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sion, before the convening of the General Assembly next succeeding such general election, and prepare and submit to the said Legislature a report of such investigations, with the amount of appropriation which such committee deems absolutely necessary to meet the wants of each of said institutions and officers, with such other recommendations as the committee deems wise."
In accordance with the above statute will you please prepare a report, to be submitted to the investigating committee, showing the receipts of your office from funds derived from appropriations made by the last General Assembly, together with a statement in detail of the expenditures of such funds for each year of the biennial period, showing each fund separately, and setting the amounts for the year ending October 31, 1901, and the year ending October 31, 1902, in separate columns, side by side.
Please include also in your report a statement of the needs of your office in the way of appropriations by the coming Legislature for the biennial period ending October 31, 1905, or appropriations desired to be made available for the present year.
This report should be addressed to the Legislative Investigating Committee, care of Custodian of State House, and submitted not later than December 22d. Very respectfully yours,
FREMONT GOODWINE, Chairman.
Indianapolis, Ind., December 20, 1902. To the Legislative Investigating Committee, care Custodian of State
Gentlemen-In accordance with the request of your letter of December 13th, we respectfully submit itemized fiscal statements for the years ending December 31, 1901 and 1902, also a summary of expenditures for the two years in separate columns, side by side. In further accordance with your request we submit a statement of the needs of the State Health Board for the biennial period ending October 31, 1905. First, permit us to make plain that the first step in the work of preventing disease is to secure a correct knowledge of the whereabouts, extent, character and destructiveness of all diseases; in other words, the first essential thing is to collect accurate vital statistics. It is by this means only that it is possible to proceed intelligently in sanitary work. The present appropriation of $6,000 for health work is very little more than sufficient to make possible the collection of said statistics, and for this reason after we have found the location, extent and character of the different diseases our funds are exhausted and we are helpless to combat the same. We therefore request your honorable committee to recommend to the coming Legislature that not less than $10,000 over and above the salaries of the Secretary and assistant, be given annually for disease-prevention work. We estimate that the people of Indiana lose annually not less than $5,000,000 on account of diseases which could be prevented. Certainly it would be wise and true economy for Indiana to vigorously fight "preventable diseases” as other States are doing with much signal success.
We respectfully call your attention to the amounts appropriated for disease prevention work in the following States, and it will be seen that
Indiana is sadly deficient in her financial support of disease-prevention work: Massachusetts
$80,000 New York
26,000 New Hampshire
SECRETARY INDIANA STATE BOARD OF HEALTH.
January, February and March, 1903.
REGULAR QUARTERLY MEETING.
OFFICE STATE BOARD OF HEALTH, April 3, 1903. . Regular meeting for the second quarter of the fiscal year, which is the first quarter of the calendar year.
Present: Drs. Forrest, Davis, Cook, Wishard and Hurty.
REPORT OF SECRETARY FOR QUARTER ENDING
MARCH 31, 1903. It is to be recorded for the first quarter of the year 1903 that smallpox, which first appeared in the State in February, 1898, was more severe in every way than in any quarter since it first appeared. In January, 1903, there were reported 921 cases, with fifty deaths in fifty-six counties. Compared with January of the preceding year this is an increase in cases of 98 per cent., in deaths of 900 per cent., and in area invaded 80 per cent. In February 889 cases were reported, with fifty deaths in fifty-nine counties. As compared with the same month of the preceding year this is an increase in cases of 49 per cent., in deaths of 1,533 per cent., and in area invaded of 17.5 per cent. Although the returns for March are not all in at this date, enough is known to make plain that the increase in cases, deaths and area invaded, over the same month of the preceding year, will be proportionate to that shown for January and February.
It may be we are now at the climax of the epidemic, but surely it is not wise to so assume, for we know by previous history the disease may continue until not less than 80 per cent. of the unvaccinated are attacked.
It is the belief of the Secretary that at the highest estimate not over 50 per cent. of the people of Indiana are protected by vaccination and by having had the disease. This is certainly true in Indianapolis, where the urgent necessity for vaccination has been most forcibly presented. It will be remembered that in January and, February the city authorities offered free vaccination to the people and that the vaccination of school children was insisted upon. The City Board of Ilealth estimates that outside of school children the last public effort succeeded in inducing 20,000 to submit to vaccination. Counting all of these as successful “takes” (which is not warranted by experience), and counting all the school children and teachers—21,700 in number—as protected, then assume another 20,000 to have been voluntarily vaccinated, we have a total of 61,700 protected people in Indianapolis. For fear this is too low, let us add another 40,000, and this makes 100,000, or 50 per cent., of the population which is protected. In other words, counting the population of Indianapolis at 200,000, there remain 100,000 unprotected persons, 80 per cent. of whom, or 80,000, will almost certainly have smallpox unless they are vaccinated. If the death rate drops to 1 per cent., which is certainly a low estimate, we may count on having here in Indianapolis, before smallpox departs, assuming vaccination neglected, not less than 800 deaths. This figure, of course, will never be realized, because if deaths again begin to appear, it will stimulate vaccination. These forecasts are further sustained by the experience of 1901-1902, as appears in the following table, and which shows the steady increase by all methods of comparison:
SMALLPOX STATISTICS BY MONTHS, 1901-1902.
The totals disclose almost a threefold increase in cases, deaths and area invaded in 1902 as compared to 1901, The first three months of 1903 show an increase over the same period for the preceding year of 73 per cent. in cases, 1,200 per cent. in deaths and 48.7 per cent. in area invaded. If, as most probably will be the case, a corresponding increase occurs in the remaining three quarterly periods of this year, we will have to record for 1903 not less than 15,000 cases, and 200 to 300 deaths. In view of these facts and deductions I recommend that the State Board issue a proclamation to the people urging vaccination and revaccination in order to avert positively the probabilities which now appear.
The Secretary, at his own expense, has made the following examinations and analyses: Twenty-seven sputums examined, eighteen positive and nine negative; eleven diphtheria cultures, six positive and five negative; twenty-two samples of water, nineteen polluted.
In January and February, during the session of the Legislature, the Secretary was called upon to vaccinate the larger proportion of the members. This furnished an excellent opportunity to call attention to the importance of public health work. The opportunity was embraced, and it is very likely good results were secured.
The board presented five measures, four of which were passed by the Assembly; but one--the Laboratory bill—was vetoed. The four measures were:
(1) An increase of appropriation. Heretofore $6,000, over and above the salaries of the Secretary and Chief Clerk, have been available for public health work. The sum now allowed for the same purpose is $10,000.
. (2) The Quarantine bill: This bill, somewhat modified by amendments for the measure, written by this board, was passed and now is law.
(3) The bill providing for the better ventilation of the State House. That better ventilation is badly needed for the State House, and especially for the legislative chambers, has been plainly apparent to the most superficial observer. The bill presented by this board in 1889 and in 1901 was again introduced and this time became a law,