Biennial report of the North Carolina State Board of Health

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HEALTH AFFAIRS LIBRARY
Thirty-Second Biennial Report
OF THE
NORTH CAROLINA
STATE BOARD HEALTH
JULY 1, 1946—JUNE 30, 1948
MEMBERS OF THE STATE BOARD OF HEALTH
Elected by the North Carolina Medical Society
S. D. Craig, M.D.
Term expires 1949
G. G. Dixon, M.D.
Term expires 1951
W. T. Rainey, M.D.
Term expires 1949
John LaBruce Ward, M.D.
Term expires 1951
APPOINTED BY THE GOVERNOR
Hubert B. Haywood, M.D.
Term expires 1949
H. Lee Large, M.D'.
Term expires 1951
James O. Nolan, M.D.
Term expires 1949
Jasper C. Jackson, Ph.G.
Term expires 1951
Paul E. Jones, D.D.S.
Term expires 1949
1399
LETTER OF TRANSMITTAL
Raleigh, N. C, 1948.
His Excellency, R. Gregg Cherry,
Governor of North Carolina.
My Dear Sir:—Under Authority of Chapter 118, Article 1, Section
7050, Consolidated Statutes of North Carolina, I have to submit to you
for transmission to the General Assembly the Biennial Report of the
State Board of Health for the period July 1, 1946, to June 30, 1948.
Yours sincerely,
John W. R. Norton,
Secretary and State Health Officer.
TABLE OF CONTENTS
Page
The Chronological Development of Public Health Work in
North Carolina 7
Report of the Secretary-Treasurer and State Health Officer 71
Annual Report North Carolina State Board of Health to
Conjoint Session State Medical Society 89
Division of Preventive Medicine 101
Division of Sanitary Engineering Ill
State Laboratory of Hygiene 120
Division of Epidemiology and Vital Statistics 130
Venereal Disease Education Institute 137
Reynolds Research Laboratory 138
Field Epidemiological Study of Syphilis 142
Division of Local Health Administration 145
Nutrition Division 164
School-Health Coordinating Service 169
Division of Tuberculosis Control 171
Division of Oral Hygiene 175
Division of Industrial Hygiene 178
Bureau of Cancer Control 181
Senior Publicity Specialist 183
THE CHRONOLOGICAL DEVELOPMENT OF
PUBLIC HEALTH WORK IN NORTH CAROLINA
In the seventies Dr. Thomas Fanning Wood, of Wilmington, caught the
vision of the possibilities of public health work to North Carolina. How
fully he grasped the far-reaching consequences of his idea, how clearly
he saw the ever-growing hosts of lives saved as a result of his vision and
inspiration, we shall never know. We do know that the vision never left
him, and that under its sway he worked, through the Medical Journal
which he edited and through the North Carolina State Medical Society
until his influence reached the people of the State in their General
Assembly of 1877, with the effect that on February 12, 1877, the North
Carolina State Board of Health was born. Ours was the twelfth state
board of health to be established.
Without treating the development of the newly-established board with
that thoroughness that could be termed history, we think it enough to
set down here in chronological order the principal events in the life and
growth of the North Carolina State Board of Health.
1877. Board created by the General Assembly. Consisted in the beginning
of entire State Medical Society. Society acted through a com-mittee.
Annual appropriation, $100.
1878. First educational pamphlet issued. Subject, "Timely Aid for the
Drowned and Suffocated." Annual appropriation, $100.
1879. The General Assembly reconstituted the Board of Health. Made it
to consist of nine members: six appointed by the Governor, three
elected by the State Medical Society. Term of office, five years.
Dr. Thomas F. Wood elected first Secretary of the Board, May
21. Dr. S. S. Satchwell was first President of the Board. Other
legislative provisions: (1) Chemical examination of water, and
(2) organization of county boards of health, composed of all
regular practicing physicians and, in addition, the mayor of the
county town, the chairman of the board of county commissioners,
and the county surveyor. Four educational pamphlets issued. Sub-jects:
"Disinfection, Drainage, Drinking Water, and Disinfect-ants";
"Sanitary Engineering"; "Methods of Performing Post-mortem
Examinations"; "Limitation and Prevention of Diph-theria."
Annual appropriation, $200.
1880. Much of the activity this year was devoted to efforts to control
diphtheria. Prompt reporting of cases was urged. Water supplies
and sewage disposal provoked much discussion. A survey of school-houses
was carried out through the County Superintendents of
Health. Most of the public schoolhouses were of one-teacher size,
of frame and log construction, and none of them in rural districts
had any type of privy.
8 Thirty-Second Biennial Report
1881. General Assembly passed a law requiring regulation of vital
statistics at annual tax listing; law ineffective. Annual appropra-tion,
$200.
1882. Dr. Thomas F. Wood, State Health Officer, was President of the
North Carolina Medical Society and the annual meeting was held
in Concord. At this meeting the State Board of Health appointed
a committee for each county of one physician to "canvass (the
people) in the interest of prospective legislation" on public health
matters. The subject of the annual essay presented by Dr. W. P.
Beall of Greensboro was "Preventive Medicine." The chief items
of public health interest this year was the emphasis placed on
the effectiveness of smallpox vaccination and the increasing
realization of polluted water as a source of typhoid fever.
1883. Dr. J. W. Jones of Wake Forest was elected to membership on the
State Board of Health by the State Medical Society at its annual
meeting at Tarboro. Dr. Jones became at once an active "friend
and promoter of sanitary work." Due to his efforts, a meeting
of all county superintendents of health was called in Raleigh
early in the next session of the Legislature. One of the chief
purposes of the proposed meeting was to urge the enactment of
vital statistics legislation, and to procure a small appropriation
for printing.
Several epidemics of smallpox with numerous deaths were re-ported—
one of the most severe was in Clay and Graham counties.
1884. Dr. Wood, Secretary and Treasurer of the State Board of Health
made a pessimistic report this year. He said that "during the
year little more had been done than to issue pamphlets on the
subject of city sanitation." Dr. Wood pointed out that it was
impossible to inaugurate public health work to say nothing of
carrying it on without some money at least.
The State Medical Society adopted a resolution at its con-joint
session held in Raleigh requiring the President of the
Medical Society to appoint a committee "to go before the Legisla-ture
and request an adequate appropriation to be used by the
Board in behalf of the high and humane objects of the Board."
1885. General Assembly made county boards of health more efficient;
allowed printing privileges not to exceed $250 annually. Annual
appropriation, $2,000.
1886. The Health Bulletin made its appearance in April. Pamphlet on
"Care of Eyes and Ears," by Dr. Richard H. Lewis, printed and
distributed.
1887. Fear of yellow fever which had made its appearance late in the
year through the port of Key West, Florida, where a patient with
the disease had been smuggled in, was one of chief concern to
the Boai'd. Much interest and discussion in the BoJ\rd member-
North Carolina Board of Health 9
ship and throughout the state this year centered about the neces-sity
for providing some safe method of drinking water and
sewage disposal.
1888. Yellow fever epidemic in Florida and refugees to Western North
Carolina demonstrated value of a Board of Health to cope with
situation. Annual appropriation, $2,000.
1889. The chief item of interest and importance to the cause of public
health was a state-wide "sanitary convention" held in Raleigh
February 6. It was largely attended by physicians and others
from many cities and towns who were much concerned about the
problems of a pure water supply and sewage disposal. The Board
published an exhaustive paper by Dr. H. T. Bahnson of Salem,
President of the Board, entitled: "The Public Water Supply of
Towns and Cities in North Carolina."
Providing refuge for hundreds of people who had fled from
their homes farther south on account of yellow fever was a grave
problem.
1890. A widespread epidemic of influenza or as it was commonly called
at the time "grip" or "La Grippe," spread over the state in Jan-uary.
The epidemic appeared first in Russia about November 1,
1889. By December 15, 1889, 200,000 cases were reported in New
York alone. It struck North Carolina during the first week in
January and in two weeks time it was reported to be raging in
68 counties.
1891. Influenza continued to be present in all sections of the state through-out
the year. The conjoint session met in Asheville on May 27. The
term of Dr. W. D. Hilliard of Asheville as a member of the Board
expired this year. Dr. S. Westray Battle also of Asheville was
elected to succeed Dr. Hilliard. Dr. Thomas F. Wood was re-elected
Secretary and Treasurer for a term of six years.
1892. Dr. Thomas F. Wood, the Secretary of the Board, died August 22.
Dr. Richard H. Lewis elected Secretary to succeed Dr. Thomas F.
Wood, September 7. Annual appropriation, $2,000.
1893. Legislative provisions, (1) Laws improving the reporting of con-tagious
diseases, (2) the protection of school children from epi-demics,
(3) protecting the purity of public water supplies, and
(4) regulation of common carriers. Legislature provided that
the Governor appoint five of the nine members of the Board of
Health, that the State Medical Society elect four, and that the
term of office of the members of the State Board of Health be
six years. The $250 printing limit was removed. Pamphlet on
quarantine and disinfection was prepared and reprinted by many
of the state papers. Annual appropriation, $2,000.
1894. A number of public health conferences were arranged and held in
different towns of the state. Bulletin was increased from a mailing
list of 800 to 1,200. Annual appropriation, $2,000.
10 Thirty-Second Biennial Report
1895. Dr. Albert Anderson and Dr. W. T. Pate were elected bacteriologists
for the Board. Annual appropriation, $2,000.
1896. Board passed a resolution requiring- chemical and bacteriological
examinations of municipal water supplies. Dr. Venable, of Chapel
Hill, undertook the chemical examination, and Drs. Anderson
and Pate the bacteriological examination. Board also directed
Mr. John C. Chase, the engineer member, to inspect all municipal
water plants in the state. Annual appropriation, $2,000.
1897. General Assembly enacted law requiring county superintendents
of health to be elected by county commissioners and reduced term
of office to one year. Annual appropriation, $2,000.
1898. The address of the President of the North Carolina Medical Society
this year by Dr. Francis Duffy of New Bern was devoted almost
exclusively to the promotion of public health. It really marked an
epoch as sounding an advanced note in the advancement of human
progress.
The State Health Officer, Dr. R. H. Lewis, devoted a great deal
of time and energy to try to arouse the people of the state to the
necessity for vaccination against smallpox.
1899. General Assembly improved the laws protecting public water sup-plies.
Smallpox prevailed extensively in the state. Dr. Henry F.
Long, and later, on Dr. Long's resignation, Dr. Joshua Tayloe.
were employed to travel over the state, consulting with and
advising the local sanitary authorities as to proper means for
protecting the public. Annual appropriation, $2,000.
1900. State Board of Agriculture, on request of State Board of Health.
agreed to examine samples of water from public water supplies
until Board of Health could provide its own examiner. Annual
appropriation, $2,000.
1901. State Board of Embalmers, with representatives of State Board of
Health, established. County health work placed in the hands of
county sanitary committees composed of county commissioners
and two physicians which commissioners elected to serve with
them. Term of office of county superintendent of health made two
years. Annual appropriation, $2,000.
1902. This year will be long remembered for the widespread prevalence
of smallpox in virulent form. It caused many deaths in different
sections in the early months of the year. In one county at least
fifty people died, including many well-to-do men. Not having any
system of vital statistics reports, it is impossible to even estimate
the number of cases, except from physicians' voluntary reports
and death notices in the newspapers.
1903. General Assembly enacted law permitting Board of Health to
charge $5 for each analysis of a public water supply, this fee to
be used in paying Department of Agriculture for services of ex-
North Carolina Board of Health 11
aminer. Dr. C. W. Stiles, U.S. P.H.S., before the State Medical
Society at Hot Springs, called attention to prevalence of hook-worm
disease in the South. Dr. J. L. Nicholson and Dr. W. S.
Rankin, working under State Board of Health during fall of 1903
and spring of 1904, showed great prevalence of this disease in
North Carolina. Annual appropriation, $2,000.
1904. A stenographer was employed. One hundred and twenty thousand
pamphlets on tuberculosis were printed and distributed. There
was a renewal and an extension of cooperative work between the
Board of Health and the state press, a number of articles deal-ing
with hygienic and sanitary subjects being furnished the
papers and published in them. Annual appropriation, $2,000.
1905. General Assembly established State Laboratory of Hygiene; im-posed
water tax of $64 on all public water companies; voted $600
annually for the support of laboratory. Small appropriation made
it necessary for the Department of Agriculture to continue to
assist State Board of Health. Annual appropriation, $2,000.
1906. The North Carolina Association for the Study and Prevention of
Tuberculosis was organized. Annual appropriation, $2,000.
1907. Two thousand dollars appropriated for the State Laboratory of
Hygiene. Pasteur treatment provided. State Sanatorium for treat-ment
of tuberculosis founded; $15,000 appropriated for perman-ent
improvements and $5,000 for maintenance. A law requiring
the separation of tuberculosis prisoners from other prisoners was
enacted. Annual appropriation, $4,000.
1908. January 1, Dr. C. A. Shore became Director of State Laboratory
of Hygiene. Annual appropriation, $4,000.
