Since the adoption of the regulations providing for the issuance of these permits there have been held eight examinations-two of which were in connection with the meetings of the State Funeral Directors Association outside of Des Moines-viz. at Waterloo and Boone.

As a result of these examinations there have been issued four hundred and sixty-six embalmers licenses. The Board subsequently passed a resolution agreeing to issue licenses to undertakers of other states who were possessors of embalmers licenses granted upon examination by their respective State Boards of Health upon the payment of the fee, without examination-provided like courtesy was shown to licensed embalmers of this state. Several states have promptly signified their willingness to thus reciprocate; and one party holding an Illinois license has been awarded, on these conditions, a license by this board making the total number of licensed embalmers in Iowa four hundred and sixty-seven.

In addition to the examining and licensing of embalmers this department has printed the transportation permits used all over the State, and printed and issued all the application blanks and disinterment blanks and permits used by the Board and has paid for the same out of the fees received for examinations. In this way the State has had the benefit of a most valuable sanitary service without any expense. Before the organization of this embalmers' department the cost of the printing and distribution of blanks and permits relating to the disinterment and transportation of corpses was paid out of the appropriation for the State Board of Health.

From the time of the adoption of the regulation relative to the issuing of embalmers' licenses, May 11th, 1898, to the end of this biennial period, June 30th, 1901, there have been issued from the office of the State Board of Health 1,623 ordinary disinterments-1,217 of which were within the last biennial period; and 120 special permits of which 96 were within the period ending as above stated. The special permits referred to were granted in cases of death from infectious diseases-principally diphtheria and scarlet fever, and imposed the following conditions upon those interested:

1. That the disinterment is for the purpose of re-interment in another part of the same cemetery, or in a cemetery nearly contiguous.

2. That the removal shall not be by any public conveyance.

3. That the removal shall be done at an hour when there is the least possible exposure of other persons.

4. That no children shall be present, and only such persons as are actually necessary.

5. That the coffin shall not be opened.

6. That the sexton and all other persons engaged in such removal shall immediately thereafter change their clothing and properly disinfect or burn the same, and shall thoroughly disinfect their hands, head and face.

The time is not far distant when the methods of disinfection shall be so reliable and the skill of the embalmer such that bodies dead from smallpox, asiatic cholera, plague and yellow fever will be transported as safely as though dead of scarlet fever and diphtheria. Indeed, Michigan, through its Board of Health, has already expressed such confidence in her licensed embalmers that the restrictions against the transportation of bodies dead of infectious diseases heretofore prohibited by all other Boards have been so modified as to permit their transportation under certain prescribed conditions.

The State of Iowa was one of the first to adopt these rules relating to the transportation of dead bodies and the first to provide for the examination and licensing of embalmers, and it is a source of great gratification and commendable pride to find that the means of safety thus adopted have become well nigh universal so far as Canada, the United States and Mexico are concerned. In taking up this line of work the Board builded better than they knew, not only in conserving the public health but at the same time making it possible, without danger, to grant those bereaved the comfort and satisfaction of having their loved ones, though dead of contagious disease, repose in places of their own selection.

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 increas ing 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.

dred dollars

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 hunper 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.