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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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1

REPORT OF THE SANITARY SURVEY COMMISSION.

-of

The West Virginia State Board of Health.

An Intensive Study of the Prevalence of Intestinal Parasites among the Coal Miners of McDowell County.

Professor W. H. Schultz, Ph. D., Messrs. C. O. Gorby, H. C. Bray, and Wilbur Shirkey.

December 10, 1914.

ACKNOWLEDGMENT.

In making this report, I wish to acknowledge the coöperation of Mr. Edward O'Toole, general superintendent and Mr. Klier, chemist of the U. S. Coal & Coke Company. Mr. O'Toole gave instructions that he would do anything that would aid in the success of our work. Mr. Klier's laboratories were practically turned over to us. Too much praise can not be given a man who lends such able assistance in public work of this kind as did Mr. Klier in aiding as collector and interpreter throughout our stay at Gary.

We wish to acknowledge the intelligent coöperation of, the superintendents of the Bottom Coal Co., Messrs. Sam and Joe Patterson, both of whom aided us in securing data and put at our disposal their offices as headquarters while at Vivian.

Mr. Samuel Evans, general manager at Pageton, and his brother, also rendered valuable service, and took much interest in the work of the commission, as did Mr. W. W. Wood, the superintendent, at Omstead.

We wish also to acknowledge the courteous, and at times helpful interest of Doctors A. M. Spangler of Pageton, Shanklin of Gary, Stephens and Harrison of Kimbal.

In the seventeen mines that we studied, the bank bosses of each and every one lent us every assistance possible.

Morgantown, W. Va.

Dec. 10, 1914.

W. H. SCHULTZ.

Preliminary investigations and incomplete reports of them may easily mislead, and so do considerable injustice to communities or per'sons. In the realm of pure science there are editors who refuse to publish preliminary reports of experiments, maintaining, and with good reason, that it is only completed investigations that yield reliable data. Thus they are helping cultivate in their readers a patience such as is not general, which is born of confidence in the value of thorough and accurate work. The American public is constantly getting the wrong viewpoint, as a result of hasty conclusions obtained from getting the wrong viewpoint, as a result of hasty conclusions got from the press and pseudo-scientific journals. In public health matters, this is signally true. The newspaper is a strong advocate for public health, but its 'copy' is often based upon some ambitious individual's preliminary investigation, and may indeed attract attention to the activities of the investigator, but at the same time unjustly focus the attention of the public upon the health problems of a particular community.

This is practically what was done in West Virginia, when there was given to the public press by some one the result of a very cursory investigation of hook-worm in McDowell county. As a matter of fact there was considerable talk about a subject concerning which no one had any definite information. The notoriety served this purpose; the Governor, members of the Board of Health, and the director of the State Hygienic Laboratory wanted facts, and to this end made possible a scentific study of the problem of sanitation with reference to the parasite, within a limited area of the state. It is the result of this scientific study that I wish to present in the following report.

Method of Precedure. The method of precedure employed by the Commission differs from that employed by many health commissions. It has been a very common practice among public health workers to enter a community and issue a general invitation to those interested to submit to examination. By this, what may for convenience be called the voluntary, method, it is possible to secure a very high percentage of infection; but it neither represents the actual condition of a community nor of a particular class of workers, except in the cases where each and every individual of a community or class volunteers to be examined. This, of course, is seldom the case.

Our method, for convenience, may be called the census method. Upon securing the coöperation of a given mining company, it was requested that some responsible employee be sent into the mine with the collector, and a personal interview be held with each and every miner on the pay roll, or that a given number of men be interviewed, representa given section of the mine, as seemed wisest.

The first object was to determine whether or no there was a general infection among the miners, whether this infection was in any way limit

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