1909. General Assembly provided for (1) whole-time State Health Of-ficer;
(2) collection of vital statistics of towns having a popula-tion
of 1,000 or over; (3) that all public water companies file
plans and specifications of their plants with the State Board of
Health, and that the State Board of Health pass necessary rules
and regulations for the care of public watersheds and plants and
furnish such rules and regulations and other advice to those hav-ing
charge of public water supplies; (4) that counties provide
free diphtheria antitoxin for county indigents, and (5) that the
maintenance appropriation for the Sanatorium be increased from
$5,000 to $7,500, and an additional $30,000 be granted for perman-ent
improvements. Dr. Richard H. Lewis resigned as Secretary
of the Board, and Dr. W. S. Rankin was elected as his successor,
beginning his official work July 1. Annual appropriation, $10,500.
1910. General effort to interest the people and state oi-ganizations in
public health work. Bulletin increased from 3,500 edition to 10,-
500 edition. Addresses on public health work delivered to Con-ference
of County Superintendents of Schools, State Federation of
Women's Clubs, State Press Association, and Sanitary Sunday
12 Thirty-Second Biennial Report
observed in April. Dr. John A. Ferrell elected, February, Assist-ant
Secretary for Hookworm Eradication; began work under
State Board of Health and Rockefeller Sanitary Commission.
1911. Legislature established county boards of health to take the place of
the county sanitary committees; county board of health com-posed
of chairman board of county commissioners; county super-intendent
of schools, mayor of county town, and two physicians
selected by the three county officials to serve with them. Legisla-ture
also abolished quarantine for smallpox and improved the
quarantine laws. One thousand dollars annually appropriated
to contract with antitoxin manufacturers for state supply of
high-grade diphtheria antitoxin, with result that price of anti-toxin
was cut to one-fourth former price, saving the citizens of the
state over $30,000 annually. Bulletin increased from 11,500 copies
to 20,000 copies each edition ; closer cooperation with press of
state developed; regular weekly press articles prepared and sent
to papers; increase in numbers of popular pamphlets for distri-bution.
Hookworm this year largely educational through the
school forces and investigated through county dispensaries;
thousands of children found infected and treated. Strong senti-ment
began to make itself felt for better health work by counties,
four counties employing whole-time county health officers. Guil-ford
County—one of the four—began its work June 1 and was
the first county in the United States to inaugurate full-time
county health work. Maintenance appropriation for State Sana-torium
increased to $12,500, with $20,000 voted for permanent
improvements. Annual appropriation, $22,500.
1912. Bulletin increased to 40,000 edition; number of popular pamphlets
dealing with different diseases increased; press work improved;
educational work of Board along all lines amplified. Secretary
of Board of Health called attention of conjoint meeting of State
Medical Society and State Board of Health to the relative im-portance
of health problems and the bearing of this subject upon
the proper apportionment of health funds; instrumental in pass-ing
a resolution to the effect that pellagra was an interstate
problem, not a state problem, and requesting the Federal Govern-ment
to deal with pellagra as a Federal problem; resolution
responsible, to considerable extent, for successful effort on part
of Hon. John M. Faison's securing Congressional appropriation
of $45,000 for the study of pellagra by the Federal Government.
Hookworm work extended and county funds appropriated to sup-plement
state and Rockefeller Foundation for this work. Annual
appropriation, $22,500.
1913. General Assembly passed Model Vital Statistics Law with $10,000
appropriation for its enforcement. County superintendent of
health changed to either county physician or county health officer,
depending on whether part-time or full-time service. Educational
efforts of Board continued and enlarged. Hookworm work along
North Carolina Board of Health 13
same line as year before increased in amount. Dr. John A. Fer-rell
resigned as Assistant Secretary to accept position with the
central office of the Rockefeller Sanitary Commission in Wash-ington,
D. C. Dr. C. L. Pridgen succeeded Dr. Ferrell. The move-ment
for improved county health work had by this time resulted
in ten counties electing wholetime county health officers. The
State Sanatorium for Treatment of Tuberculosis turned over by
Extra Session of 1913 to the management of State Board of
Health. Annual appropriation, $40,500.
1914. Preceeding work of the Board continued. Board of Health took over
management of Sanatorium; started out under many difficulties
on account of the institution owing many debts and the appro-priation
being limited. Hookworm work changed to community
work directed to the installation of sanitary privies in all homes.
Laboratory began to produce and distribute free anti-typhoid
vaccine. Dr. C. L. Piidgen resigned as Director Hookworm Eradi-cation,
and Dr. W. P. Jacocks succeeded him. Annual appropria-tion,
$40,500.
1915. General Assembly makes state vital statistics law conform to na-tional
model by requiring burial permits in rural communities;
enacts legislation permitting county commissioners and towns
and cities to appropriate money for support of tuberculosis
citizens in State Sanatorium; provides $15,000 for purchase and
building of antitoxin plant; appropriates $60,000 for payment of
Sanatorium debts and new buildings and other improvements,
and $25,000 annually for maintenance and $10,000 for extension
anti-tuberculosis work. Educational work greatly extended: Bul-letin
now 47,000; traveling public health exhibit shown at fairs
and other assemblages ; press work greatly developed through
employment of Miss Kate Herring, a journalist, for her whole
time; stock lectures with lantern slides supplied public speakers
in different parts of the state; community soil pollution work
under Dr. W. P. Jacocks stops in April, and Bureau of Rural San-itation,
with Dr. G. M. Cooper at its head, succeeds, beginning
work May 1. Considerable amount of work done for improvement
of prison conditions. The unit system of county health work gets
a good start; over 52,000 people given three complete vaccina-tions
against typhoid fever, and medical inspection of schools put
on in six counties. Annual appropriation, $50,500.
1916. North Carolina was admitted to the Registration Area for deaths.
To the educational agencies of the Board was added a self-sup-porting
moving picture health show. Many saw this show during
the year and, seeing, believed in health work as never before.
Bulletin reached 51,000 edition. Cooperation with University in
developing a plan and putting on a home post-graduate course
in medicine, giving first course to 169 doctors. Put into operation
an optional system of hotel inspection, with grading and publish-ing
scores. Continued Bureau of Rural Sanitation, giving three
14 Thirty-Second Biennial Report
anti-typhoid injections to 48,000, making 100,000 immunized in
summers of 1915 and 1916. Did complete medical inspection of
six counties and with inspection a large amount of educational
work as to sanitary and hygienic living. Secured effort by Federal
Children's Bureau to develop unit of child hygiene work, the
Bureau using two employees to work in Cumberland and Swain
counties for about eight months. Laboratory of Hygiene buys
land and erects its own building. Annual appropriation, $55,500.
1917. The General Assembly passed the following important health
legislation: Chapter 263, entitled "An act to prevent and control
the occurrence of certain infectious diseases in North Carolina";
Chapter 244, entitled "An act to provide for the physical exami-nation
of the school children of the state at regular intervals";
Chapter 276, entitled "An act for the cooperative and effective
development of rural sanitation"; Chapter 257, entitled "An act
to prevent blindness in infancy, designating certain powers and
duties and otherwise providing for the enforcement of this act";
Chapter 66, entitled "An act to provide for the sanitary inspec-tion
and conduct of hotels and restaurants"; Chapter 286, entitled
"An act to regulate the treatment, handling and work of
prisoners." Following the enactment of this legislation, admin-istrative
machinery, consisting of a Bureau of Epidemiology
under the direction of Dr. A. McR. Crouch, a Bureau for the
Medical Inspection of Schools under the direction of Dr. Geo. M.
Cooper, and a Bureau for County Health work, under the direc-tion
of Dr. B. E. Washburn, was established. Dr. Washburn, an
officer of the International Health Board, was loaned to the state
without cost, and the International Health Board, in addition to
furnishing Dr. Washburn, appropriated $15,000 annually for
County Health Work in accordance with the provisions of Chap-ter
276.
The United States Public Health Service in February, 1917, de-tailed
Dr. K. E. Miller to study county health work in different
sections of the country and to establish for demonstration pur-poses,
in Edgecombe County, a department of health on an
economic basis easily within the financial reach of the average
county.
The State Laboratory of Hygiene moved into its own building
January 15, 1917.
The state was admitted to the registration area of the Union
for births in January, 1917, the Bureau of the Census having
found after investigation that our birth registration was 96 per
cent complete.
The special campaign against typhoid fever began so satisfac-torily
in 1915 was continued. Free vaccination of the people, how-ever,
was interfered with by the difficulty in securing medical
officers to do the work, the preparedness program of the Govern-ment
having caused many physicians and nurses to enter the
army and navy; nevertheless, a total of 30,000 citizens of the
North Carolina Board of Health 15
state were vaccinated as a direct result of the Board's activities,
and many thousands of others were vaccinated by the physicians
of the state as a result of the educational work of the Board
directed to impressing the people with the value of vaccination
as a means of prevention for typhoid fever.
In December, 1917, life extension work, which consisted briefly
of the free physical examination of interested citizens for the
purpose of advising them as to their physical condition and needed
hygiene reform and medical treatment, was begun on a county
basis. The funds necessary for this work were appropriated partly
by the state and partly by the counties in which the life exten-sion
work was carried out. Dr. Amzi J. Ellington, of Raleigh,
who at the time was a resident physician in the New York City
Hospital, was employed and placed in charge of the work. Life
extension work was carried out in Vance, Alamance, Lenoir, and
Robeson counties, and resulted in the full physical examination
of 4,000 citizens. This work was very favorably received, and the
outlook for its continued development seemed excellent when, with
the declaration of war and the call for physicians to enter the
military service of the country, Dr. Ellington enlisted in the Medi-cal
Corps of the Army. For this reason, and for the further rea-son
that it has been almost impossible to secure health officers
during the past two years, the work was not resumed.
The educational work of the State Board of Health consisted
in the issuance of eight issues of the Monthly Health Bulletin,
each monthly edition amounting to 45,000, and a daily newspaper
health article. The Bureau continued its moving picture show ex-hibit.
Arrangements were made for the preparation of news-paper
plate, which was sent to and extensively used by 202 papers
having a total circulation of 303,000.
The annual appropriation for the State Board of Health was
$60,772.16. The annual appropriation for the State Laboratory
of Hygiene was $12,500. and this, in addition to $9,087.22 in fees
permitted under the laws of the state to be paid to the Labora-tory
for special work, provided the Laboratory with a total annual
budget of $21,587.22.
1918. Much of the work this year was influenced by the war and has to
do with preparedness. The State Health Officer visited Washing-ton,
at the request of the Council of National Defense and as
chairman of a committee of State Health Officers, on a number
of occasions for conferences with respect to preparedness meas-ures,
provisions for the control of venereal diseases, arrange-ments
for coordinating the control of infectious diseases in the
civilian population with their control in cantonments, and to ar-range,
if possible, with the Public Health Service and the Sur-geon-
General of the Army for preserving the personnel of state
health departments during the war.
Considerable time was given to assisting Major John W. Long,
Medical Aide to the Governor, in the work of organizing the
16 Thirty-Second Biennial Report
Medical Advisory Boards and in interesting physicians in enter-ing
the medical service of the Army and Navy, and later in the
year, in inducing- the physicians of the state to become members
of the Volunteer Medical Service Corps.
Partly as a result of these activities, the Surgeon-General of
the Army assigned Major Joseph J. Kinyoun to assist the State
Board of Health in the control of communicable diseases, the
Board being under no financial obligation for Major Kinyoun's
assistance; and as a result of the successful termination of the
activities of various interests looking to more effective control
of venereal diseases, the Kahn-Chamberlain bill passed Congress,
and made available to the State of North Carolina, and without
condition, $23,988.61 for venereal disease work.
The Laboratory during this year began the distribution of a
high grade of diphteria antitoxin.
The Bureau of Medical Inspection of Schools, under the direc-tion
of Dr. G. M. Cooper, developed, and with a degree of success
that we may say established, free dental clinics for the public
schools of the state. The Bureau also developed to a successful
extent an arrangement in the form of adenoid and tonsil clubs
for the practical and economic treatment of public school children
suffering from these defects.
The Bureau of Epidemiology employed two third-year medical
students, equipped them with motorcycles, and put them into the
field to investigate infringements of the quarantine law. Sufficient
convictions were obtained to impress the people with the determi-nation
of the state to enforce its health laws, and a fairly satis-factory
compliance with the laws regarding the reporting of com-municable
diseases was brought about.
The Bureau of Venereal Diseases, paid for by the Federal ap-propriation,
was established in September under the directorship
of Dr. James A. Keiger.
Mr. Warren H. Booker, for the last seven years the efficient
director of the Bureau of Engineering and Education, left in
September for Red Cross work in France, the work of his bureau
being continued, with the exception of the engineering work, by
Mr. Ronald B. Wilson, who had been employed earlier in the year
to succeed Miss Herring in assisting Mr. Booker with the jour-nalistic
work, Miss Herring having been engaged by the War De-partment
for educational work.
Perhaps the most outstanding feature of the health work dur-ing
the year 1918 was the epidemic of influenza. The epidemic
began early in October and caused in October alone 6,056 deaths;
in November 2,133 deaths, and in December 1,497 deaths, a total
during the last three months of 9,686 deaths.
