REPORT.

The law providing for the establishment of the State Board of Health took effect July 30th, 1873. This first Annual Report, for the year ending September 30th, 1873, is therefore for a period of only two months. The Board began its work on the very earliest day possible under the law, and notwithstanding the very short period of its existence, it is hoped that even this first report will prove of interest and value to the people.

For the purpose of giving an outline view of the legal establishment, organization, officers, and committees of the Board, and also of its labors performed and plans for the future, the papers and statements relative thereto are here submitted in the following order:

1st. The act establishing the Board.

2d. Proceedings for its organization.

3d. Names of officers and members of the Board.

4th. Titles of committees and names of chairmen of same.

5th. A statement of expenditures.

6th. The circulars issued.

7th. Some of the statistics collected.

8th. Remarks, including statements of any proceedings deemed essential to a proper understanding of the labors of the Board.

9th. Special papers on important topics connected with public health.

ACT ESTABLISHING THE BOARD.

ACT NO. 81, LAWS OF 1873.

AN ACT to establish a State Board of Health, to provide for the appointment of a Superintendent of Vital Statistics, and to assign certain duties to Local Boards of Health. SECTION 1. The People of the State of Michigan enact, That a board is hereby established which shall be known under the name and style of the "State Board of Health." It shall consist of seven members as follows: Six members who shall be appointed by the Governor with the consent of the Senate, and a secretary, as provided in section four of this act. The six members first appointed shall be so designated by the Governor that the term of office of two shall expire every two years, on the last day of January. Thereafter, the Governor, with the consent of the Senate, shall biennially appoint two members to hold their offices for six years, ending January thirty-first. Any vacancy in said board may be filled, until the next regular session of the Legislature, by the Governor.

SEC. 2. The State Board of Health shall have the general supervision of the interests of the health and life of the citizens of this State. They shall especially study the vital statistics of this State, and endeavor to make intelligent and profitable use of the collected records of deaths and of sickness among the people; they shall make sanitary investigations and inquiries respecting the causes of disease, and especially of epidemics; the causes of mortality, and the effects of localities, employments, conditions, ingesta, habits, and circumstances on the health of the people. They shall, when required, or when they deem it best, advise officers of the government, or other State boards, in regard to the location, drainage, water supply, disposal of excreta, heating and ventilation of any public institution or building. They shall from time to time recommend standard works on the subject of hygiene for the use of the schools of the State.

SEC. 3. The board shall meet quarterly at Lansing, and at such other places and times as they may deem expedient. A majority shall be a quorum for the transaction of business. They shall choose one of their number to be their president, and may adopt rules and by-laws subject to the provisions of this act. They shall have authority to send their secretary, or a committee of the board, to any part of the State, when deemed necessary to investigate the cause of any special or unusual disease or mortality.

SEC. 4. At their first meeting, or as soon as a competent and suitable person can be secured, the board shall elect a secretary, who shall, by virtue of such election, become a member of the board, and its executive officer. The board may elect one of their own number secretary, in which case the Governor shall appoint another member to complete the full number of the board.

SEC. 5. The secretary shall hold his office so long as he shall faithfully discharge the duties thereof, but may be removed for just cause at a regular meeting of the board, a majority of the members voting therefor. He shall keep his office at Lansing, and shall perform the duties prescribed by this act, or required by the board. He shall keep a record of the transactions of the board; shall have the custody of all books, papers, documents, and other property belonging to the board, which may be deposited in his office; shall, so far as practicable, communicate with other State boards of health, and with the local boards of health within this State; shall keep and file all reports received from such boards, and all corres

LAW ESTABLISHING THE BOARD.

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pondence of the office appertaining to the business of the board. He shall, so far as possible, aid in obtaining contributions to the library and museum of the board. He shall prepare blank forms of returns, and such instructions as may be necessary, and forward them to the clerks of the several boards of health throughout the State. He shall collect information concerning vital statistics, knowledge respecting diseases, and all useful information on the subject of bygiene, and through an annual report, and otherwise, as the board may direct, shall disseminate such information among the people.

SEC. 6. The secretary shall receive an annual salary, which shall be fixed by the State Board of Health. The board shall quarterly certify the amount due him, and on presentation of said certificate the Auditor General shall draw his warrant on the State Treasurer for the amount. The members of the board shall receive no per diem compensation for their services, but their traveling and other necessary expenses while employed on the business of the board shall be allowed and paid.

SEC. 7. The sum of four thousand dollars per annum, or so much thereof as may be deemed necessary by the State Board of Health, is hereby appropriated to pay the salary of the secretary, meet the contingent expenses of the office of the secretary, and the expenses of the board, which shall not exceed the sum hereby appropriated. Said expenses shall be certified and paid in the same manner as the salary of the secretary.

