The blank forms for death returns are furnished by the Secretary of State to the various village and city registrars and by them are put into the hands of the undertakers and sextons. The registrar is entitled to a fee of twenty-five cents for each death recorded and reported by him to the Secretary of State-except in cities of ten thousand inhabitants and upward where the registrar receives a salary there is no fee for such report.

These reports are sent monthly to the Secretary of State and he compiles and publishes a bulletin monthly showing: "the mortality of the State in detail, the prevalence of important causes of death, and such other information as shall be of public interest and sanitary value. "'* The registrar shall also send a transcript monthly to the clerk of his county containing a record of all of the deaths entered upon his register during the preceding calendar month for entry upon the county records of deaths. All certificates of death, local registers, or county records authorized under this act or certified copies thereof shall be prima facie evidence in all courts and for all purposes of the facts recorded therein.

The act also imposed suitable penalties for refusal or neglect to comply with its provisions.

The State Board of Health, while having nothing to do with the collection, registration, or publication of the mortuary data of the State, is greatly interested in the statistics thus obtained, because of the great benefits to be derived from a sanitary standpoint.

Iowa, and every State in the Union, will watch the results of this law with interest, and doubtless with profit.

PREVENTION OF BLINDNESS AND CARE
OF INFANTS.

Upon the recommendation of the State Board of Health and others interested in the public health, the Twenty-sixth General Assembly enacted chapter fifty-seven, as follows: AN ACT to Prevent Blindness, and for the Care of Infants Affected With Disease of the Eyes, and to Provide a Penalty for the Violation Thereof. Be it Enacted by the General Assembly of the State of Iowa:

SECTION 1. Should one or both eyes of an infant become inflamed or swollen, or reddened at any time within two weeks after its birth, it shall * Extract from Sec. 4. Act above referred to.

be the duty of the midwife, parent, guardian, or nurse, or other person having charge of such infant, to report within six hours after discovery thereof by such person in charge of such infant, to the health officer or some legally qualified medical practitioner of the city, town or district in which the parents of the infant reside, the fact that such inflammation or swelling or redness of the eyes exists.

SEC. 2. It is hereby made the duty of attending physicians and midwives to instruct parents and nurses in regard to the provisions of this act, and the danger of sore eyes in infants.

SEC. 3. Any failure to comply with the provisions of this act shall be punished by a fine not less than twenty-five dollars nor more than one hundred dollars, or imprisonment not to exceed thirty days, or both.

SEC. 4. This act being deemed of immediate importance shall be in force and take effect on and after its publication.

Though recommended by the Code Commissioners for adoption in the new Code for some reason unknown it was omitted. It is reasonable to assume that the subject was not considered in all its relations to the public weal or was accidentally overlooked.

The importance of preventing or at least limiting the number of cases of blindness needs no argument. If it is a fact that every case of blindness is a money loss to the State, it must be true that every case of blindness prevented is a money gain. Hence the effort to prevent this affliction is one of great interest to the political economist as well as to the humanitarian.

On this subject three propositions may be stated:

"First. There is in the United States a rapid increase in the number of the blind.

"Second.-A large percentage of the blindness is due to the disease known as purulent ophthalmia of the new born.

"Third. By the use of known methods this could be very materially lessened."

BLINDNESS INCREASING.

In proof of the first proposition the census of the United States for 1880 gives the following:

Total population in the United States in 1870 was thirtyeight million five hundred and eighty-eight thousand three hundred and seventy-one.

Total number of persons blind in the United States in 1870, twenty thousand three hundred and twenty.

The proportion of blind to the entire population in 1870 was therefore one to nineteen hundred.

The total population of the United States in 1880 was fifty million one hundred and fifty-five thousand seven hundred and

eighty-three, showing an increase in ten years of nearly thirty per cent.

The total number of blind persons in the United States in 1880 was forty-eight thousand nine hundred and twenty, showing the rate of increase of blindness for the ten years to have been one hundred and forty-seven per cent.

This shows that the increase of blindness for the ten years given was one hundred and seventeen per cent greater than the increase of population.

The proportion of blind persons to the entire population in 1880 was one to ten hundred and twenty-five instead of one to nineteen hundred as for the year 1870.

These cold figures are eloquent as well as conclusive.

OPHTHALMIA IN THE NEW BORN AS A CAUSE OF BLINDNESS.

In support of the second proposition the following facts are given:

Fuchs found that among three thousand two hundred and four cases of blindness collected from asylums in different parts of Europe 23 per cent were due to ophthalmia neonatorum. In the New York Institution for the Blind, at Batavia, 23 per cent of the inmates are there as the result of the same disease.

Horner has shown that among one hundred blind asylums in different countries the variation was from twenty to seventy-nine per cent - average thirty-three per cent.