The annual appropriation for the State Board of Health for
1918 was $73,210.38.
North Carolina Board of Health 17
The annual appropriation for the State Laboratory of Hygiene
was $12,500. The Laboratory, during this year, collected $8,532.48
in fees for special work, so that the total income of the Labora-tory
for this year was $21,032.48.
1919. The General Assembly passed the following important health
legislation: Chapter 71, entitled "An act to prevent the spread of
disease from insanitary privies"; Chapter 192 entitled "An act to
provide for the physical examination and treatment of the school
children of the state at regular intervals"; Chapter 206 entitled
"An act for the prevention of venereal diseases"; Chapter 213,
entitled "An act to require the provision of adequate sanitary
equipment for public schools"; Chapter 214, entitled "An act to
obtain reports of persons infected with venereal diseases"; Chap-ter
215, entitled "An act to amend Chapter 671, Public-Local
Laws of 1913, relating to the injunction and abatement of certain
nuisances."
The Bureau of Engineering and Inspection was organized in
April. The engineering work of the Board had been suspended
with the resignation of Mr. Warren H. Booker in September,
1918, Mr. Booker having gone to France to engage in tuberculosis
work under the direction of the Red Cross. Between September.
1918, and April, 1919, the engineering problems coming before
the Board had been referred and very kindly and effectively taken
care of by Col. J. L. Ludlow of Winston-Salem, the engineer mem-ber
of the Board. Mr. H. E. Miller, an engineer and a graduate
of the University of Michigan, was placed in charge of the new
bureau, and his brother, Dr. K. E. Miller, of the United States
Public Health Service, was detailed by the Service to assist him
in the organization of his work. Mr. H. E. Miller and Dr. K. E.
Miller spent the spring and summer and a part of the fall in
studying various types of privies, in preparing plans for the
construction and maintenance of privies, and in preparing the
necessary notices and literature to inform the people of the objects
and requirements of the new privy law.
On May 1 Dr. A. J. Warren, health officer of Rowan County,
was appointed to and accepted the position of Assistant Secretary
of the Board.
About the first of the year, Miss Herring returned to the edu-cational
work of the Board. After a few months she returned
to the Federal Service, and Mr. R. B. Wilson, who had left the
Board work upon Miss Herring's return, was again offered a
place with the Board. Mr. Wilson accepted and assumed his
duties on July 1.
On August 1 Dr. A. McR. Crouch, Director of the Bureau of
Epidemiology, resigned to accept a position with the city of Wil-mington.
Dr. F. M. Register, whole-time health officer of North-ampton
County, succeeded Dr. Crouch as director of the bureau.
18 Thirty-Second Biennial Report
Dr. E. J. Wood resigned this year, effective at the end of his
term, and Governor Bickett appointed Dr. E. J. Tucker of Rox-boro
for a six years term—first dentist to serve on the Board.
In September Dr. J. R. Gordon, Director of the Bureau of Vital
Statistics since 1914, resigned on account of impaired health, and
on October 1 the Bureau of Epidemiology and the Bureau of Vital
Statistics were combined and placed under the direction of Dr.
Register.
In September Mrs. Kate Brew Vaughn, Director of the Bureau
of Infant Hygiene, resigned. The bureau was reorganized under
an understanding with the American Red Cross and was enlarged
to include, in addition to infant hygiene, the problem of public
health nursing, the name of the bureau being changed to that
of "Bureau of Public Health Nursing and Infant Hygiene."
Under the agreement with the Red Cross this bureau was to
have an available appropriation of $12,000 a year, half of which
was to be furnished by the American Red Cross and half by the
State Board of Health. The personnel of the bureau and its plan
of work, under the agreement, was made contingent upon the
approval of both participating agencies, the American Red Cross
and the State Board of Health. In December Miss Rose M. Ehren-feld
took charge of the new bureau and began its organization
and work.
On October 1 Dr. Jas. A. Keiger, Director of the Bureau of
Venereal Diseases, resigned and Dr. Millard Knowlton was ap-pointed
to succeed him.
The typhoid campaign carried on during the summer through
previous years was continued in the summer of 1919, using third-year
medical students, furnished either with automobiles or motor-cycles
for getting about. Campaigns were carried out in the fol-lowing
counties : Bertie, Cabarrus, Chatham, Chowan, Columbus,
Craven, Hertford, Iredell, Johnston, Lincoln, Onslow, Pasquo-tank,
Perquimans, Randolph, Richmond, Rockingham, Stanly,
Union, Warren, Wayne. A total of 49,076 were given complete
vaccination.
The educational work of the Board consisted of the publication
of a 48,000 monthly edition of the Bulletin, and the distribution
of about 350,000 pieces of public health literature.
The funds available during this fiscal year amounted to $198,-
549.14, of which $102,301.98 was from state appropriations and
the remainder from outside sources.
The appropriation for the State Laboratory of Hygiene for
this year was $28,500 ; in addition to this, the Laboratory collected
in fees for special work, for antitoxin, and in water taxes a total
of $14,344.02, making a total of $42,844.02 available for work of
Laboratory.
1920. During this year there was a Special Session of the General
Assembly, lasting twenty days and held in the latter part of
August. This Special session passed an act amending the vital
North Carolina Board of Health 19
statistics law, making the fees for local registrars 50 cents instead
of 25 cents for each certificate properly filed with the State Board
of Health.
On January 1 Dr. B. E. Washburn, who had had general direc-tion
of the cooperative county health work and who had ren-dered
most acceptable service, was recalled by the International
Health Board and detailed to take charge of their interests in
Jamaica. Dr. K. E. Miller, of the United States Public Health
Service, who had been detailed in January, 1917, to organize a
model county health department in Edgecombe County and then,
in 1919, to assist his brother, Mr. H. E. Miller, in organizing
the work of the new Bureau of Engineering and Inspection, to
which was assigned the duty of enforcing the state-wide privy
act, succeeded Dr. Washburn as director of the Bureau of County
Health Work.
In January a cooperative effort with the United States Pub-lic
Health Service and the International Health Board to demon-strate
the possibilities and advantage of the eradication of ma-laria
from certain towns and cities in the eastern part of the
state was begun. The terms of cooperation were that the Inter-national
Health Board and the State Board of Health were to
pay one-half of the expenses of the local work and the town or
city in which the work was done the other half, the Public Health
Service furnishing, as its part, expert supervising personnel.
The towns and cities chosen for this work were Goldsboro, Farm-ville,
and Greenville, the budget for each municipality being re-spectively:
Goldsboro, $13,670.98; Farmville, $5,000, and Green-ville,
$9,000, a total investment in this work of $27,670.98. Mr.
W. A. Fuchs, Associate Sanitary Engineer, was detailed by the
Service to have supervision of the work.
In February Dr. A. J. Warren, Assistant Secretary of the
State Board of Health, resigned his position in order to accept
the appointment of city health officer of Charlotte, N. C.
In the winter and spring of 1920 the North Carolina Land-owners
Association, under the progressive leadership of Mr. W. A.
McGirt, of Wilmington, undertook a very extensive educational
campaign against malaria, which was carried on through the pub-lic
schools of thirty-eight counties in eastern North Carolina. A
series of county and state prizes for the best essay on malaria by
public school children were offered as an inducement to the school
children to interest and inform themselves and, indirectly, their
parents with regard to the importance of this disease. To make
possible this work by the school children 75,000 malaria catechisms,
prepared by Dr. H. R. Carter, of the United States Public Health
Service, were distributed through the public schools of the eastern
part of the state to the school children. Thousands of essays
were written, and it is reasonable to believe that the campaign
was one of the most successful public health educational attempts
yet undertaken.
20 Thirty-Second Biennial Report
In June it was found advisable to separate the Bureau of Epi-demiology
and the Bureau of Vital Statistics which had, on account
of the scarcity of health officers, been placed under the director-ship
of a single bureau chief, Dr. F. M. Register. Dr. Register
was appointed Director of the Bureau of Vital Statistics and Dr.
J. S. Mitchener was appointed Director of the Bureau of Epi-demiology.
In April the Interdepartmental Social Hygiene Board assigned
to the State Board of Health several workers for making a study
of vice conditions in North Carolina towns and cities and for
taking such steps as were found expedient for decreasing prosti-tution.
This group of workers was withdrawn in September on
account of differences developing between them and Dr. Knowlton,
chief of the Bureau of Venereal Diseases, with the understanding
that another group of workers would be assigned to this work at
a later date.
In June arrangements were made with the United States Pub-lic
Health Service and the American Social Hygiene Association
for the development of an elaborate educational unit on sex
hygiene and venereal diseases designed to reach rural meetings
through the use of picture films and a portable truck. An outfit
consisting of several lecturers and a moving picture truck began
work in Cumberland County in August, and from its very begin-ning
met a most cordial reception and gave every promise of
developing into one of the most useful agencies for dealing with
the venereal disease problem.
During the year anti-typhoid vaccination campaign was con-tinued
in Alamance, Bladen, Columbus, Duplin, Franklin. Gaston,
Harnett, and Mecklenburg counties. Cooperative campaigns, in
which the counties furnished the working personnel, were also
carried on in Anson, Johnston and Rutherford counties. A total
of 29,435 citizens have been vaccinated against the disease, and
this does not include Columbus County, in which the work was
just beginning when this report was completed.
The educational work of the State Board of Health during this
year consisted of a 48,000 monthly edition of the State Board of
Health Bulletin and the distribution of approximately 350,000
pieces of public health literature.
The funds available during this fiscal year amounted to $342,-
284.33, of which $176,152.61 was state appropriation and the re-mainder
from outside sources.
The appropriation for the State Laboratory of Hygiene for
this year was $25,000; in addition to this, the Laboratory col-lected
in fees for special work, for antitoxin and in water taxes,
a total of $13,698.89, making a total of $38,698.89 available for
the work of the Laboratory. The above amount being insufficient,
the Special Session of the Legislature authorized a loan of $15,000
to enable the work of the Laboratory to be carried on, making a
total of $53,698.89 available for the work of the Laboratory during
this year.
North Carolina Board of Health 21
1921. The Legislature meeting early in January of this year was asked
by the Board to amend the state law restricting the salary of
the executive officer of the Board to $3,000 annually, so as to
make the salary $5,000. Such an amendment was passed. A
further request from the Board was that legislation be enacted
removing the inspection tax of forty cents from privies coming
under the supervision of the Board of Health. Such an amend-ment
to the State-wide Privy Law was also enacted. A bill was
introduced in this session of the General Assembly under the
initiative of Hon. Emmet H. Bellamy requiring a physical exami-nation
of all applicants for marriage and making issuance of
license contingent upon the physical qualifications of the applicant.
The State Board of Health approved and supported Mr. Bellamy's
bill, realizing, as did the author of the bill, that the proposed leg-islation
was but a step in the right direction and was, therefore,
rather loosely drawn and left many things to be desired. The bill
finally passed in amended form as Chapter 129, Public Laws
of 1921.
The Governor appointed Mr. Chas. E. Waddell, an engineer of
Asheville, to succeed Col. J. L. Ludlow as the engineer member
of the Board.
Perhaps the most important change inaugurated in state health
administration during this year was the adoption of a cost basis
for standardizing and measuring the efficiency of public health
work in those counties in which the state participated financially.
This new principle is fully described in the State Board of Health
Bulletin for January, 1922, and a further discussion of cost basis
for public health work is unnecessary here except, perhaps, to say
that it is apparently at least one of the first attempts to introduce
the cost system of industry into government.
The Bureau of Venereal Diseases, in charge of Dr. Millard
Knowlton, established as a part of the war-time activities of the
Board in cooperation with the Bureau of Venereal Diseases of the
Federal Government, was combined with and made a part of the
work of the Bureau of Epidemiology, under the general direction
of Dr. J. S. Mitchener.
Funds available for the year included state appropriation,
$275,000; miscellaneous receipts, $164,184.42; total, $439,184.42.
1922. In order to bring the records of this department into harmony with
those of other state departments, in accordance with the Act of
the General Assembly of 1921, changing the fiscal year of the
state so as to begin on July 1 each year, this report ends with
June 30, 1922. It, therefore, covers a period of nineteen months,
one full fiscal year from December 1, 1920, to November 30, 1921
;
seven months from December 1, 1921, to June 30, 1922. Effective
February 1, the American Red Cross Society abrogated the agree-ment
existing since 1919 by which it jointly financed, with the
Board of Health, the Bureau of Public Health Nursing and Infant
Hygiene. This bureau was reorganized April 1 as the Bureau of
22 Thirty-Second Biennial Report
Maternity and Infancy, fox- its maintenance the state receiving
$27,259.66 annually from the United States Government in accord-ance
with the Sheppard-Towner Act for the promotion of the wel-fare
of mothers and infants, Dr. ,K. P. B. Bonner, of Morehead
City, was secured as the director of the reorganized bureau, with
Miss Rose M. Ehrenfeld as supervisor of nursing and Mrs. T. W.
Bickett in charge of educational work.
The funds available during this period, and their distribution
were seven-twelfths of the amounts set out under the tabulation
for 1921.
