IV LEGISLATIVE SUGGESTIONS One of the duties of the Secretary in respect to the preparation of the biennial report, as required by section 2565 of the Code, is to make "such suggestions as to further legislation as may be thought advisable." In compliance with this requirement the following suggestions are respectfully submitted: APPROPRIATIONS When the State Board of Health law was enacted in 1880, the appropriation per annum was fixed at five thousand dollars. Notwithstanding the work of the Board has been greatly increased, covering subjects of sanitation not thought of, and greatly increasing the expenses of the Board, the appropriation has remained the same as it was twenty-one years ago. The State Board of Health, through its oil inspection service, organized since 1880, not only is no expense to the State, but pays into the State Treasury much more annually than double the amount received by it by appropriation. To meet the legitimate demands of the Board, and to provide for original bacteriological, chemical and other sanitary investigations, the appropriation should not be less than seven thousand five hundred dollars annually. The per diem of the members of the Board should be increased to ten dollars instead of eight as provided by the present code; the Secretary should receive a salary of not less than fifteen hundred dollars per annum instead of the twelve hundred now paid, and section 2575 should be further amended so as to insert after the word "office" the words "except postage and stationery," which shall be drawn from the supply department of the State. VITAL STATISTICS A glance at the data respecting "vital statistics" as shown elsewhere in this report will show that something should be done to either repeal section 2566 and all of 2567 after the words "immediately preceding," or enact such penalties as will secure on the part of the assessors a better observance of the law; or else return to the old law requiring the physicians to report births and deaths. Vital statistics are of no benefit unless approximately correct. The physicians are the legitimate—the natural-agents for reporting births and deaths, and should under proper penalties be required by law to make these returns. They shonld also be reasonably compensated therefor. The reports of marriages are as nearly correct as could be expected, and are consequently quite reliable. REPORTING INFECTIOUS DISEASES It is painfully and dangerously apparent that a considerable number of physicians holding certificates from the State Board of Medical Examiners either through ignorance or a disposition to shield their patients from quarantine fail or neglect to report to the proper authorities cases of diphtheria, scarlet fever, smallpox and other infectious diseases as required by the regulations of this Board. The Board has disciplined some of these physicians, but its authority in such cases, so far as suspension from practice or revocation of the certificate is concerned, has not as yet been determined by the courts, nor is there as yet any direct legislative enactment in regard to this matter-the only provision for such discipline being the rather indirect question of "incompetency" as found in section 2578 of the Code. In order that there may be no question as to the powers of the Board in regard to this matter, a prominent attorney has suggested the following amendment to section 2570 of the Code: "Any person who shall purposely conceal or withhold information of any case of smallpox, varioloid, scarlet fever. or other quarantinable disease from the legally constituted public health authorities of the locality in which the same may occur, shall be punished on conviction thereof by a fine of not less than one hundred, or more than five hundred dollars, or by imprisonment for not less than six nor more than twelve months, or by both fine and imprisonment at the discretion of the court. And in case the person offending is a physician or holds a license from the State Board of Medical Examiners, in addition to the above. penalties, his license shall be suspended, and on conviction of a second offense, it shall be permanently revoked." STATE BOARD OF MEDICAL EXAMINERS The fees received from applicants for certificate are not adequate to meet the expenses of this Board. Three methods are suggested by which these expenses might be more nearly, if not entirely, provided for. First-The fees for itinerant physicians' permits issued by the Board, under section 2581 of the Code, might be paid into the Board for its use instead of into the State treasury for the use of the State. As the State is at no expense whatever on behalf of the Board of Medical Examiners such a diposition of these fees would only be just. Second-The fee for examination might remain as at present with an additional fee of five dollars for the certificate where the examination is successful. This is the requirement in Illinois and would increase the fees of the Board thirty-three and one third per cent. Third-A renewal fee of one dollar annually, might be required of each physician holding a certificate from the Board, as is the case with those holding pharmacy certificates. In addition to this plan furnishing an ample income, it would have the advantage of enabling the Board to keep in intimate touch with every legitimate physician in the State, or out of the State, who desired. to keep his certificate in force. It would also enable the Board to furnish for publication with this report a reliable roster of all the legal medical practitioners of the State. RAILROAD ACCIDENTS AND CAR SANITATION The legislature of Iowa in 1892 enacted a statute requiring all railroads operating in Iowa to equip their cars with air brakes and automatic couplers. This was done to prevent accidents resulting from the ordinary methods of braking and coupling. As the change was expensive and required time, the period for full compliance with the law was fixed for January, 1, 1900. It will be interesting to know what the results have been in the way of preventing accidents. The time since the last limit expired has been so short that valuable comparisons can hardly be instituted. The Iowa Board of Railroad Commissioners in its report for 1900 says relative to the compliance of the railroads. with the statute above referred to: "It is the opinion of the Board that all railway companies operating lines within the State have substantially, or as nearly as may be, complied with the law with reference to equipping their cars with automatic couplers." This report furnishes some interesting data relative to accidents occuring since 1882. From the tables given it is shown that beginning with 1882, the first tabulated report of accidents in Iowa, the following number of casulties have occurred to employes "from coupling cars" and "falling from trains:" The number killed, including the year 1900, from coupling cars, 199; from falling from trains, 385; total, 584. Number injured, including 1900: From falling from trains. Total .... .3,408 971 .4,378 As stated previously, the law requiring the change in method of coupling and braking was enacted in 1892. Inasmuch as but few of the roads could comply with the law for a year or two at least, and an extension of time was granted, but little reduction in the number of accidents could be expected at once. The records show the following, beginning with 1892: |