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The following rules governing the Hygienic Laboratory were agreed upon:

The services of the laboratory are free to any state, county or municipal officer, and to railroad companies for the examination of water, either chemical or bacteriological. To any private party wishing such examination there is to be a small fee charged which will go into the laboratory fund. In matters that affect the Public Health, such as examination of suptum for tuberculosis, diphtheria swabs, widal and diazo tests for typhoid, smears for syphilis, actinomycosis, glanders, etc., laboratory service is free.

Examination of the brains of animals for suspected rabies is

free.

Pathological examinations of tissue will be made for physicians, for which a small fee will be charged unless the patient is unable to pay for it.

The Wasserman test for syphilis will be made for a small fee. Samples of drugs will be tested in the department of pharmacology, and pure food analysis will be made by the department of chemistry. The laboratory shall be in charge of the Dean of the School of Medicine as director.

The working basis for suceeding years is to be adjusted by the board of health and the University authorities.

Approved:

(Signed) S. L. JEPSON,

Secretary State Board of Health. (Signed) THOS E. HODGES,

President West Virginia University."

Necessary additional equipment was added to the laboratory of the University as soon as possible, and all the supplies necessary for the work of the institution have been added as needed. The laboratory has been in successful operation for more than a year and the demands made upon it are constantly increasing. A complete report of the work done since the organization of the laboratory will be found on another page.

VITAL STATISTICS.

Report for the Years 1912 and 1913.

The report on the vital statistics of the state is here made because it is the requirement of the law. The Registrar, however, is quite well aware of the very small value to be attached to the report. The law provides that "every physician and accoucheur shall report every birth and death which may come under his supervision to the clerk of the county court in which it may happen, stating in case of a birth the time and place, name of the child, if it have one, and the names of the parents; in case of a death, the time and place, the name of the decedent and the cause of death, and in either case such additional facts as may be required by

to be prepared by the board as hereinafter provided, and in accordance with such instructions as may be given it."

In the absence of a physician, "the oldest resident member is required to make the report," and the coroner and undertaker are to report monthly cases coming under their care. A fee of 25 cents is provided for each report. In some counties the county courts have refused to pay the authorized fee, and as a result physicians decline to make the reports. Hence, by no means all of the births and deaths are reported. The county clerk is required to tabulate the reports reaching him, with such additions as may be made by the assessor after his house to house visits and annually send this to the registrar of vital statistics. When the reports are made by a layman, as is very often the case, the causes assigned for deaths are seldom accurate, and we find in the tabulated reports reaching this office such meaningless causes as "inflammation," "liver disease," "stomach trouble," "dropsy," "bold hives," "child birth," "hemorrhage," "complication" and many even more absurd.

When possible we have endeavored to solve the mystery of these causes, but many remain which we are compelled to assign to the columns, "miscellaneous" and "unknown," and many come to us with "unknown" given as the cause of death.

If this report serves no other purpose, it will at least demonstrate the necessity for a more effective law regulating the reporting and registration of vital statistics. No report of deaths approaching accuracy need ever be expected until a state law is enacted which forbids the burial of any dead body until a burial permit is issued by some authorized person, which permit shall be based upon a certificate of death filled by the attending physician, if there has been one, or in cases of necessity by a coroner. It is hoped that such a law will be enacted by the next legislature.

It will be noted in the statistical tables that from a number of counties no report is given. The law requires that the county clerk of each county shall send to the registrar of vital statistics by September 1st of each year, a report of the births and deaths of the preceding year, and the marriages are to be reported by March 1st. Notwithstanding this law, we found when compiling these statistics, that many counties had not been reported even for the year 1912, and two, in some cases three, letters to the clerks of the delinquent counties have failed to bring these reports. Hence, the incompleteness in our tables here presented.

NEW HEALTH LAW.

The present State Board of Health, as doubtless others before it, has realized the impossibility of performing efficient service for the state because of imperfections in the health law under which it operates. In other parts of this report have been given illustrations of the impossibility of improving sanitation by reason of the lack of authority in the board. Solely with a desire of rendering more

appointed a committee on legislation composed of President Golden and Drs. Brandebury, Robins and Rusmisell, to which the secretary was afterwards added. The principal purpose of this committee is to formulate a law more or less in conformity with those of other states in which the science of preventive medicine is quite advanced, and with a view of rendering to the people of the state more valuable service. Dr. Golden has for months been untiring in his work on this committee, and by correspondence with the surgeon general of the United States Public Health Service, and by the co-operation of His Excellency, Governor Hatfield, who has shown a constant interest in the work of the State Board of Health, has been instrumental in securing the detail of an officer of the U. S. Public Health Service, who is now in the state and co-operating with the committee in the formulation of new health legislation. This officer is Assistant Surgeon Taliaferro Clark, who has had large experience in the work of State Health Boards. It is hoped that the result of the committee's deliberations will be such that it will commend itself to the legislature of the state, and that the members of that body may see the necessity of enacting into law the bill which will be presented for their consideration.

SERVICE OF MEMBERS.

