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Give their periods of incubation.
In what trades is there danger of bacterial infection?
What are the methods of purification of public water
supply?
What are the various sources of contamination of milk?
Name the social measures of the prophylaxis of infectious
disease.

10

Practice of Medicine and Pediatrics.

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Cerebro-spinal meningitis, etiology, clinical history, and
treatment.
Scorbutus—etiology, diagnosis, symptoms and treatment.
Thyroiditis—definition, pathology, etiology, and treatment.
Mitral incompetency-definition, etiology, symptoms and
treatment.
Outline the normal liver dullness.
Barley water, for bottle-fed babies; directions for making.
Intestine colic, child of two years, treatment.
Bed wetting, child six years, treatment.
Average pulse in healthy child during sleep-
(1) Six to twelve months.
(2) Two to six years.
(3) Seven to ten years.
(4) Eleven to fourteen years.
Etiological factors, diagnosis and treatment of typhoid
fever.

10

Obstetrics and Gynecology.
Give three positive signs of pregnancy.
2 Give symptoms and treatment of eclampsia.
3 Give indications for caesaren section.
4 Give treatment for Parenchymatous Mastitis.

Differentiate pregnancy from ovarian tumors.
Give symptoms and treatment of phlegmasia alba dolens.
Give a differential diagnosis of a bartholin gland cyst

and labial hernia. 8 What are the varities of fibroid tumors? 9 Differentiate acute salpingitis from acute appendicitis. 10 Describe an operation for shortening round ligaments.

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Surgery.

1 Name the varities of carcinoma and give the histology of

each.
State what should be done to prevent post-operative shock.
Give in detail the treatment of a depressed fracture of the
skull.
Describe an amputation of the lower third of the forearm
and name three nerves and at least six muscles which will
be severed in this amputation.
State how you will recognize pus in the urine and give

the common causes and sources of this condition. 6 Give the differential diagnosis between intestinal lumbri

coids, appendicitis, ureteral calculus and salpingitis dextra. 7 Give the pathology and treatment of carbuncles. 8 Give all the signs and symptoms available for an early

diagnosis of intestinal perforation in typhoid fever.

10 Give' very briefly the pahtology of the following: Wen,

ganglion, strabismus, dactylitis and senile grangrene.

Special Medicine.

1 Nature—diagnosis and treatment of membranous croup.

Give symptoms and treatment of acute rhinitis.
3 Give symptoms and treatment of simple conjunctivitis.

Etiology—symptoms and treatment of herpes zoster.
5 Etiology-symptoms and treatment of glaucoma.
6 Differential diagnosis between variola and varicella.

Diagnosis and treatment of angina pectoris.
8 Diagnosis and treatment of facial neuralgia.
9 Etiology and treatment of purpura hemorrhagica.
10 Diagnosis and treatment of acute otitis media.

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Conclusions.

As a result of eighteen months experience in the public health service of the state, several important suggestions have forced themselves upon my attention.

1. The authority granted to the State Board of Health is not sufficient to enable it to do as effective work as it should for the preservation of the public health. This is especially true as regards the abatement of nuisances of various kinds, which, with the authority now possessed by the board, can be accomplished only by the very slow operation of court procedure, to determine which may require months.

2. The board should have authority to supervise all contemplated water supplies and sewerage systenis, and to negative any proposition for the construction of either sewerage or water suply plants when deemed by it necessary for the protection of the public health.

3. The scope of the board's operations needs to be greatly enlarged, and several additional paid skilled employees are necessary if the board is to be expected materially to reduce disease in this state.

4. It is very important, in order that a very early diagnosis of diphtheria may be made, (and possibly some other diseases), and in order that it may be scientifically determined when a convalescent diphtheria patient may be released from quarantine with safety to the public, that there be in the state a number of places selected where a competent bacteriologist may be employed for this special work in which haste is so essential.

5. It is deemed of the greatest importance that a hospital be opened for the treatment of trachoma, which has been shown to prevail very extensively in Wyoming and other near-by counties. As already shown, this is a disease which, by impairing vision, interferes with the earning capacity of our citizens and in some cases results in blindness.

6. It is deemed essential that the sanitary survey of the mining regions of the state be continued the coming summer, with a view to a further investigation of the hookworm disease.

7. The law regulating the reporting of infectious diseases should department have thus far failed to induce physicians to obey the law, and, unless prompt reports of these cases are sent in, no effective work in prevention can be expected.

8. The law regarding the registration of vital statistics is in its operation a farce. The majority of death reports come from undertakers and other laymen. Hence, the causes of death as given are, as a rule, extremely defective and misleading. The result is, that the vital statistics, as reported to the health department and printed at the cost of the state, are almost without value.

9. On account of the occasional hesitation of prosecuting attorneys to aid the board in the prosecution of unlicensed physicians, it is deemed necessary that the board should have the right in exceptional cases to employ a special attorney in the conduct of such prosecutions.

10. From the above suggestions it will be seen that, for the accomplishment of the purposes for which the board was created, namely: the improvement in the sanitary conditions of the state and the diminution of preventable diseases among the people, the appropriations granted to the board should be made adequate to accomplish these ends.

S. L. JEPSON, Secretary State Board of Health.

Figure 1. A very undesirable method of disposing of human excreta.

Here are represented about 27 double outhouses supplying at least 54 families. The infection among the children of this community was 90% of the samples turned in.

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