The appropriation for the State Laboratory of Hygiene for the
nineteen months between December 1, 1920, and June 30, 1932,
was $87,083.33; in addition to this, the Laboratory collected in
fees for special work, for antitoxin and in water taxes, a total
of $30,872.51, making a total of $117,955.84 available for the work
of the Laboratory.
1923. The General Assembly of 1923 enacted some important and far-reaching
legislation affecting public health work in North Carolina.
The most important legislation enacted this year was the act pro-viding
for an independent board of directors for the State Sana-torium
for Tuberculosis, removing the direction of that institu-tion
from the authority of the State Board of Health. Facilities
were also provided at the State Sanatorium for the confinement,
care, and treatment of tuberculosis convicts. Other legislation in-cluded
the act to provide for the sanitary manufacture of bedding,
the latter act to be enforced by the State Board of Health. The
Bureau of Epidemiology was again combined with the Bureau of
Vital Statistics.
On March 1 Dr. G. M. Cooper was made Assistant Secretary
of the State Board of Health, and Dr. J. S. Mitchener was assigned
to the Bureau of Medical Inspection of Schools, after the con-solidation
of the Epidemiology work, which he had directed with
the Bureau of Vital Statistics. Dr. K. E. Miller, of the United
States Public Health Service, was recalled for duty elsewhere.
In order to experiment with the plan of District Health Work,
an effort was made to place responsibility for all State Board of
Health activities under the direction of district directors attached
to the staff of the State Board of Health. This effort was con-tinued
throughout the year, but proved to be ineffective and un-satisfactory.
During the year Dr. F. R. Harris resigned from membership on
the State Board of Health to become health officer of Vance
County. The Board elected Dr. D. A. Stanton, of High Point, to
fill the unexpired term of Dr. Harris.
In order to further carry on the important work of malaria
control in a number of the counties of the coastal plain area of
the state, which work was so effectively commenced in an educa-tional
capacity in 1920, the Intei-national Health Board was re-quested
to participate in this work and to provide a director for
North Carolina Board of Health 23
that service. The Intei-national Health Board agreed, accepted the
invitation and assigned Dr. H. A. Taylor, of Alabama, to head this
division. Pamlico County was selected as headquarters for Dr.
Taylor. The cost of this work was borne by the State Board of
Health and Pamlico County contributing 40 per cent, each and the
International Board the remaining 20 per cent. The International
Health Board, of course, paid the salary of Dr. Taylor.
In June Dr. J. S. Mitchener resigned as director of the Bureau
of Medical Inspection of Schools and Dr. Roy C. Mitchell, who
had been doing some special educational field work for the Board,
temporarily succeeded Dr. Mitchener.
Early in 1923 Dr. W. S. Rankin, the State Health Officer, was
invited by the Committee of Municipal Health Department Prac-tice
of the American Public Health Association to become field
director for the committee in making a study of municipal health
practices in the United States. This was for the purpose of work-ing
out a basis or set of principles through which city health de-partments
could be given classification or grading, and also for
the purpose of assisting such departments in their organization
work. The request was brought before a special meeting of the
executive committee of the Board, and it directed the Secretary
to take advantage of the opportunity offered. The Board granted
to the Secretary one year's leave of absence, but requested him
at the same time to continue in touch as executive officer of the
Board with the work of the Board.
On November 1 Dr. Rankin assumed his duties and established
official headquarters in New York City for the work of the
committee.
The general organization of the executive staff of the Board
was continued with the Assistant Secretary, Dr. G. M. Cooper,
as official head of the staff. Local health work in the eastern half
of the state was directed by Dr. H. A. Taylor, and that in the
western part of the state by Dr. E. F. Long, who had been assist-ant
to Dr. K. E. Miller as director of county health work. To
assist Dr. Taylor in the east, Dr. George Collins, formerly health
officer of Mecklenburg County, was employed, and to assist Dr.
Long in the western half of the state Dr. C. N. Sisk, formerly
health officer of Forsyth County, was employed.
During the year a plan for the more adequate sanitary control
of public milk supplies in the state was formulated. This work
was undertaken under the direction of the Bureau of Engineering
and Inspection, and Mr. Malcolm Lewis was employed to organize
this work. Several changes in personnel took place this year.
Dr. M. L. Isley, who had been employed in county health depart-ment
work, and Dr. Roy C. Mitchell resigned. Miss Rose Ehren-feld
also resigned.
1924. During this year Dr. Rankin continued his work with the American
Public Health Association until November 1. During this period
the work of the Board was directed by Dr. G. M. Cooper, serving
24 Thirty-Second Biennial Report
as Acting Secretary. On November 1 Dr. Rankin returned, and
during that month, under the direction of Dr. Maxey of the United
States Public Health Service, a school for health officers was con-ducted
under the auspices of the State Board of Health for one
week in Raleigh. This meeting was well attended, and every
modern method which might be utilized in the work of a modern
public health department was discussed throughout the week.
Dr. M. L. Townsend was placed in charge of the Division of
Health Education. Dr. K. P. B. Bonner resigned as director of
the Bureau of Maternity and Infancy.
1925. Dr. Rankin resigned, effective June 1, to accept the position of
director of the Hospital and Orphan Division of the Duke Founda-tion.
At a meeting of the Board of Health on May 30 Dr. G. M.
Cooper was unanimously made Acting Secretary for an indefinite
period of time to succeed Dr. Rankin. During the year Dr. E. F.
Long resigned as director of county health work and Dr. C. X.
Sisk, who had been assistant to Dr. Long, was placed in charge
of county health work, without an assistant.
1926. On June 21 Dr. Charles O'H. Laughinghouse, a member of the
Board, was elected permanent Secretary and State Health Officer
to fill the unexpired term of Dr. Rankin. Dr. Laughinghouse ac-cepted
and took office October 1. Dr. G. M. Cooper, who had for
sixteen months administered the work of the Board as Acting
State Health Officer, continued with the service and was assigned
to the Bureau of Health Education succeeding Dr. M. L. Town-send,
who resigned. On August 6 Dr. Richard H. Lewis died.
Dr. Lewis had served as a member of the Board since 1885, and
from 1892 to 1909 he served as Secretary of the Board. Since
1909 he had been a member of the executive committee. Dr. Lewis
held his membership on the Board by appointment from the Gov-ernor.
To fill the term of Dr. Lewis, expiring in 1931, Governor
McLean appointed Dr. John B. Wright, of Raleigh. Among other
reasons assigned for this appointment, the Governor stated that
it had been the rule since the Board of Health was established to
have at least one of the members of the Board a resident of
Raleigh.
When Dr. Laughinghouse resigned, in order to accept the elec-tion
to the position of State Health Officer by his fellow members
on the Board, the remaining members of the Board elected Dr.
W. S. Rankin, of Charlotte, former Secretary of the Board to
succeed Dr. Laughinghouse.
1927. There were no changes in personnel or in staff organizations during
the year 1927. The most important event occurring this year was
the death of Dr. J. Howell Way on September 22. Dr. Way had
been a member of the Board for many years and had been Presi-dent
of the Board for a long time. Governor McLean appointed
Dr. C. C. Orr, of Asheville, to succeed Dr. Way. At the first meet-ing
of the State Board of Health following the death of Dr. Way,
North Carolina Board of Health 25
Dr. A. J. Crowell, of Charlotte, was made President of the Board.
In April of this year Dr. W. S. Rankin resigned as a member of
the Board, and Dr. L. E. McDaniel, of Jackson, was elected by the
other members of the Board to succeed Dr. Rankin.
1928. Dr. J. C. Johnson, who had been director of the Oral Hygiene
Division, resigned as director of the oral hygiene work of the
Board, effective December 31.
During this year a corps of nurses employed in the Maternity
and Infancy Division of the Board, one-half of whose expenses
were paid by the Federal Government from Sheppard-Towner
funds, held midwife classes in about thirty counties of the state.
The nurses gave special instruction to midwives in groups, and
the county authorities enacted midwife rules and regulations for
the control of their practice.
The educational work of the Board was of a high order during
this year. A thirty-two page Bulletin was issued monthly, and a
moving picture machine with several films en modern health
subjects was exhibited in many sections of the state.
1929. With aid secured from the International Health Board, the Life Ex-tension
Division was added to the activities of the Board this
year. Dr. Frederick R. Taylor, of High Point, was made director
of this division. Dr. Taylor carried this work before the medical
profession in all sections of the state.
On January 1 Dr. Ernest A. Branch accepted the appointment
as director of the Division of Oral Hygiene to succeed Dr. J. C.
Johnson, resigned. Dr. Branch immediately set in motion reorgani-zation
plans for the oral hygiene work to include more lectures
and more educational demonstration work. Dr. Branch made con-tacts
with several of the colleges of the state and training schools
for teachers.
Expenditures for the Board work this year reached the highest
peak in the history of the Board, totaling about $486,000. There
were no significant changes, other than those mentioned above, in
personnel during the year.
1930. This year marked many significant changes in the affairs of the
State Board of Health. Early in the year Dr. C. N. Sisk, director
of county health work, resigned. Dr. D. A. Dees succeeded Dr.
Sisk as director of county health work. Soon after the resignation
of Dr. Sisk, Dr. F. M. Register, director of the Bureau of Vital
Statistics, resigned, and the work of that bureau was assigned tc
Dr. G. M. Cooper, in connection with his work as director of health
education. On August 26, Dr. Chas. O'H. Laughinghouse, State
Health Officer, died. Soon after his death, in a meeting of the
Board, Dr. H. A. Taylor was made Acting State Health Officer.
On September 24, following the death of Dr. Laughinghouse, the
Board elected Dr. W. P. Jacocks State Health Officer to succeed
Dr. Laughinghouse. On November 20 Dr. Cyrus Thompson, for
2fi Thirty-Second Biennial Report
many years a member of the Board, died. On December 1(5 the
Board met and unanimously elected Dr. James M. Parrott, of
Kinston, as a member to succeed Dr. Thompson.
1931. At the beginning of this year, Doctor Jacocks having declined to
accept the position of State Health Officer, to which he had been
elected by the Board on September 24, 1930, a bill was introduced
in the Legislature abolishing the State Board of Health as then
constituted. This bill was passed and became law during the ses-sion
of 1931. With the enactment of the new law the terms of
the members of the old Board were automatically terminated.
Under this new law governing the state health work, legislative
machinery providing for the establishment of a new organization
to carry on the public health work of the state was enacted. The
new law differs in many respects from the old law under which
the Board had operated for so long. However, the most important
provision of the old law was retained; that is, the non-political
character of the Board and the retention of the permanency of
the policies of the Board, although shortening the terms of office
and making it impossible for the Board to become a self-perpet-uating
machine.
The important provisions in the new law under which the Board
of Health work is now operating are as follows: The Governor
still retains the power to appoint five of the nine members of the
Board, the maximum term of office being four years instead of
six, as under the old law. The Medical Society of the State of
North Carolina still retains the power to elect four of the nine
members of the Board, the same conditions as to term of office to
obtain here as in those appointed by the Governor. It was recom-mended
to the Governor, although not written into the law, and
Governor Gardner accepted the suggestion, that he appoint one
member from the State Dental Society and that he appoint a man
recommended by that society. This is equivalent to allowing the
State Dental Society to name one of the members, but still leaves
the balance of power in the hands of the Governor. This seems to
be a very satisfactory arrangement.
Another important change is that the Board still elects the
State Health Officer, but it can only become effective upon the
approval of the Governor. The term of the State Health Officer,
along with members of the Board of Health, was restricted to
four years.
Following the adjournment of the Legislature, the Governor
appointed the following named members: Drs. J. T. Burrus, High
Point; H. Lee Large, Rocky Mount; J. N. Johnson, Goldsboro, the
dental member; Professor H. G. Baity, of the University of North
Carolina and Mr. J. A. Goode, a druggist in Asheville. The State
Medical Society at its first meeting after the adjournment of the
Legislature elected the following physicians to membership : Drs.
James M. Parrott, Kinston; Carl V. Reynolds, Asheville; S. D.
Craig, Winston-Salem; L. B. Evans, Windsor.
North Carolina Board op Health 27
It will be noted that Dr. Parrott was the only member of the
outgoing- Board honored with election to membership on the new
Board.
On May 28 the new Board met and organized. On that day it
unanimously elected Dr. James M. Parrott State Health Officer.
Dr. Parrott took the offer under consideration for a period of two
weeks. On June 11 the Board met again. Dr. Parrott accepted the
election and agreed to assume office on July 1. Dr. Parrott
resigned his membership on the Board before being elected to the
position of State Health Officer, and under the provisions of the
new law the executive committee of the State Medical Society
selected Dr. G. G. Dixon, of Ayden, to serve in Dr. Parrott's
place until the 1932 meeting of the State Medical Society. It will
be noted that this is an important variation from the provisions
of the old law. Under the old law the other members of the Board
held the authority to name a successor, whether a member resigned
or died. Under the new law the Governor names his vacancies in
his list and the executive committee of the State Medical Society
is permitted to name a successor to serve only until the first meet-ing
of the State Medical Society following.
In the meeting of June 11 the new Board found it necessary to
eliminate some members of the staff and to make some consolida-tions,
on account of reduced appropriations for the Board work.