Haussmann gives the number in the asylum in Copenhagen made blind by this disease eight per cent, in Berlin twenty per cent, in Vienna thirty per cent, in Paris forty-five per cent.

According to the report of the Royal Commission on the Blind, of the English government, published in 1889, thirty per cent of the inmates of the institutions and seven thousand persons in the United Kingdom have lost their sight from this cause. Professor Magnus, of Breslau, finds that less than seventy-two per cent of all who be ome blind during the first year of life are rendered so by purulent ophthalmia, and shows that of ten thousand children under five years of age 42 are blinded by this disease. In the blind asylums of Switzerland the proportion who have lost their sight from this disease is twenty-six per cent; in the asylums of Austria, Hungary and Italy about twenty per cent, while in Spain and Belgium it falls to about eleven or twelve per cent. An investigation into the causes of the blindness of one hundred and sixty-seven inmates of the Pennsylvania Institution for the Blind, made by Dr. George C. Harlan, of Philadelphia, developed the fact that fifty-five owed their affliction to purulent ophthalmia, and that more than half of these cases occurred in infancy.

What produces this ophthalmia? It is clearly an infectious disease, and can therefore only occur because the specific poison producing it has come into actual, and more or less prolonged, contact with the conjunctiva.

The disease is caused not only by a secretion from the mother due to gonorrhoea, but may be produced by what is regarded as a simple leucorrhoea; and the infection occurs either during or soon after birth.

If occurring during birth the disease generally manifests itself in the child by redness and puffiness of the eyelids at from the second to the fifth day. It may occur several days later—the infection then being caused by uncleanliness on the part of the hands of, or the sponges or cloths used by the nurse or attendant. Soon after this redness and puffiness appears, if the lids are separated the whole eye-balls will be found bathed in a thick purulent secretion, and unless prompt remedial measures are practiced the sight of the eye is either destroyed or permanently impaired.

MEASURES RECOMMENDED FOR PREVENTING THIS OPH

THALMIA.

The Iowa law above quoted regards the presence of this disease, and the blindness resulting from it, as largely criminal. It assumes that the disease, if it does occur, should be promptly recognized and reported, and successfully treated. From the foregoing statement as to the cause, there is indeed no excuse for its existence.

It is a preventable disease, and therefore comes within the purview of legislation for the public good, and the police powers of the State.

LEGISLATIVE SUGGESTIONS.

LOCAL BOARDS OF HEALTH.

There is an ambiguity, indefiniteness and apparent conflict in the provisions of chapter sixteen, title twelve, of the Code which should be removed, and such changes made as will leave no cause for doubt or misunderstanding thereof.

Section five provides that local boards of health "proclaim and establish quarantine against all infectious or contagious diseases dangerous to the public, and maintain and remove the same." It does not declare whether the board shall have authority to do this, or should do so, or whether the mayor or clerk shall do so.

The closing paragraph of the same section provides that the mayor of a city or clerk of a township upon written notice given by any practicing physician of the existence or termination of such disease, may declare or terminate the quarantine, as the case may be.

There is an indefiniteness of expression, if not conflict herein which tends to confusion, and will inevitably result in misunderstanding among local officers. It is also merely directory whereas it should be mandatory. The old law, chapter fifty-nine, laws of 1892, which was substituted for section sixteen, chapter one hundred and fifty-one, laws of 1880, was much better for the purpose intended,—that of suppressing contagious diseases, inasmuch as the original law after faithful trial had been found inefficient and expensive. This substitute read as follows:

Upon written notice given by any practicing physician, that small-pox, diphtheria, scarlet fever, or any other contagious disease dangerous to the public health exists in any place, it shall be the duty of the mayor of any incorporated city or town, and the clerk of any district township, forthwith, without other authority, to establish quarantine in such cases and to maintain and remove such quarantine in like manner.

* * *

Time is an important factor in suppressing an infectious and contagious disease in a community. A few hours delay may result in the loss of many human lives. In the above given substitute the word "written " should be stricken out.

There is a great tendency for parents and physicians to secrete cases of contagious disease, or to call it by some other name. Suppose a physician refuses to give notice to the proper officers, should the intent and purpose of the statute be frustrated, and the public imperiled? The mayor or township clerk should be directed to act forthwith upon satisfactory evidence that a contagious disease exists in his jurisdiction. If there be a question as to the exact nature of the disease, investigation can be made and if the disease be found not contagious, the quarantine can be released, and no injury is done, whereas, on the contrary, without such summary proceeding irreparable injury may be done, and many lives sacrificed.

Further, under this section five, it is necessary for a local board to be convened in each case of contagious disease within their jurisdiction, in order that the proper order may be made for quarantine, and so decided by the supreme court, which in townships where the members are widely apart, requires lapse