Before closing this report the secretary desires to bear testimony 'to the active interest in the work of the board manifested by its members. Almost all the members of the board have been regularly present at its meetings, engaged in its deliberations, and shown a vital interest in the work of the board. In addition to this, although not a duty specified in the law, they have come to the aid of the secretary on all occasions when requested to do so. The epidemic of smallpox which has prevailed in the state during the past two years has entailed upon the secretary an amount of work which it has not always been possible for him to perform unaided. In emergencies the following members of the Board have been requested to leave the field of their private labors and perform service for the state that has been by no means pleasant in connection with the epidemic:

Drs. W. W. Golden, H. A. Barbee, H. A. Brandebury, W. J. Davidson, G. D. Lind and J. E. Robins. There has been no occasion to call upon the other members, who would no doubt have been equally prompt and active in responding to the call. Dr. J. L. Pyle and other members of the board have taken an active part with the local health authorities in the suppression of epidemic disease when it has occurred in their respective communities. In but a single case has a word of criticism reached the secretary as to the lack of interest on the part of any member of the board in public health work.

The president of the board is especially worthy of commendation for the unusual interest manifested by him in the work of the board, In addition to his work as chairman of the committee on legislation he has always manifested the greatest zeal in all matters affecting the public health, and has not hesitated to communicate to the secre

the secretary to better serve the public. The secretary feels quite sure that the state has never had a more faithful official.

As a matter of public interest especially to physicians and applicants for licensure, we here present the questions that have been propounded, during the past two years, to those appearing for certificates to practice in the state. The members of the board who examine and grade the papers of applicants do not know who the applicants are, as the papers are numbered and no names appear, the secretary being the only member of the board who has the names, and he grades no papers. The examinations are therefore absolutely fair and unprejudiced. The grade required to pass is eighty per cent, and no one is admitted to the examination who has not a preliminary education the equivalent of graduation from a high school with a four year course, and who is not the possessor of a diploma from a medical school graded as A. or B. by the council on Medical Education of the American Medical Association.

Chemistry and Medical Jurisprudence.

1-To what salts do most cathartic minerals owe their virtue 2-What are proteids? Name one.

3-What pathological conditions produce bile in the urine? 4-Mention several tests for sugar in the urine.

5 Give the chemical antidote to silver nitrate, mercury bichlor-
ide, tincture iodin. What is formed?

6-Define oxidation, and where does it occur in the body?
7-How would you determine the presence of organic matter
in water?

8-How do gun-shot wounds differ from other wounds?

9-Give the distinguishing marks between ante and post mortem wounds.

10-Differentiate between dementia and hysteria.

Materia Medica and Therapeutics.

1-Convert liter, gram and c.c. into weights and measure ordinarily used in the U. S. A.

2-Write a prescription containing four remedial agents.

3 What is normal blood pressure? Name two drugs that increase it.

4-Describe enteroclysis and hypodermoclysis.

5-Tinct. nux vomica: Give dose and the per cent of strychnia it contains.

6-Iodin: Give theapy.

7-Air and sunshine: Give therapy.

8-Iron: Give therapy.

9-Digestive ferments: Name the principal ones and give ther

apy.

10-Mineral acids: Give therapy.

Anatomy and Embryology.

1-Describe in detail the scapula.

2-What bones enter into the formation of the wrist joint?
3-Give origin and insertion of the biceps and triceps muscles.
4-Give the origin and branches of the femoral artery.

6-Describe the coverings of the brain.

7-Give the divisions of the spinal nerves and the number of

each.

8-Name the anatomical divisions of the abdomen and describe

the linea alba.

9-Describe the gall bladder and name the bile ducts. 10-Describe the male urethra.

Practice of Medicie and Pediatrics.

1-In what cases would the ophthalmoscope aid in diagnosis? 2-Of what import is the spleen in the diagnosis of febrile conditions? Define splenic dullness.

3-Differentiate early pleurisy from intercostal neuralgia. 4-Make a diagnosis of aneurysm of the descending aorta. 5-Describe treatment of acute inflammatory rheumatism. 6-What diseases may cause occlusion of the common bile duct? 7-Differentiate the coma of opium poisoning from that of cerebral hemorrhage.

8-What treatment would you recommend for diphtheritic paralysis?

9-Give symptoms and treatment of whooping cough.

10-Give symptoms, complications and treatment of mumps.

Bacteriology and Hygiene.

1-State the agencies by which the body protects itself against the entrance and bad effects of pathogenic bacteria. 2-State the products of bacteria. Give functions.

3-Define spirilla; bacilli; illustrate.

4-Name the important pathogenic diplococci.

5-State the chief sources of contamination of drinking water. 6-What precautions are necessary to insure healthful sleep. 7-Name the most common sources of infection of diphtheria. 8-How would you prepare an artificial food for a new-born

infant?

9-Describe the effects of a cereal diet.

10-Give a proper diet in a case of diabetes.

Physiology and Histology.

1-Define a reflex action and name three reflexes of interest to the practitioner.

2-Give the general relations of the grey and white matter in the cord. How do we determine from what region any given section of the cord is taken?

3-Mention some important characteristics of the pulse in health and disease.

4-Give a general description of the heart, defining its func

tion.

5 Give the physiology of respiration.

6-Describe the pressure conditions in the lungs and thorax, and their influence on the circulation.

7-Describe the digestion and absorption in the stomach.

8-Give the histologic structure of the cornea.

9-What is urea and where formed?

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