The services of Dr. D. A. Dees and Mr. R. B.- Wilson were dis-pensed
with, effective July 1. The Board reorganized the staff
and made many consolidations. The new reorganization follows:
The Board reorganized the work into divisions, making many
consolidations and increasing the duties of the directors of each
division. Following are the divisions organized. Administrative
Officer, Dr. James M. Parrott; Director Division of Laboratories,
Dr. C. A. Shore; Director Division of Preventive Medicine, Dr.
G. M. Cooper; Director Division of Oral Hygiene, Dr. Ernest A.
Branch. The division of County Health Work and Epidemiology
was temporarily assigned to Dr. H. A. Taylor, but on August 3,
Dr. Taylor resigned and Dr. John H. Hamilton, health officer of
New Hanover County, was appointed. director of this division. The
position of director of Division of Sanitary Engineering was filled
on July 14 by electing Mr. Warren H. Booker, who had formerly
headed that work, to succeed Mr. H. E. Miller.
The election of Dr. Parrott was received throughout medical
and public health circles of the entire state with enthusiasm.
Under his able direction the work of the Board during the last
half of this year moved with a precision which was gratifying
to all the friends of public health work in the state.
1932. The year 1932 was uneventful in public health work. The term of
none of the members of the Board expired this year, but all mem-bers
continued their service just as the Board was constituted at
the close of 1931.
28 Thirty-Second Biennial Report
The International Health Board Awarded a scholarship to Dr.
J. C. Knox for a year's special Public Health Work at Harvard
and to Dr. R. T. Stimpson for a year's special work in the School
of Hygiene at Johns Hopkins.
Following the very favorable reception of Doctor Parrott's an-nual
report at the conjoint session of the State Board of Health
and the State Medical Society, which was presented at Winston-
Salem in April, the work of the Board was carried on on all fronts
with satisfactory results, although on account of reduced appro-priations
many activities carried on in previous years had to be
curtailed or definitely eliminated.
The death rate in North Carolina for 1932 was 9.6 per 1,000
population. This is the lowest death rate ever before recorded in
North Carolina. The trend in typhoid fever death rates has been
consistently downward from 1914 to 1930. This year there were
three more deaths than in 1931, there occurring a total of 158
deaths from typhoid fever. The increase in population, however,
offset the slight increase in number, and the rate recorded was
slightly lower than 1931. The cases and deaths from diphtheria
this year were also the lowest of any previous year, although prog-ress
in the elimination of these diseases has not been so satisfac-tory
as it should have been. Deaths from pellagra continue to
show a marked decline.
This year is the third year of the so-called financial depression,
and it is too early to record any opinion as to what effect unem-ployment
and decreased income and rather widespread suffering
may have on the health of the people of the state. It is not too
much to say, however, that the effect will be felt more severely by
the children than by any other class of the population.
The infant mortality this year was 66.4 per 1,000 live births.
This is so far the best record the state has ever made. The ma-ternal
mortality remains high, and indications are that with de-creased
expenditures for maternal and infant hygiene the rates,
particularly for infant deaths, will rise again, pushing the state
back among those having an excessive infant death rate.
Expenditures for this year for all purposes by the Board were
$315,276, of which amount $262,438 represented appropriations.
This amount was just a little more than half of the total expendi-tures
made by the Board of Health for the fiscal year ending
June 30, 1930.
1933. The event of outstanding importance to the Board of Health this
year was the death of Dr. C. A. Shore, which occurred on Feb-ruary
10. For twenty-five years Doctor Shore had been director
of the State Laboratory of Hygiene. He had built the work of
the laboratory during these years up to a point where its prestige
and usefulness was equal to that of any other public health lab-oratory
in America.
North Carolina Board of Health 29
Doctor Shore served longer as a member of the executive staff
than any other man who has ever been connected with the State
Board of Health with the exception of Drs. R. H. Lewis and Geo.
M. Cooper. He held the confidence and esteem of the medical pro-fession
as well as the general public to a marked degree. He was
a man of extraordinary ability, and much of the success of the
public health work in North Carolina may be attributed to his
fine and wholesome service.
Suitable tribute has been paid to Doctor Shore and recorded in
other publications of the Board and of the State Medical Society.
One event in this connection, however, should be recorded here,
and that is that by legislative action all buildings of the State
Laboratory of Hygiene are hereinafter to be known as the Clarence
A. Shore Laboratory, in memory of his distinctive service.
A few weeks after the death of Doctor Shore, Dr. John H.
Hamilton, director of County Health Work, of Vital Statistics, and
of Epidemiology, was made director of the laboratory woi'k. Doc-tor
Hamilton, on assuming his duties as director of the Laboratory,
resigned the duties of director of County Health Work and of
Epidemiology, but retained, however, with the assistance of Dr.
R. T. Stimpson as statistician and field director, the Bureau of
Vital Statistics. Dr. D. F. Milam, a consultant assigned to the
State Board of Health by the International Health Board, was
made acting director of the Bureau of Epidemiology in place of
Doctor Hamilton. Doctor Milam had as his assistant Dr. J. C.
Knox. Dr. M. V. Ziegler, consultant assigned to the Board by the
United States Public Health Service, assumed the duties of acting
director of County Health Work to succeed Doctor Hamilton.
During this year Mr. W. D. Riley, assigned to the work as
Venereal Disease Control Officer by the United States Public
Health Service, organized his work and succeeded in making an
important contribution to the work of the Venereal Disease Con-trol
in North Carolina.
The following changes in personnel of the State Board of Health
took place during this year: Dr. W. T. Rainey, of Fayetteville,
was elected by the State Medical Society for a four-year term to
succeed Dr. L. B. Evans, of Windsor, whose term expired this year.
Dr. S. D. Craig was reelected for a term of four more years. The
Governor reappointed Dr. J. N. Johnson, dental member of the
Board, for another term, which will expire in 1937. The Governor
appointed Dr. Hubert B. Haywood, of Raleigh, for a four-year
term, to take the place of Dr. J. T. Burrus, of High Point. The
Governor also appointed Mr. James P. Stowe, a druggist of Char-lotte,
for a four-year term, expiring in 1937. Mr. Stowe suc-ceeded
Mr. J. A. Goode, a druggist of Asheville. Dr. Carl V. Rey-nolds
succeeded Dr. Burrus as President of the Board. On July
1, Drs. Knox and Stimpson returned to the Board work and re-sumed
their places after satisfactorily concluding their year's
scholarship work at Harvard and Hopkins, respectively.
30 Thirty-Second Biennial Report
The year was not marked by any widespread outbreak of epi-demic
disease, and notwithstanding a continuation of the financial
depression, the work of the State Board of Health held up fairly
well. The appropriations being lower this year than before for
many years, much of the personnel service had to be reduced. A
material reduction in state aid to County Health Work caused
considerable contraction of the activities of County Health De-partment
Work, but for the most part the morale of State Board
of Health employees as well as the county health employees has
held up remarkably well.
The Legislature, meeting for an extended session following its
opening in January, made drastic reductions in appropriations to
all state health work and reduced the salaries of all state health
employees. This was said to be necessary in order to balance the
state budget and to maintain the state's credit.
The total expenditures for the Board of Health this year, that
is, for the fiscal year ending June 30, were $291,786. Of this
amount $225,274 was appropriated by the Legislature. It will be
noted that this sum was less than half of that appropriated and
spent for the fiscal year ending June 30, 1930.
1934. The event of greatest importance to the State Board of Health and
to the health work throughout the state in this year was the death
of Dr. James M. Parrott and the election of Dr. Carl V. Reynolds
as his successor. Dr. Parrott assumed the duties of State Health
Officer on July 1, 1931. He had thus served a little more than
three years and four months at the time of his death. Dr. Parrott
was the first State Health Officer to serve under the new, or reor-ganized,
Board of Health. He was stricken with an attack of
angina pectoris early in December, 1933. The last eleven months
of his life, therefore, were ones of recurring illness and courageous
fortitude in remaining at the helm of the Board of Health work.
On the occasion of the first illness, with the consent of the mem-bers
of the State Board of Health, he designated Dr. G. M.
Cooper as Acting State Health Officer to be the responsible head
of the work in such periods as he was physically unable to at-tend
to the duties of the office. The following sketch, concerning
Dr. Parrott and his work, written by the Editor, was published
in the Health Bulletin.
"The death of Dr. James M. Parrott, State Health Officer of
North Carolina, occurred on Wednesday evening, November 7,
1934. Doctor Parrott had been health officer of North Carolina
for a little more than three years. He was so active mentally and
so near and dear to his co-workers here at the office that to me,
even yet, it seems impossible and unbelievable to think that he
is dead. Nearly thirty years ago I 'took' the State Board ex-amination
for license to practice medicine. He was a member of
that board. From then on I looked on him as one of the big
men in the medical profession. He held every office within the
North Carolina Board of Health 31
gift of his profession and loved it and served its interests with
a passionate devotion.
"He took over the direction of the work of the State Board
of Health in one of the darkest hours in the history of the Board.
He brought to the affairs of the Board a new kind of leadership,
a fresh outlook, a new viewpoint, and a breadth of vision which
served notice on the world that the Board had a resourceful and
able executive in charge. Although he came to the Board work
without previous experience in an administrative capacity of this
type, and knowing little or nothing of the practical workings
of a modern public health organization, his chief contribution,
which will be duly recorded in the history of this period, to the
cause of public health advancement was his stand for the pro-fessionalization
of public health work.
"Before he had been here sixty days, he realized that all de-partment
divisions as well as all county health offices should be
manned by physicians technically trained and experienced in
public health work. It became necessary for him to oppose the
ambitions of some of his lifelong friends in the medical profes-sion,
which hurt him; but it may be said to his credit that he
stood four-square for competently trained men as public health
officials.
"On assuming office, he realized that he had some very un-pleasant
duties confronting him in reorganizing the work of the
Board. He soon demonstrated that he had convictions and the
courage to back them up. When he laid down his armour for
the great adventure, he left an organization of his own building
functioning at top speed. He proved to his fellow workers here
that he was tolerant to everything but laziness and lying and
inefficiency. Being a man of clean personal life, and governed
in all his actions by a strict sense of honor, he naturally ex-pected
such qualities in his staff and other subordinates.
"For the past year he struggled against the malady which
finally ended his life, and at the same time he felt keenly his
official responsibility. He knew all during that last year that,
in justice to himself and his family, he should resign and be re-lieved
of the extra tax on his failing strength. On the other hand,
he felt that his work was not quite done. He saw many essential
features of public health work sacrificed to a program of ques-tionable
economy. He did not question the good intentions of the
Governor, the Budget Bureau, nor the Legislature, but he felt
that the time had come to put an end to the further needless
sacrifice of human life for the lack of intelligent preventive
efforts. He had a conviction that the incoming General Assembly
would see eye to eye with him. He was ready to submit a pro-gram
of far-reaching importance to the people of the state. It
could not be. His big brain is forever inactive. His profound
knowledge of the public health needs of the people is left for
his successor to acquire for himself.
32 Thirty-Second Biennial Report
"No man could build for himself a better monument than
Doctor Parrott did in the record of worth-while work well done.
In his death the state loses an honest public servant, and I lose a
warm and understanding friend whose confidence was more
precious to me than the riches of Araby."
Following Dr. Parrott's death, the State Board of Health
assembled in Raleigh on November 10, 1934, and unanimously
elected Dr. Carl V. Reynolds, who at that time was serving as
President of the Board, to the position of State Health Officer
and Secretary and Treasurer of the State Board of Health. Dr.
Reynolds immediately accepted and assumed his duties at once.
The following Editorial appeared in the Health Bulletin in Jan-uary,
1935, concerning Dr. Reynolds and his work. It is herewith
reproduced in order that this chronological record may be com-plete.
"Dr. Carl Vernon Reynolds, of Asheville, on November 10,
took the oath of office and immediately assumed his duties as
Acting State Health Officer, succeeding Dr. James M. Parrott,
who died November 7. Doctor Reynolds was unanimously elected
to the position by his fellow members on the Board.
"Doctor Reynolds is a native of Asheville. His father was a
successful Asheville physician who died when Doctor Reynolds
was only three years old. Dr. Reynolds obtained his literary edu-cation
in the private schools of Asheville and Wofford College,
Spartanburg, South Carolina. He received his medical education
at the college of the City of New York, graduating in medicine
there in 1895. After his graduation he took a postgraduate course
in London, England. Doctor Reynolds located in Asheville for the
practice of medicine, specializing in pulmonary tuberculosis. His
skill in combatting that disease has been widely recognized by
the medical profession. An example of their confidence was his
election as president of the North Carolina Medical Society, in
which place he served with distinction in 1920.
"On beginning practice he at once became interested in health
work. His first connection was with the city health department
in 1896. Following that period, for more than twenty years he
served as city health officer of Asheville, in which capacity he
rendered his city and the whole state important and permanent
service. Some of his contributions to public health may be cited
as follows:
"He organized the first crusade against the common housefly
ever undertaken anywhere.
"He assisted in drafting the first milk ordinance for Asheville.
"He secured progressive sanitary laws.
