, Petersburg; J. B. Hodges, Harper's Ferry; F. M. Kearns, Hundred; W. J. Leahy, Mannington; J. S. Kennedy, Salem; T. F. Lanham, Grafton; W. H. Lemley, Littleton; John L. Meyers, Shepherdstown; F. E. Martin, New Martinsville; A. L. Peters, Fairmont; S. J. Posten, Morgantown; J. A. Reyburn, Ravenswood; M. R. Stone, Parkersburg; S. M. Scott, Terra Alta; J. A. Striebich, Moundsville; J. W. Strothers, Belington; H. R. Werner, Thomas; H. C. Whistler, Smithfield; C. R. Weirich, Wellsburg; J. V. Woofter, Troy; W. H. Yeakley, Keyser; O. L. Aultz, Charleston; E. W. Crooks, Parkersburg; J. M. Kearney, Wirt county; U. L. Dearman, Roane county; W. T. W. Dye, Grantsville; E. E. Fankhauser, New Martinsville; A. L. Grubb, Berkeley Springs; U. G. Harper, Beverly; M. M. Hoff, Philippi; A. P. Jones, Pennsboro; J. N. Judy, Petersburg; R. W. Love, Moorefield; C. H. McLane, Morgantown; T. E. Rymer, Ripley; M. M. Reppard, Middlebourne; C. N. Reger, Roanoke; C. F. Shafer, Grafton; J. W. Shull, Romney; R. A. Reger, Upshur county; J. T. Thornton, Wheeling; J. E. Womack, St. Mary's; E. E. Watson, Preston county, and L. N. Yost, Fairmont.

An address by His Excellency, Governor Hatfield, was expected, but he was detained by pressing business. The remainder of the program was carried out as follows:

"The Prevention of Typhoid Fever in Town and Country," W. H. Frost, passed assistant surgeon U. S. Public Health Service.

"My experience with an Epidemic of Smallpox," Dr. W. T. Henshaw, health officer of Berkeley county.

"The Production and Distribution of Milk," Dr. J. T. Thornton, health officer of Ohio county.

"The Duties and Trials of County Health Officers," Dr. H. A. Barbee, member of state board and health officer of Mason county.

The questions presented and the various papers read were freely discussed by a number of those present.

At eight o'clock, p. m., in the Y. M. C. A. hall, a public health meeting was held at which His Honor, Mayor Murdock, presided and delivered a pleasing address, after which Judge Tavener gave a brief address, followed by Dr. W. W. Golden, President of the board, who told the audience, "What the State Board of Health is Doing and Planning to Do." At the conclusion of his address, Dr. S. L. Jepson secretary of the board, read a paper on "Fads, Fakes and Faith Cures."

The next School of Instruction was held in the governor's reception room at Charleston, May 6th, 1914. In addition to the members of the board, namely: Dr. W. W. Golden, Dr. J. H. Shipper, Dr. G. D. Lind, Dr. J. L. Pyle, Dr. J. A. Rusmisell, Dr. W. J. Davidson, Dr. J. E. Robins, Dr. H. A. Brandebury and Dr. S. L. Jepson, there were present thirty-five county and municipal health officers chiefly from the southern part of the state.

The following program was carried out:

"Typhoid Fever and Illegal Practitioners vs. The State of West Virginia," Dr. W. W. Golden.

"What West Virginia Can Do to Eliminate Typhoid Fever," Dr. J. L. Pyle.

"Illegal Practice in this State," Dr. W. J. Davidson.

"Small-pox, its Sanitary Control," Dr. S. L. Jepson.

"What a Health Officer should Bear in Mind in reference to the Transmission of Disease." Dr. H. A. Brandebury.

"The Chemistry and Physics of Common Disinfectants," Dr. G. D. Lind.

"Legal Questions Pertaining to Public Health," Attorney General A. A. Lilly.

"What Charleston is Doing in the Interest of Public Health," Dr. O. L. Aultz, health officer of Charleston.

"What Huntington is Doing in the Interest of Public Health," Dr: T. E. W. Grover, health officer of Huntington.

A morning and afternoon session was necessary to complete the program. Free discussion was indulged in until five o'clock, p. m., when the school adjourned.

We cannot but believe that great good will be accomplished by these meetings, in exciting renewed interest in public health matters and familiarizing the various health officers of the state with modern methods of sanitation and the control of infectious diseases.