SEC. 8. It shall be the duty of the health physician, and also of the clerk of the local board of health in each township, city and village in this State, at least once in each year, to report to the State Board of Heal h their proceedings, and such other facts required, on blanks and in accordance with instructions received from said State Board. They shall also make special reports whenever required to do so by the State Board of Health.

SEC. 9. In order to afford to this board better advantages for obtaining knowledge important to be incorporated with that collected through special investigations and from other sources, it shall be the duty of all officers of the State, the physicians of all mining or other incorporated companies, and the president or agent of any company chartered, organized, or transacting business under the laws of this State, so far as is practicable, to furnish to the State Board of Health any information bearing upon public health which may be requested by said board for the purpose of enabling it better to perform its duties of collecting and distributing useful knowledge on this subject.

SEC. 10. The secretary of the State Board of Health shall be the Superintendent of Vital Statistics. Under the general direction of the Secretary of State, be shall collect these statistics, and prepare and publish the report required by law relating to births, marriages, and deaths.

SEC. 11. The Secretary of State shall provide a suitable room for the meetings of the board at Lansing, and office-room for its secretary.

ORGANIZATION OF THE BOARD.

In accordance with the provisions of the law, the Governor commissioned the following persons as members of the State Board of Health:

The first meeting of the board was held at the office of the Secretary of State in Lansing, July 30, 1873, the following members being present: Dr. H. O. Hitchcock, Dr. R. C. Kedzie, Rev. J. S. Goodman, and Dr. Z. E. Bliss.

Dr. H. O. Hitchcock, as senior member and temporary chairman, gave the following introductory outline of the prospective labors of the board:

INTRODUCTORY ADDRESS BY DR. HITCHCOCK.

GENTLEMEN:-In accordance with the request of the Governor I have asked you to convene at this time, in order that, at the earliest possible day, the Michigan State Board of Health might be organized and ready for its work.

I trust it may not be considered impertinent for me to suggest an outline of the work that seems to me to have been laid upon us.

For years some of us have been laboring earnestly for the establishment of such a Board in this State. The arguments for its establishment were many and weighty, and the words free and earnest with which we urged it. As it is far easier for most people to show that something ought to be done, than definitely to point out what that something is; to lay burdens upon others' shoulders than to assume them themselves, so we found real pleasure in urging the preparation of a burden for somebody's shoulders, not stopping to think "what if it should be let down upon our own?" And I imagine that each one of us received a little shock one day and, for a time at least, an abatement of his zeal in the cause of Preventive Medicine, when our good Governor gently laid upon us his hand and the burden of making a State Board of Health popular with, because useful to, the people of the State.

Here, then, we are to-day, face to face with the questions, "What is the work to be done by this State Board of Health?" and "How are we to do it?"

INTRODUCTORY ADDRESS BY DR. HITCHCOCK.

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People are accustomed to look upon the loss of life and treasure in time of war as something fearful to contemplate; one of the greatest calamities to the State. And the whole story of the State's loss by war is not told in the number of lives and the amount of treasure destroyed, but society is demoralized, families are broken up, marriages and births are prevented, the constitutions of many of the young men are broken by the hardships of the field or the hospital, and they are thus disabled to the State, and many of them transmit to their children enfeebled constitutions, susceptible to disease, thus securing that the race, so far as they are concerned, shall soon run out.

War, with all its attendant calamities, destruction of life and property, demoralization of society, and its tendency to the extinction of the race can and ought to be averted, and that ruler or those legislators and citizens who, by diplomacy, wise and liberal legislation, the broad and general education of the people, enable a nation to avoid it, are cherished and honored while they live, and are crowned as benefactors of their race and the world.

But war, in which this State has materially suffered, has occurred but once in the 36 years of her history as a State, and has therefore brought to her an average loss for each of those years, of only about 600 men, and, in round numbers, $500,000 in treasure; whereas, during those very four years of war and each preceding and succeeding one, there have been preventable causes of disease and death silently at work that have cost the State far more in lives and treasure.

According to the vital statistics of 1870, it appears that from the four principal causes of death, this State suffered a loss for that year of 3284 lives.

Is there an observant and thoughtful physician who does not believe that by the intelligent 6bservance of all the now known principles of hygiene more than one-half the deaths occurring from consumption, scarlatina, typhoid fever, and diarrhoea, may be prevented and thus there may be yearly saved to the State 1,642 lives that are now lost from these four causes alone! And what man is there who has given any attention to the subject but is fully aware that of all the deaths occurring in the State from all other causes (7,452) there might have been prevented, to say the least, 358?

Thus, at a low estimate, there might be saved to this State, if the people were properly instructed in and would carefully observe the principles of hygiene, 2,000 lives that are now annually sacrificed by ignorance and neglect.

For every case of death it is estimated that there are 20 cases of sickness which, in loss of time, medical attendance, nursing, etc., cost, on an average, $50 each. Thus the State loses in treasure by preventable sickness $2,000,000 per annum, to say nothing of the cost of burying the dead.

But the whole of the detriment to the State is not found in the loss to its