"He put through the compulsory vaccination law requisite to
school attendance.
"He secured the adoption of a bread-wrapping ordinance and
one requiring the tuberculin testing of cows.
North Carolina Board of Health 33
"He saw typhoid fever drop from an average of two hundred
and seventy cases a year in the city of Asheville to about five
while he was city health officer, and saw smallpox practically
eliminated.
"We enumerate these things so that the people of the state may
know they have a well-trained health officer at the head of the
State Health Department—one fully worthy of confidence and
support."
The general routine work of the State Board of Health during
this year was satisfactory and successful in every way. Dr. D. F.
Milam, who had been loaned to the State Board of Health by
the International Health Board and who had been acting as State
Epidemiologist, was transferred to other fields and on the first
of July Dr. J. C. Knox, who had been Assistant in the Division
of Epidemiology, became State Epidemologist.
Dr. M. V. Ziegler, of the United States Public Health Service,
who had also been loaned by that organization as a consultant
in the Division of County Health work and who had been Acting
Director of that Division, was transferred back to Washington
about the first of September. Dr. R. E. Fox, who had completed
a postgraduate course in the Public Health School of Harvard
University, was made director of the Division of County Health
Work.
Dr. R. T. Stimpson, who had also successfully completed a
postgraduate course in the School of Public Health of Johns
Hopkins University, and who had been acting as Assistant in
the Department of Vital Statistics, was made Director of that
Division.
On November 10, at the time Dr. Reynolds was elected State
Health Officer, Dr. G. M. Cooper was elected Assistant State
Health Officer. Dr. Reynolds, of course, had to resign from his
place on the Board in order to accept the office of State Health
Officer. To succeed him as President, Dr. S. D. Craig of Winston-
Salem was elected to that position. Dr. J. N. Johnson of Golds-boro,
dental member of the Board of Health, was elected to the
place of Vice President of the Board. The law provides that in
case of a vacancy occurring on the State Board of Health among
the membership elected by the State Medical Society, that the
Executive Committee of the Medical Society of the State of North
Carolina shall have the authority to appoint a successor to serve
until the next ensuing meeting of the State Society. In this case,
the vacancy coming so close to the annual meeting of the State
Society and the Board of Health on the following May 1 and
there being no regularly scheduled meeting of the Executive Com-mittee
of the State Medical Society, it was decided to defer the
election of a successor to Dr. Reynolds to the meeting of the
Society the following May 1.
34 Thirty-Second Biennial Report
1935. Dr. Carl V. Reynolds served as Acting State Health Officer, the
Governor having deferred the approval of his electon the previous
November 10, 1934, but at the annual meeting of the State
Board of Health, which was held in Pinehurst May 7, 1935, Dr.
Reynolds was unanimously elected State Health officer. His elec-tion
was for a full four-year term to begin on the first of July
following. The Governor immediately approved the election of Dr.
Reynolds to be State Health Officer for the full term as stated.
At the meeting of the conjoint session at Pinehurst on Wednes-day,
May 8, Dr. Grady G. Dixon was reelected to succeed
himself to membership on the State Board of Health for a term
of four years.
Dr. J. LaBruce Ward of Asheville was elected for the four-year
term to succeed Dr. Carl V. Reynolds, resigned.
In this year an important development in public health work
was the experimental course put on in the school year of 1934-
1935 at the University of North Carolina, under the auspices
of the Public Health Administration, of a course of instruction
designed to prepare physicians for positions as health officers.
The courses in this school met with such success, plans were
perfected to enlarge the scope of this new school as a part of the
medical School at the University. A fuller description of the
inauguration of this school will be found under the records for
1936.
During this year following the enactment of the National
Social Security law. plans were worked out for an expansion
of the work of all the divisions of the State Board of Health,
through financial aid coming through the Children's Bureau and
the United States Public Health Service at Washington. It was
a year which noted much activity in public health work all
throughout the state, and the perfection of plans, state and local,
for extending health department activities.
A Division of Industrial Hygiene was tentatively established
in September of this year. The organization of this division
resulted from an amendment to the Compensation Laws of the
state by the 1935 General Assembly. This legislation made dis-ablement
or death by occupational disease interpretable as an
injury by accident and thus compensable. For the execution of
this legislation a sum of $10,000 was appropriated by the Legis-lature.
The Industrial Commission appreciating that a problem
of preventive medicine was involved, engaged in a series of con-ferences
with the State Board of Health and Officers of the
United States Public Health Service. The discussions culminated
in the $10,000 appropriated for the administraton of the occupa-tional
disease legislation being placed at the disposal of the
State Health Officer. With this money, an Industrial Hygiene
program was inaugurated as an activity of the State Board of
Health. This arrangement was made with the understanding that
the work would be subsidized by the United States Public Health
North Carolina Board of Health 35
Service when Social Security funds should become available. To
begin the work of this division and to prepare the program for
enlargement to its full scope, Dr. H. F. Easom of the State Sana-torium
for Tuberculosis Medical Staff was selected as the Director
of the division. Mr. M. F. Trice, formerly in the Division of
Sanitary Engineering of the State Board of Health, was made
Engineer of this new division.
193f>. What may be termed the outstanding event of importance for the
first half of this calendar year covered in the period of this report
may be said to be the definite establishment of the new public
health department at the University of North Carolina and the
selection of Dr. Milton J. Rosenau as its director. This new de-partment,
of course, is an integral part of the School of Medicine
of the University of North Carolina. The March issue of the
Health Bulletin published the following descriptive news item of
the inauguration of this department:
"The most important development in public health circles in
many years for this section of the South is the establishment at
Chapel Hill of a department of public health in connection with
the School of Medicine, and the selection of Dr. Milton J. Rose-nau
as its director. This development has been made possible by
the coordination of the staffs of the faculties of the North Car-olina
State Board of Health and the schools of medicine and
engineering of the University of North Carolina.
"The new department, while an integral part of the Univer-sity
School of Medicine with Dr. C. S. Mangum, Dean, will be
under the personal direction of Dr. Rosenau. Dr. Rosenau is
generally regarded as America's foremost authority on public
health. His books on preventive medicine are used everywhere
as standard textbooks in all schools of public health. Until his
retirement recently from that faculty he had been head of the
famous Harvard School of Public Health for many years.
"For a long time the officials of the State Board of Health
have worked hard to secure the establishment of such a school.
The necessity for it has been apparent to all responsible health
workers. The chief credit for success in launching the enterprise
should go to Dr. Charles S. Mangum, Dean of the University
Medical School, and to Dr. Carl V. Reynolds, State Health
Officer. Both of these officials have worked hard and cooperated
with each other in overcoming all difficulties in the way of the
establishment of the new department.
"In the opinion of Drs. Mangum and Reynolds the development
was in part made possible by the success of the course put on in
the school year of 1934 and 1935 at the University under the
auspices of the School of Public Administration. The first course
put on with the teaching aid of the Schools of Medicine and
Engineering of the University and members of the staff of the
State Board of Health comprised a course of instruction for
physicians in public health administration and extended over a
36 Thirty-Second Biennial Report
period of twelve weeks. The work was so excellently done that
they received recognition from the United States Public Health
Service which assigned several of its applicants for postgraduate
work to take the second course.
"We hope and believe that this enterprise under Dr. Rosenau's
direction will expand into one of the most important depart-ments
of public health education in the entire country. The need
for special training for physicians who want to enter public
health work is great. Efficient public health departments, Na-tional,
State and local in modern conditions of living are an
absolute necessity. There are large numbers of young physicians
who with proper postgradute training could make excellent health
officers.
"The success of the new department at Chapel Hill will go a
long way toward establishing an efficient system of public health
work on a sound basis thi'oughout the entire southeastern section
of the country."
On February 1 of this year, funds from the Social Security
Act became available to the State Board of Health through the
Public Health Service and the Children's Bureau at Washington.
In addition to adding a division of field training of public health
nursing in connection with the new department of public health
at the State University, a department of Public Health Dentistry
was also established in connection with the Public Health School
at Chapel Hill. This is said to be the first school of like character
in the country. The County Health Department was enabled
through the Social Security subsidy from Washington to aid all
the whole time county health departments in an expansion of
their work. The Division of Preventive Medicine employed Mrs.
J. Henry Highsmith to begin work on February 20 as an Assist-ant
in the field of health education. The work of this division, of
course, took on enlarged activities. Plans were immediately set
in motion to establish special county nurses in counties having
no whole time health organization as special demonstration
service for such counties. Plans were also launched to establish
Maternity and Infancy Centers in many sections of the state as
Demonstration Centers, looking toward an eventual lowering of
the infant and maternal death rates in this state.
A sum of $17,500 of Social Security money was appropriated
by the United States Public Health Service for the Division of
Industrial Hygiene. Dr. M. T. Plyler was employed as an Assist-ant
Medical Director in that division and Mr. C. R. Matheson as
a Medical Technician. Both of these men had been employed on
the staff of the North Carolina Tuberculosis Sanatorium. Up to
the first of July more than 150 plants involving siliceous dust
hazards had been surveyed. The entire asbestos industry in the
state involving five plants had been studied, in cooperation with
the United States Public Health Service, a granite cutting estab-lishment
investigation made, and a foundry study inaugurated.
North Carolina Board of Health 37
There were 525 asbestos textile workers and 46 granite cutters
examined during the investigatory work. In addition, preemploy-ment
examinations have been made of approximately 400 workers.
All persons examined have X-ray films made of their chests. Dur-ing
this work nearly 300 atmospheric dust samples were analyzed.
During the period, the physician and the engineer attended a
four week's special course on Industrial Hygiene given by the
Public Health Service in Washington. The division has installed
a complete office equipment, as well as portable equipment neces-sary
for successful execution of this important work. The new
division is housed in the basement of the State Board of Health
Building.
On April 1 of this year, the State Board of Health established
a service for crippled children. This followed the approval in late
March of the North Carolina Plan for Crippled Children prepared
by the State Board of Health and submitted to the United States
Children's Bureau. This plan was a prerequisite of the Children's
Bureau toward participation by the state in the distribution of
Social Security appropriations for this purpose. Dr. G. M. Cooper
of the Division of Preventive Medicine was designated as Medical
Director of this service, and Mr. J. T. Barnes was employed by
the State Board as State Supervisor in charge of administrative
duties of this service. An advisory committee representative of
the Medical, Health, welfare, and lay interest of the state in
the problem of the crippled child was formulated to advise in
the execution of this program. Prior to June 30, public clinics
were arranged in various centers of the State under the direc-tion
of the State Board of Health. Cooperation had been arranged
with the North Carolina Orthopedic Hospital and was being
carried out satisfactorily.
Under the provision of the Children's Bureau regulations, an
advisory committee was secured by the Director of the Division
of Preventive Medicine for the purpose of advising from time
to time on the general program of maternal and child health
service work. This committee held its first meeting on March 27
at the State Board of Health in Raleigh. Representatives from
the following organizations were present: State Medical Society,
State Dental Society, State Public Health Officers Association,
State Nurses Association, State Federation of Women's Clubs,
State Parent-Teacher Association, State Welfare Department,
Division of Pediatrics and Obstetrics of the State Medical Society.
On or before June 30, the enlarged program of all the divisions
of the State Board of Health was well underway.
1937. There was no event of outstanding importance occurring in the
year 1937. Few changes in the staff or the sub-staff of the State
Board of Health have occurred. Following the expansion of
service throughout the year 1936 with the aid of Social Security
funds coming through the United States Children's Bureau and
the United States Public Health Service at Washington, a tre-
38 Thirty-Second Biennial Report
mendous amount of work was done during- the entire year 1937
in expanding the work of the health department throughout the
State, an increased number of nurses were employed, additional
county health departments were established and more intensive
efforts were made along all lines than in any previous year. The
new School of Public Health Administration at the University
of North Carolina under the direction of Dr. Milton J. Rosenau,
aided materially by Dr. Carl V. Reynolds, State Health Officer,
and the faculty of the Medical School of the State University,
made substantial and satisfactory progress. An increasing num-ber
of sanitary engineers, sanitary inspectors, and health officers
from this State and other states in the southeastern regional
territory were trained at Chapel Hill.
An Advisory Committee of leaders in different organizations
in North Carolina, including such organizations as the State
Medical and Dental Societies, Public Health Association, Parent-teacher
organizations, Women's Clubs, and the State Nurses
Association, together with some independent members of the
medical profession in the field of pediatrics and obstetrics and
orthopedic surgery, was organized and held its first satisfactory
meeting during this year.
Dr. T. C. Worth joined the staff of the Division of Preventive
Medicine on September 21, 1936, and served until April 15, 1937,
in the capacity of assistant to Dr. Cooper. Dr. Worth aided ma-terially
in assisting in the organization of Maternity and Infancy
Centers in some forty counties of the State and contributed a
great deal toward strengthening the department work. Upon Dr.