By,

the convenience of the different local health officials, and two schools will be held each year, one so located as to accommodate those residing in the upper part and the other those in the lower part of the state. We believe that in this way we can diminish expenses, accommodate a larger number of health officials, and, therefore, secure a fuller attendance at the meetings.

BULLETIN OF THE STATE BOARD OF HEALTH.

The amendments of 1913 to the Public Health Laws of the state provided, that the State Board of Health "shall gather information in respect to matters embraced in this section and kindred subjects for diffusion among the people." The matters embraced in this section were, in general terms, the causes of diseases, the methods of their propagation, the sources of mortality, the effects of locality, employments, habits and circumstances of life on the public health, and the means of prevention of diseases. Following the precedents established by the boards of health of other states, after due deliberation and consideration of the means available for the purpose, our board at its November meeting 1913, resolved to issue a Bulletin, and the secretary, with President Golden and Dr. G. D. Lind were appointed an editing committee. The first issue of the Bulletin was in January, 1914, and it is now issued quarterly under the title, "Bulletin of the West Virginia State Board of Health." This is a pamphlet containing approximately 35 pages, and it aims to communicate to the public the important part of the board's transactions, with additional information on public health matters, and especially instruction in proper methods of living and the means of preventing disease. Eight thousand copies of the Bulletin are issued quarterly, and from the very numerous requests that come to us for copies of the publication, we are quite sure that it is meeting a long felt want. The education of the people as to the character of disease and the methods of its prevention must ever constitute a large part of public health work. The distinguished Dr. Gorgas, surgeon general of the United States army, whose sanitation of the Canal Zone has made for him a world-wide reputation, has recently said that he regards an increase in the wages of a working man as a sanitary measure of the greatest importance.

This simply means that when a family has more money it can secure for itself a more healthful environment. It may be said with even greater truth, that the better education a family possesses the more certain is the environment of that family to be ideal as to sanitation. The board is, therefore, endeavoring to educate the people in sanitary matters, and if means are provided they purpose in the future to use the moving picture films illustrative of disease, bad sanitation, etc., believing that in this way many of our people can be educated who can in no other way be reached.

The secretary has, as opportunity has offered, given public lectures on sanitary matters in a number of the counties of the state. It is hoped that this part of the public health work may be enlarged

a

enable it to secure some very greatly needed assistance. The time of the secretary is so greatly occupied in correspondence, that but little time is left in which to carry on educational work outside his office. Many people will listen to a talk on disease and its prevention who will not spend the time in reading about it. It is therefore deemed necessary to carry the message of health to the people by word of mouth as often as circumstances and the means at the board's disposal will permit.

COMPLAINTS.

Innumerable complaints of various kinds reach the office of the secretary of the state board entailing an enormous correspondence. These vary in character from very just complaints as to the impurity of water supplies to those of chickens allowed to run at large in the neighborhood of a country tavern. The writers not unnaturally believe that the State Board of Health is possessed of plenary power to cause the removal of whatever may in the remotest degree tend to the production of disease or constitute a nuisance offensive to the eyes or the olfactories. The secretary promptly answers all complaints that come into his office, and attempts to do what is possible in the matters of which complaint is made. We here present some of the more grave complaints and the disposition made of them. It would occupy entirely too much space were we to give in detail an account of all matters of this kind that come to our notice.

Under date of August 8, 1913, the following communication was sent from Hinton, W. Va., to the president of the board.

"Hinton, W. Va., August 8, 1914.

West Virginia State Board of Health,

Elkins, W. Va.

Dear Sir:

By request I am herewith inclosing a petition from approximately 400 citizens of Hinton and Avis, asking that your board make a thorough examination of Hinton's water supply. You will note that the councils of the city of Hinton and the city of Avis havě endorsed this petition and I feel that it is surely a matter deserving your attention.

The Business Men's Association has not as yet acted upon this matter as they have held no meeting since the petition has been in circulation. However, the matter will be brought to their attention at the next meeting and I will probably have a communication from them to present to you a later date, I have been designated to represent the citizens before your board and you will please address any communication with reference to the matter to me.

Yours very truly,

The petition referred to was as follows: "To the Board of Health of West Virginia:

C. C. GRIMMETT."

We, the undersigned citizens and residents of Hinton and Avis, West Virginia, respectfully represent that we are dependent upon the Hinton