cases. They are quiet, orderly, and industrious and daily manifest their enjoyment of life in a manner that tends to allay suspicion and dispel discontent from the disturbed minds of their associates. Many of these patients when removed from their present supporting influences lose their self-control and become a menace to their associates, or else lapse into a deplorable dementia. To force such a result upon any of

these unfortunates is a crime.

There is little doubt but that Polk county will experience the same results from its institution that Linn county has from theirs.

The asylum is located at the poor farm, five or six miles from Des Moines, where the nearest physician resides. The Cedar Rapids Times recently said that poor farms are practically poor houses and ought to be called by that name. It declares that the worst mistake that Linn county ever made was when it put twenty thousand dollars into a county insane asylum. It is located five miles from Marion, where the nearest physician resides, and a large number of insane people are kept in it and given poor care and attention.

Not long ago the Ft. Dodge Messenger agitated the question in Webster county. It recommended the building of a county asylum and explained in detail how much such a move would save the county. Other counties will also want the same thing. It is to be hoped the experiments in this line already made will be sufficient to convince the people that it is a certain step backward in the care of the insane, and its extension should not be further recommended.

The State of Iowa cannot afford to save money at the expense of this unfortunate class.

VITAL STATISTICS.

As suggested in the last biennial report, the Twenty-Sixth General Assembly made a radical change in the manner of collecting and making the returns of births and deaths.

Instead of requiring these returns to be made by physicians and midwives to the clerk of the district court they are collected by the assessors. The following is the exact language of the Code:

SECTION 2566. It shall be the duty of all assessors, at the time of making assessment, to obtain and report to the clerk of the district court, upon blanks adopted by the State Board of Health and furnished by the county auditor, such registration of births and deaths as occur within their respective districts for the year ending December 31st immediately preceding.

SECTION 2567. The clerk of the court in each county shall keep a book in which shall be recorded all marriages occurring within the county, together with such data respecting the same as shall be required by the State Board of Health, and shall report to the Secretary of the State Board of Health on or before the first day of June in each year such data respecting such marriages for the year ending December 31st immediately preceding. The clerk of the district court of each county shall keep a book in which shall be recorded all births and deaths occurring within the county as shown by the returns filed in his office by the assessor, as provided in section twenty-five hundred and sixty-six; and on or before the first day of June in each year shall furnish to the Secretary of the State Board of Health a report of such births and deaths.

In accordance with the provisions of these sections the State Board of Health, at the annual meeting held May 5, 1897, adopted the forms for records of births and deaths as shown on page sixty-six of this report.

one.

Time will demonstrate whether the change has been a wise If the assessors are faithful in collecting, recording, and returning these data the record will be more correct numerically than under the former law. Even in this particular, however, there will necessarily be many defects as to the births and deaths having occurred during the year, because of changes of residence, especially because of removals from the State. The report however, ought to show the exact number at the time when the assessment was made.

From a professional standpoint and as a basis for sanitary conclusions however, the death reports must always be unreliable because of the inaccuracy with which the causes of death-the names of the diseases must of necessity be stated.

No argument is needed to demonstrate the advantages of reliable vital statistics. They constitute the basis for practical sanitary investigation; and for the application of proper restrictive and preventive measures. If such statistics showed an undue mortality from any special disease throughout the entire State or in any particular locality, intelligent inquiry could be made as to the cause and the proper remedies could be applied intelligently. After the application of these restrictive measures subsequent statistics from the same localities would demonstrate the efficiency of the methods employed.

In a few years there might thus be demonstrated the particular localities in the State where certain diseases have been, or are, most prevalent, and the type of the disease, whether malignant and fatal in character, or whether mild.

Again, statistics showing accurately, or even approximately the marriages, births and deaths occurring in the State furnish comparisons between the number of births and deaths, and data respecting the number of births to each marriage, that are not only interesting and suggestive, but important.

Michigan has recently enacted a law respecting a registration of deaths that went into effect August 29, 1897. The features embraced in this law have been held and expressed by the writer hereof for some years, viz: That no one should be interred within the State without a proper certificate, showing name, age, cause of death, etc. The practical operation of the law thus far as shown by the first Bulletin issued is highly satisfactory. It shows returns from over two million sixty-one thousand six hundred and sixteen of the total population of the State, leaving less than seven per cent of the State unreported. The following sections are from the Michigan law referred to: SECTION 1. The People of the State of Michigan enact, That the body of no person whose death occurs in the State shall be interred, deposited in a vault or tomb or otherwise disposed of, or removed from the township, village or city in which the death occurred, until a permit for burial or removal shall have been properly issued by the clerk of the township, village or city in which the death occurs, who shall be the registrar of deaths: Provided, That in cities that have, or shall institute, a system of immediate registration of deaths by the Board of Health, the health officer or Secretary of the Board of Health shall act as registrar of deaths under this act, in lieu of the city clerk, and shall in all respects conform to its provisions.

SEC. 2. Whenever any person shall die, the undertaker, householder, relative, friend, manager of institution, sexton or other person superintending the burial of said deceased person, shall cause a certificate of death to be filled out with all of the personal and family particulars required in section three of this act, and attested by the signature of a relative or some competent person acquainted with the facts. The physician who attended the deceased person during his last illness, shall fill out the medical certificate of cause of death, which death certificate shall be delivered to the registrar within the time designated, if any, by the local board of health. In case of death without the attendance of a physician, or if it shall appear probable that the deceased person came to his death by unlawful or suspicious means, then the registrar shall refer the certificate to the health officer or coroner for immediate investigation and report prior to issuing the permit: Provided, That when the health officer is not a physician, and only in such case, the registrar is authorized to insert the facts relating to

the cause of death from statements of relatives or other competent testimony. Upon the presentation of a certificate of death properly filled out and signed, the registrar shall issue a permit for the burial or removal of the body and shall immediately record the death in the register of deaths, numbering all certificates consecutively in the order in which they are received, beginning with No. 1, for the first death that occurs in each year. In deaths from dangerous communicable diseases, burial or removal permits shall be granted by the registrar only in accordance with the rules of the local board of health and of the State Board of Health relating theret ). These certificates of death are sent by the registrars or clerks directly to the Secretary of State, and are in the following form:

Parent of...children, of whom .are living. Birthplace (State or country)

...189... to.. he died on...

183

189...

I hereby certify that I attended deceased from.......... that I last saw h alive on........、、、、 .....189..., that about......o'clock, ......M., and that to the best of my knowledge and belief the CAUSE OF DEATH was as hereunder written:

DURATION OF EACH CAUSE.

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.

*