Worth's departure on April 15 to continue his postgraduate edu-cation
in Boston, Dr. Roy Norton, who had been with the Divi-sion
of County Health Work for about a year, and was formerly
health officer of Rocky Mount, succeeded Dr. Worth. Miss Mabel
Patton, a qualified nurse, joined the staff of the Division of Pre-ventive
Medicine as a consultant nurse representing the Children's
Bureau. Dr. W. J. Hughes, a colored physician whose services
for work in the health education field in the Department of
County Health Work was made possible through contribution by
the Rosenwald Fund and who joined the staff on January 1,
1936, was able to achieve substantial progress in his work with
the colored population of the State. This was the first time a
colored physician had been admitted to membership on the sub-staff
of the State Board of Health, and the result of work in
1936 and 1937 have fully justified his employment. Dr. R. L.
Robinson joined the sub-staff of the Division of Industrial Hygiene
on April 1, 1937, to succeed Dr. M. T. Plyler of that Division.
Mr. W. H. Richardson, an experienced newspaperman who at
one time was Secretary to Governor Morrison for his four years
in the Governor's office, joined the Administrative Staff in the
department exclusively conducted by the State Health Officer. Mr.
Richardson has been a valuable addition to the staff and he has
North Carolina Board of Health 39
succeeded remarkably well in interpreting technical problems to
the lay readers in hundred of articles in the daily and weekly
press of the State. Dr. G. M. Leiby, who had been Assistant Dis-trict
Health Officer in the Haywood-Jackson-Swain District with
headquarters at Bryson City, joined the sub-staff of the Depart-ment
of Epidemiology in the fall of 1936 and after some field
experience was sent to the Hopkins School of Public Health for
a year's special studies in syphilology. Dr. F. S. Fellows of the
United States Public Health Service was loaned to the State
Board of Health as consultant in the Department of Epidemiology
in the field of venereal disease control. Miss Margaret Thompson,
who holds a master's degree in home economics and nutrition
work from the University of Iowa, joined the sub-staff of the
Division of Preventive Medicine in October, 1937. On March 15,
1937, Miss Frances R. Pratt, a specially trained nurse under the
auspices of the State Maternal Health League, joined the sub-staff
of the Division of Preventive Medicine. Miss Pratt's work
was financed by an individual contribution from an outside
agency. Her work has been to organize through the medical
profession and the local health officers on a voluntary basis a
system of contraceptive control work when based on medical
needs. Her work has been very successful and it has been a wel-come
and needed addition to the staff work.
On December 16, 1937, following Legislative Provision in the
1937 session of the Legislature, $160,000 in bonds were sold for
the purpose of building a new plant for the State Laboratory on
the grounds adjacent to the present State Board of Health build-ing
on Caswell Square, Raleigh. A PWA grant of about $130,000
additional was received and work on the building was expected to
be completed within the year 1938. A farm of 280 acres on the
Raleigh-Cary paved highway was purchased and provision made
for farm buildings to care for the animals used in the production
of vaccines and serums.
On December 17, a conference of Public Health Officers was
called at Raleigh for the purpose of discussing and making de-cisions
concerning various field work, jointly affecting the State
and local health departments. This conference was so successful
that it was voted to make it an annual affair.
During the year a central general filing system was established
and put into effect under the direct supervision of the State Health
Officer and the Administrative Division of the Board of Health.
This is proving to be a very satisfactory and progressive step.
Malaria was made a reportable disease and a malaria inspec-tion
and control unit was established in the Department of Epi-demiology
July 1, 1937. Effective also in 1937 was the new plan
of the Division of Vital statistics with reference to the notifica-tion
of birth registration certificates to parents. Instead of wait-ing
for a parent to write to the department to inquire if the birth
has been reported and to send 50c for certificate, the plan was
40 Thirty-Second Biennial Report
adopted of sending to each parent whose baby's birth was reported
properly a small neat certificate of the baby's birth. This was
through an arrangement with the Bureau of the Census of the
United States Government. Franking privileges are allowed in
this work. It simply informs parents that their babies' births have
been properly recorded and the idea is through this method to
reach many of those parents whose babies' birth have never been
reported and get them to send in the reports.
There were no changes in the membership of the State Board
of Health this year. All members whose term expired were re-elected
by the State Medical Society or re-appointed by the Gov-ernor,
for additional four-year terms.
The total expenditures for the State Board of Health during
the fiscal year ending June 30, 1937, were $881,484.01. * Of this
amount $287,747.04 was appropriated by the Legislature, $191,-
943.85 was by the United States Children's Bureau, $312,210.42
by the United States Public Health Service, and finally $89,582.70
from fees received by the Laboratory in water taxes, etc., and
other miscellaneous items.
1938. During 1938, the extension and consolidation of health work in all
departments of the State Board of Health was further accom-plished.
This year two outstanding events may be recorded. First,
the Zachary Smith Reynolds Foundation decided to donate its in-come
from a fund of about seven million dollars to the State Board
of Health to aid in a long time program of syphilis control. The
initial donation from this fund by the officials of the foundation
to Dr. Reynolds was a check of $100,000. This philanthropy will
will bring to realization one of the finest dreams of Dr. Carl V.
Reynolds, State Health Officer. It promises to enable the State
Board of Health to accomplish in the near future some of the
objectives that have sometimes seemed to be long years off. A
long time before the Government began to realize its responsibility
in the prevention of disease and the preservation of the health
of its citizens as a means of bringing about better social and eco-nomic
conditions and the promotion of human happiness, philan-thropists
such as Rockefeller led the way. This gift of the Rey-nolds
Foundation, however, affords the practical means of enabling
the State Board of Health to organize in collaboration with the
various city and county health departments of the State an effec-tive
system through which the venereal diseases may be eventually
controlled in this State.
The other event in the same connection was the passage by
the United States Congress early in 1938 of a bill known as the
LaFollette-Bulwinkle Bill, sponsored and carried through the lower
House of the United States Congress by Representative A. L.
Bulwinkle of Gastonia, who has long represented his district in
the lower House of Congress. Through the provision of this bill
the State was able to receive during the year about $80,000 addi-tional
funds for work in syphilis control. The proceeds of these
North Carolina Board of Health 41
funds enable the State Board of Health to attack the ravages of
syphilis even in the prenatal stages by treating syphilitic mothers
early enough in pregnancy to prevent the birth of hopelessly syph-ilitic
babies. It is probably a fact that the benefaction of the
Smith Reynolds Foundation is the largest single gift for this par-ticular
purpose that has ever been made by any public or private
organization in this country. The cause is not only a worthy but
a pressing one. It takes money to control and eliminate such dis-eases
as yellow fever, typhoid and syphilis.
The School of Public Health Administration of the State Uni-versity
at Chapel Hill has made such material progress that it
became necessary on the first of September this year to employ
an additional full-time professor in that department. Dr. Roy
Norton, who for the preceding fifteen months had been an assistant
in the Division of Preventive Medicine where he has done excellent
work, was persuaded to accept the professorship. The State Board
of Health reluctantly agreed to Dr. Norton's transfer in view of
the fact that the School of Public Health Administration is of
such far-reaching importance that it should have the services of
the very best available talent in the medical profession of North
Carolina. Dr. Norton is admirably equipped for this important
work. There are now five full-time professors in this division of
the University.
Under the persistent work of Dr. Reynolds a stationary exhibit
has been erected in the large halls of the central building of the
State Board of Health, at Raleigh, an exhibit which is an educa-tion
in itself. It demonstrates the work of all the departments.
Some of the State's foremost artists were called into the work
and the officials of the National Youth Administration provided a
great deal of the actual work at little cost to the State Board
of Health. It would pay any citizen of North Carilina who is
interested in the State's progress to visit this exhibit sometime
during the year.
With the exception of the loss of Dr. Norton, there have been
few staff changes of importance. Dr. R. L. Robinson who came
with the Industrial Hygiene Division as a field worker in April,
resigned and returned to his home to engage in private practice
on the first of August. Mr. C. D. King, Jr., an Industrial Hygiene
man, came with the Board in the Industrial Hygiene Division on
June 15 as an assistant to Mr. M. F. Trice. Dr. G. M. Leiby re-turned
at the completion of his course in Johns Hopkins University
and assumed his duties as field director of the syphilis control
program. Dr. Fellows still remains with the Board and continues
to render valuable assistance.
The officials and employees of the Department of Preventive
Medicine were saddened this year on account of the death of two
veteran nurses. Miss Katharine Livingston died on May 26 and
Mrs. Margaret Sloan died on July 12. Both of these nurses had
rendered valuable service in this Division for many years.
42 Thirty-Second Biennial Report
There were no expiration of terms of service of the member-ship
of the State Board of Health this year, therefore no changes
in personnel occurred.
In March, 1938, the Board received a report from a committee
previously appointed to study pneumonia. The committee headed
by Dr. H. B. Haywood of Raleigh as chairman, Dr. W. T. Rainey
and G. G. Dixon from the Board, with Doctors Fred Hanes, C. T.
Smith as consultants, and Dr. C. V. Reynolds, ex-officio, made a
full report. Arrangements were made through Dr. Hanes of the
Duke Medical faculty for a special course to train local technicians
which was largely attended.
An important piece of field work which met with wide-spread
appreciation throughout the State this year was a series of 34
health institutes for teachers and principals of schools in as many
places representing the State. Eight thousand teachers and prin-cipals
attended these Institutes which were of a practical char-acter.
The Institutes were conducted under the joint auspices of
the State Board of Health, State Department of Public Instruction
and the Extension Service of the North Carolina State College.
The officials who executed this piece of work were Dr. Roy Norton
and Mrs. H. P. Guffy, nurse, of the State Board of Health, Miss
Mary Thomas, nutrition specialist of the State College Extension
Service, Mr. H. A. Perry and Mr. Charles E. Spencer of the State
Department of Public Instruction. This work was under the gen-eral
supervision of Doctors Reynolds and Cooper of the State
Board of Health, and it was carried out under the health educa-tion
division of the Board, and Dr. J. Henry Highsmith of the
State Department of Public Instruction.
The total expenditures for the State Board of Health for the
fiscal year ending June 30, 1938, were $1,041,895.98. Of this
amount $353,953.55 was appropriated by the Legislature, $226,-
297.57 by the United States Children's Bureau, $337,914.39 by the
United States Public Health Service, and $123,730.47 from fees
received by the Laboratory in water taxes, etc., and other miscel-laneous
items.
Dr. Roy Norton, who for nearly two years had been assistant
director in the Division of Preventive Medicine, resigned to accept
the position of Professor of Public Health Administration in the
School of Public Health in the University of North Carolina. Dr.
Norton's resignation was effective September 1. A successor to Dr.
Norton was not appointed during the remainider of the year.
Beginning with July 1 of this year, the following counties set
up whole time health department organizations: Alamance, Alle-ghany,
Ashe, Davie, Polk, and Union. On September 1, Catawba,
and September 16, Cleveland. On November 1, Currituck became
a member of the district health department with Dare and other
counties.
North Carolina Board of Health 43
1939. In the Division of Sanitary Engineering, John D. Faulkner returned
to the department to resume his work after taking a year of pub-lic
health engineering training at the University of Michigan.
Mr. James P. Stowe of Charlotte, for many years a member of
the State Board of Health, died on February 12. The Governor
later appointed Mr. C. C. Fordham, Jr., a Greensboro druggist
who promptly qualified as a member of the Board. During the
year there were no other changes in the personnel of the Board.
All members whose term expired were either reelected by the State
Medical Society or reappointed by the Governor.
On August 7, Dr. John S. Anderson was appointed as a mem-ber
of the staff as consultant in public health administration in
the Division of County Health Work. Dr. Anderson had previously
served as county health officer in Craven and Cabarrus counties.
On December 31, Miss Josephine Daniel resigned as consultant
in public health nursing in the Division of County Health Work
and accepted an appointment as director of public health nursing
with the Oklahoma State Department of Health.
On December 15, Dr. George M. Leiby, venereal disease con-sultant,
resigned his position with the Division of Epidemiology
to accept the position of director of venereal disease control in the
City of Washington, D. C.
On June 13, Dr. H. F. Easom resigned as director of the
Division of Industrial Hygiene to return to the North Carolina
Sanatorium as clinic physician. He was succeeded effective Octo-ber
15, by Dr. T. F. Vestal, a native of Randolph County, for-merly
a member of the Sanatorium clinical staff.
During the year, construction work was started on the new
central Laboratory on Caswell Square adjoining the administrative
building of the State Board of Health. Also, Construction work
was begun on the buildings on the State Laboratory farm between
Raleigh and Cary.
In the Division of Preventive Medicine, Mrs. J. Henry High-smith
resigned her position as health educator, effective October
1. Mrs. Highsmith's resignation was veiy reluctantly accepted.
Off and on Mrs. Highsmith had been connected with the State
Board of Health for many years. She has rendered invaluable
service in the health education work of the Board.
In the early months of the calendar year of 1939, plans were
matured after two or three years' efforts, attended by frequent
conferences of all concerned, by the State Health Officer and the
State Superintendent of Public Instruction, for the establishment
of a service through which the facilities of the State Department
of Education and the State Board of Health for the execution of
a unified health service in the public schools of the State might be
further integrated. Inauguration of this plan was made possible
by a supplementary grant of $50,000 by the Rockefeller Founda-tion
and the General Education Board to be spent over a five-year
44 Thirty-Second Biennial Report
period, commencing' July 1, 1939. The official designation of this
organization is the North Carolina School Health Coordinating
Service. The organization as a whole consists of an Advisory Com-mittee
and a full-time operating staff. The Advisory Committee
consists of five members: namely, Dr. J. Henry Highsmith, Dr.
