To His Excellency, Newton C. Blanchard, Governor of Louisiana. SIR-I have the honor to submit the Biennial Report of the State Board of Health for the years 1906 and 1907, covering the period that has elapsed since the induction of the present Board into office on January 8, 1906, and in doing so would respectfully beg to express on behalf of my colleagues and myself the profound sense of responsibility with which we have undertaken to serve our people in a line of duty so fraught with difficulties and exposed to criticism. It is, therefore, with a due appreciation of the magnitude of our work that I submit the record of what has been accomplished within the past two years, feeling that while I am warranted in exchanging congratulations wtih your Excellency on the progress thus far made, and in particular on the general good health that has prevailed in Louisiana during that period, we must not underestimate the possibility of danger from causes beyond our control, as shown by the lessons of the past. The circumstance that the direction of maritime quarantine no longer rests with the State Board of Health, while removing a certain measure of responsibility, may be regarded as still further increasing the need of watchfulness on our part, since it entails reliance on men over whom the Board has no jurisdiction, and who are relatively remote from observation. This watchfulness has not been in the slightest degree relaxed, and the beginning of the quarantine season of 1908 has been marked by an earnest protest from the Louisiana Board against taking any chances in dealing with Cuba, where there is good reason to believe the danger of infection is present unusually early this year. As will appear further on in the report, our past experience with Cuba in this particular has been very instructive, and by no means reassuring. Before proceeding with the various details of this report, permit. me to assure your Excellency of the high appreciation with which the members of the Board have noted your unfailing interest in our work, beginning with the day on which you personally inducted us into office. As the executive officer of the Board I particularly value the honor of having entered the health service of the State under your distinguished administration, and at such a critical time. I therefore take this occasion to thank your Excellency for the confidence and moral support you have so generously accorded me. MEMBERSHIP OF THE BOARD. The Board as originally appointed to succeed the one retiring from office January 8, 1906, was as follows: Dr. Clifford H. Irion, President, Bossier Parish. Dr. Whyte Glendower Owen, Vice President, Iberville Parish. Dr. T. E. Schumpert, Caddo Parish. Dr. A. J. Perkins, Calcasieu Parish. Dr. G. W. Gaines, Madison Parish. Drs. Owen and Schumpert had been members of the preceding Board, and owing to the failure of Dr. Schumpert to qualify a vacancy occurred which was most acceptably filled by the appointment of Dr. Oscar Dowling, of Shreveport, making the full Board as at present constituted. DIVISION OF THE STATE INTO HEALTH DISTRICTS. In accordance with the system adopted by the State Board of Health shortly after its reorganization under Act 192 of 1898, the new Board made the following division of Parishes into Health Districts, one member being assigned to each District in the capacity of Medical Inspector: First Health District, Parish of Orleans-Dr. C. H. Irion. Second Health District-Dr. T. E. Schumpert; Sabine, De Soto, Caddo, Bossier, Webster, Bienville, Red River, Natchitoches, Claiborne, Lincoln, Jackson, Winn, Grant and Union. Third Health District-Dr. G. W. Gaines; Morehouse, Ouachita, Caldwell, Catahoula, Concordia, Franklin, Richland, West Carroll, East Carroll, Madison and Tensas. Fourth Health District-Dr. W. G. Owen; Point Coupee, Iberville, Ascension, St. James, West Baton Rouge, East Baton Rouge, East Feliciana, West Feliciana, St. Helena and Livingston. Fifth Health District-Dr. A. J. Perkins; Cameron, Calcasieu, Vernon, Rapides, St. Landry, Acadia, Avoyelles, Vermillion, St. Mary, Lafayette, St. Martin and Iberia. Sixth Health District-Dr. J. M. Batchelor; Terrebonne, Assumption, Lafourche, St. Charles, and St. John. Seventh Health District-Dr. W. G. Armstrong; Plaquemine, Jefferson, St. Bernard, Washington, St. Tammany and Tangipahoa. SPECIAL MEDICAL INSPECTOR ELECTED. In view of the necessity for having a field officer available for duty in the extensive campaign of education and sanitation planned by the new Board, it was decided to add to its Medical Staff a Special Medical Inspector, to be chosen with reference to his special fitness for the work contemplated. For this important position Dr. Fred J. Mayer was selected, as being particularly qualified by study and training, as well as by a wide acquaintance with physicians and other influential citizens all over the State. Dr. Mayer's report, which appears elsewhere in this volume, speaks for itself as regards the extent and thoroughness of his work. POLICY OF THE NEW BOARD. AS DEFINED BY THE PRESIDENT IN AN ADDRESS BEFORE THE PROGRESSIVE UNION, OF NEW ORLEANS, Jan. 8, 1906. In response to an invitation from the Progressive Union of the city, the President of the new State Board of Health delivered an address at the annual meeting of that representative body of the citizens of New Orleans on the evening of January 8, 1906, the day on which the Board went into office, briefly outlining its policy. In addition to the many prominent