G. M. Cooper, Dr. C. F. Strosnider, Dr. R. J. Slay, and Dr. Oliver
K. Cornwell. The operating staff consists of the following seven
members: Dr. Walter Wilkins, Coordinator; Miss French Boyd,
nutritionist; Mr. Chai'les E. Spencer, physical education; Miss
Olive Brown, physical education; Miss MacVeigh Hutchinson,
nurse; Dr. Walter Hughes, Negro physician; Mrs. Irma N. Henry,
Negro health educator. In addition to these regular staff members
several nurses from the Division of Preventive Medicine have been
assigned to work with the organization for varying periods of time.
Dr. John F. Kendrick was lent to the State by the Rockefeller
Foundation to serve temporarily as administrative adviser to this
school health coordinating unit. Pi'eliminary plans involving the
selection of trained personnel and numerous other organization
preparations were undertaken during the months of July and
August, 1939, and initial field operations commenced in Stanly
County in September. In addition to Stanly, cooperative work was
undertaken in Person, Orange, Chatham, and Wayne counties dur-ing
the year.
This was the first full fiscal year in which the sum of $100,000
donated by the Zachary Smith Reynolds Foundation to aid the
Board of Health in its syphilis control work was available. This
initial donation of $100,000 in cash to the State Health Officer to
be used without strings attached, represents one of the largest
gifts ever received by the Board of Health. It has enabled the
State Board of Health to put into effect many necessary require-ments
in the State-wide work of control of the spread of syphilis.
This money has been used for the specific purpose for which it
was allotted. It has been used to employ additional men and
women who are experts in their field and for the training of other
nurses and physicians to become experts in the work necessary to
deal with this enormous problem. This trust fund has enabled the
Board to extend its activities in almost every direction and to keep
up the official work in such a manner as to make sure a long time
successful program which will be necessary to reduce the preva-lence
of syphilis in this State to a minimum.
The total expenditures for the State Board of Health for the
fiscal year ending June 30, 1939, were $1,215,056.80. Of this
amount $364,506.25 was appropriated by the Legislature, $232,-
993.80 by the United States Children's Bureau, $311,859.00 gen-eral
and $51,829.11 venereal disease by the United States Public
Health Service, $130,290.49 by the Zachary Smith Reynolds Foun-dation,
and $123,578.15 from fees received by the Laboratory in
water taxes, etc., and other miscellaneous items.
North Carolina Board of Health 45
In this year no changes in the personnel of the State Board
of Health occurred. Every member continues to serve to the full
extent of his ability, giving unstintedly of his time and efforts to
the constructive work of the State Board of Health.
1940. The most important item in the field of public health in this State
in 1940 was the completion and dedication of the central building
known as the Clarence A. Shore Laboratory of Hygiene. As stated
before in this chronology, this new plant costing about $311,000
was made possible by the selling of revenue bonds and the alloca-tion
of a PWA grant and in the acquisition of funds from various
sources. The total outlay of $311,000 represents the cost of the
central plant on Caswell Square, completed and equipped, and the
cost of the buildings on the Laboratory farm located six miles west
of Raleigh. The Shove Memorial Building was dedicated with ap-propriate
ceremonies on February 21, 1940. There were addresses
by Governor Clyde R. Hoey, Dr. S. D. Craig. President of the
State Board of Health, Dr. Carl V. Reynolds, State Health Officer,
Mr. J. W. Kellogg, assistant director of the State Laboratory of
Hygiene, Dr. George M. Cooper, Assistant State Health Officer,
and Dr. John A. Ferrell, Associate Director of the International
Health Division of the Rockefeller Foundation. Dr. John H.
Hamilton, Director of the Laboratory, presided over the exercises.
Greetings from neighboring and friendly organizations and insti-tutions
were brought by Dr. M. J. Rosenau, Division of Public
Health of the University of North Carolina, Dr. W. C. Davison,
Dean of the Medical School of Duke University, Dr. W. deB. Mac-
Nider, Dean of the Medical School of the University of North
Carolina, Dr. E. S. King, Professor of Preventive Medicine of
Wake Forest College, Dr. Hubert B. Haywood, President-elect
of the Medical Society of North Carolina, Mr. E. C. Derby, Resi-dent
Engineering Inspector of the Public Works Administration,
Dr. M. V. Zeigler, Senior Surgeon of the United States Public
Health Service, Washington, and Dr. John M. Saunders, Regional
Medical Consultant of the Children's Bureau, Washington. The
entire issue of the April 1940 number of the Health Bulletin was
devoted to the description of the dedication of the Shore Memorial
Building. The issue was increased from the normal sixteen pages
to a thirty-two page volume.
The central Laboratory building consists of four stories and is
modern in every detail. The State Laboratory of Hygiene farm
consists of approximately 280 acres of which 100 acres is under
cultivation, the balance in woodland. The farm has a frontage of
fifteen hundred and fifty feet on the great United States national
highway number one. Both the Seaboard and Southern railways
also front it. The buildings on the farm consist of the farm lab-oratory
building, horses and sheep barns and buildings for the
production of smallpox vaccine and other biologic products, as
well as the buildings for the housing of small animals needed in
this work.
4G Thirty-Second Biennial Report
On April 1, John D. Faulkner was transferred from the Division
of Sanitary Engineering to the Division of Epidemiology to have
charge of l-odent control work.
John Andrews who had effectively headed the milk sanitation
program in the Division of Sanitary Engineering resigned to ac-cept
an important position with the United States Health Service
in Washington. R. F. Hill, Jr., finished his year of specialized
training in sanitary and public health engineering at the Univer-sity
of North Qarolina and returned to his duties with the Sanitary
Engineering Division.
Effective work has been carried on with the aid of the WPA
and United States Public Health Service in the malaria control
drainage and community sanitation. Milk sanitation was advanced
with a marked increase in the number of pasteurization plants.
With the assistance of the aforementioned organizations and the
PWA, the installation of new public water systems was brought
up to a total of 52 installed during a four-year period ending June
30, 1940. Improvements, additions and extensions were made to a
great many of the water and sewage systems of the state.
In the Division of Vital Statistics, there was closer cooperation
with the local health departments in an effort to be of mutual
assistance in registration. Social Security benefits requiring proof
of number and age dependents and necessitating the presentation
of the birth and death certificates has increased the number of
verifications and copies of the certificates issued by the division.
There were no material changes in the division during the first
half of 1940.
On March 1, 1940, Miss Amy L. Fisher succeeded to the vacancy
left by Miss Daniel as a consultant nurse in the Division of County
Health Work. Miss Fisher had been supervising nurse in the
Durham Health Department. Gates County joined the district to
be composed of Hertford and Gates, the work to become effective
July 1, 1940.
In the Division of Industrial Hygiene, there was issued a pro-fusely
illustrated one hundred page printed report presenting the
results of a study of effects of exposure to dust in the mining and
milling of pyrophyllite, the field work for which was done during
the previous biennium. One of the outstanding achievements of
this division was the design of seven industrial exhaust ventila-tion
systems for the control of dust. Three of these had already
been completed by June 30 and the installation of the others was
already underway.
With the closure of the public schools for the summer holidays,
preparations were made for health courses to be given thirty white
and thirty colored teachers at the University of North Carolina
and the North Carolina College for Negroes at Chapel Hill and
Durham, respectively. These courses covered a six weeks period
ending approximately July 20, 1940, and were made possible by
North Carolina Board ok Health 47
a grant of $4,700 by the General Education Board. While it would
be premature to attempt an appraisal of what was accomplished
by this organization during its first year of existence, it may be
stated that educational and health personnel alike cooperated gen-erously,
that certain procedures were found to be satisfactory
while practical considerations necessitated the modification of
others, and that progress was made toward the maturation of a
generally accepted school health program.
On January 1, 1940, Dr. Ralph J. Sykes assumed the duties of
venereal disease consultant in the Department of Epidemiology.
Dr. Sykes had previously served for several years as county health
officer first in Surry and later in Halifax. Dr. Frank S. Fellows,
Surgeon with the United States Public Health Service who has
been assigned to North Carolina for several years, continued
to render valuable service in the capacity of venereal disease
consultant.
The main accomplishment in the Division of Epidemiology was
the great expansion of venereal disease control program. This
was largely as a result of financial aid from the Zachary Smith
Reynolds Foundation and the United States Public Health Service.
In June, 1936, there were 120 clinics in operation. They treated
13,304 patients. In June, 1940, as a result of the aforementioned
financial aid, the number of clinics have been increased to 255 in
which 27,814 patients received treatment in a single month. The
system of mechanical tabulation set up in a central tabulating
unit under the direction of this division reached its full stride in
the early months of 1940. A complete progress record is kept on
every patient receiving treatment. The central tabulating unit
renders valuable assistance to other divisions of the State Board
of Health.
The Manual of Minimum Standards for conducting venereal
disease clinics prepared by Drs. Fellows and Leiby still continues
to be very helpful to physicians and nurses and others concerned
with the conduct of venereal disease clinics. Financial aid was
given through this department to all organized counties in the
State. Fifty-one clinics were supplied with combination darkfield
and general purpose microscopes and sixteen of the largest clinics
were given fiuoroscopes.
On January 1, Dr. Emmett S. Lupton was employed as assistant
director in the Division of Preventive Medicine. Dr. Lupton had
just completed his interneship in pediatrics at the Duke Hospital.
In the Division of Preventive Medicine, organized maternal and
child health clinics were being operated in 55 counties. An increas-ing
number of infants and expectant mothers among the poor
classes were in attendance on these monthly clinics. A total of
approximately 250 physicians were cooperating on a part-time
basis at the close of the fiscal year, June 30.
The circulation of the Health Bulletin increased from about
52,000 to 60,000 monthly copies during the year.
48 Thirty-Second Biennial Report
In the Division of Oral Hygiene, there were no material changes
except some expansion and expenditures of additional funds in
the work of that division, necessitating the employment of an
additional number of dentists.
At the beginning of the calendar year 1940, the question of
adoption by the State Board of Health of a so-called merit system
as required by some sections of the Federal Government at
Washington loomed as an important item for consideration dur-ing
the year. Early in January it was required by the Children's
Bureau that standards to form the basis of a merit system should
be submitted before the allocation of Children's Bureau funds for
the winter quarter would be forthcoming. By the middle of Jan-uary,
therefore, Doctors G. M. Cooper and Emmett S. Lupton,
working in consultation with Dr. Carl V. Reynolds, State Health
Officer, worked out and submitted a seventeen-page typewritten
document setting up standards acceptable to the State Board of
Health. These standards with a few minor modifications were
immediately accepted by the Children's Bureau. Later in the
winter the Regional Medical Consultant of the United States
Children's Bureau spent several days in Raleigh discussing with
Dr. Reynolds and the representatives of the Children's Bureau in
the State Board of Health plans for further development of the
merit system, the next requirement being setting up of a merit
system council with a supervisor and submission of classification
plans for all State Board of Health workers. At this time the
State Health Officer appointed the Director of the Division of
County Health Work to be the responsible offical to work out fur-ther
plans. At a meeting of the State Board of Health on November
29, 1940, that body considered a new draft of what it termed "A
Rule for a Merit System of Personnel Administration in North
Carolina." Much discussion on the subject was indulged in by
various members of the Board at this meeting. A suggestion of
Dr. H. G. Baity, a member of the Board, at this time deserves
particular emphasis. Dr. Baity made the suggestion that a general
statement be placed somewhere in the compensation plan to the
effect that the "duties outlined for each position classified were
not to be considered as comprising all the duties that might be
required of the position and that such other duties as might be
required by the State Health Officer or the Division Director would
be included."
Later in the year 1940, the war clouds over the world were
gathering with such an ominous outlook that the United States
Army, Navy, and Public Health authorities were busy laying
the groundwork for a mighty army and navy to defend the coun-try.
One of the first consideration by the United States Public
Health Service and the North Carolina State Board of Health in
the fall of this year was an effort to detect the presence of syphilis
in as large a section of the population as possible, especially those
liable for military service. On October 10. 1940, which was regis-tration
day under the Selective Service Draft, the North Carolina
North Carolina Board of Health 40
State Board of Health utilizing the services available in its 265
venereal disease clinics then established in the State offered
to take blood samples from all registrants on a voluntary basis.
Consequently, 132,671 blood specimens were taken and examined.
This accomplishment was one of the most widespread efforts ever
made in the State up to that time to locate by serological exami-nation
the presence and distribution of syphilis in North Carolina.
The Federal Government proposed to set up what they call a
"Firing Area" in Pender and Onslow counties. It became neces-sary
for the State Board of Health to insist on the organization
first of a whole time health department in each of these two
counties, neither one having ever had such department before.
This was arranged on a joint financial basis between the counties
and the State and Federal Government, and a district health
department was set up.
The total expenditures for the State Board of Health for the
fiscal year ending June 30, 1940, were $1,380,174