men of the city who were officers and members of the Progressive Union, there were present on that occasion Dr. Quitman Kohnke, City Health Officer of New Orleans, and Dr. J. H. White, the resident representative of the U. S. Public Health and Marine Hospital Service, under whose management the local campaign of 1905, by which yellow fever had been banished from the city before the coming frost, was conducted. Both these distinguished health officials spoke, and gave the most encouraging assurances of support to the Board. The following quotation from the address of the President is here given as setting forth the declared policy of the Board: "In assuming the duties of the responsible position of President of the State Board, I realize the necessity of the co-operation of the varied interests represented by your body. I desire to state at the outset that the policy of the State Board as relating to infectious diseases will be one of no concealment; that while the State Board of Health realizes that its function is the preservation of the public health, it also realizes that the vast commercial interests of the State must be protected by every means not inconsistent with that function. Public health and commercial interests are so intimately related that the preservation of the one must be the greatest protection of the other, and to that end the State Board of Health invited the earnest co-operation of your body; it is the purpose of the State Board to inaugurate a campaign of education at once throughout the State, in order that the health authorities of the various parishes, towns and cities may be brought into close relations with the State Board, to the end that uniform system of quarantine may be established throughout the State that will give the maximum protection with the minimum restriction upon trade. It is the purpose of the State Board to send men of recognized ability as sanitarians to the various parishes of the State, to discuss with their health authorities, sanitary and quarantine affairs, in order that a mutual feeling of confidence may be established between the State and local Boards. "A thorough system of inspection will be inaugurated by this Board, so that, in the event of a recrudescence of the yellow fever at any point infected in the recent epidemic, the Board will be at once informed, and the necessary steps taken at once to stamp out the disease and protect the surrounding community. Inspectors will be placed at all dangerous ports to safeguard the interests of this State, and the surrounding States will be invited to send their inspectors to any point in Louisiana which in their opinion is necessary for their protection, and such inspectors sent from other States will be given. every facility to acquaint themselves with existing conditions. "A new sanitary code will be formulated, in the light of recent. developments in our knowledge of infectious diseases. It is the intention of the Board to invite the medical and sanitary societies of the city and the United States Marine Hospital Service to assist in the preparation of that code. Before beginning the work on the new code it is the intention to invite the Health Officers of the Southern States to a conference to be held in this city at as early a date as possible, for the purpose of discussing quarantine regulations, to the end that such regulations as are adopted in this State will be adopted by other States." RELIANCE ON LOUISIANA PHYSICIANS. On taking charge as the executive offiver of the new State Board the President promptly aligned himself with the representative medical men of New Orleans and made it known that his confidence in the ability, honesty and public spirit of Louisiana physicians was such that he had no idea of going outside the State for advice or help in the event yellow fever should reappear. His expressed determination was to rely entirely upon the doctors and other leading citizens whose homes and interest are in Louisiana for all the co-operation and support needed to bring the work of the Board home to the people, and thus insure its success. In line with this policy he let it be known to the U. S. Public Health and Marine Hospital Service that, while recognizing the good work done by Dr. White in 1905, it would be the Louisiana State Board of Health that would be supreme in this State should any recurrence of yellow fever take place. This policy has been followed without the slightest deviation by the present Board. VISIT OF HEALTH Officials to Central AMERICA. In January of 1906 Mr. C. H. Ellis, resident manager of the United Fruit Co. in New Orleans, recommended to the heads of that corporation to invite a party of representative health officials of the Gulf States and of the U. S. aMrine Hospital Service to make a tour of inspection to all the Central American fruit ports as guests, and to place one of the best passenger steamships of the company at their disposal for the entire trip. This proposition of Mr. Ellis was promptly adopted by the management, and he was authorized to arrange all the necessary details. The advantages to be derived from a direct personal inspection of the tropical fruit ports by those officials charged with the responsibility of framing maritime quarantine regulations were so obvious that the invitation was promptly accepted by the proper authorities of the State and Federal Governments, but on account of many pressing duties connected with organizing work in various departments the |