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HEALTH AFFAIRS LIBRARY
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TWENTY-NINTH BIENNIAL REPORT
OF THE
North Carolina
State Board Health
JULY 1, 1940-JUNE 30, 1942
EDWARDS a BROUGHTON COMPANY
RALEIGH
MEMBERS OF THE STATE BOARD OF HEALTH
Elected hj the North Carolina Medical Society
S. D. Craig, M.D.
Term expires 1945
G. G. Dixox, M.D.
Term expires 1943
W. T. Rainby, M.D.
Term expires 1945
John LaBruce Ward, M.D.
Term expires 1943
Appointed by the Governor
HiBKKT B. Haywood, M.D.
Term expires 1945
H. Lee Large, M.D.
Term expires 1943
J. N. Johnson, D.D.S.
Term expires 1945
H. G. Baity, Ph.D.
Term expires 1943
C. C. Fordham, Jr., Ph.G.
Term expires 1945
1397
LETTER OF TRANSMITTAL
Raleigh, N. C, September 16, 1942.
His Excellency, J. Melville Broughtox,
Governor of North Carolina.
My DEAR Sir: — Under Authority of Chapter 118,
Article 1, Section 7050, Consolidated Statutes of N'orth
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, 1940, to June 30, 1942,
Yours sincerely,
Carl V. Reynolds,
Secretary and State Health Officer.
TABLE OF CONTENTS
Page
The Chronological Development of Public Health Work in North Caro-lina
- - 9
Report of the Secretary-Treasurer and State Health Officer 51
Annual Report North Carolina State Board of Health to Conjoint Ses-sion
State Medical Society—1941 66
Annual Report North Carolina State Board of Health to Conjoint Ses-sion
State Medical Society—1942 95
Informational Service 122
Division of Preventive Medicine - - 123
Crippled Children's Department 131
Division of Sanitary Engineering 139
Division of Oral Hygiene -... - 147
State Laboratory of Hygiene 149
Division of Epidemiology - 157
Division of Vital Statistics 165
Division of County Health Work 169
Division of Industrial Hygiene 186
School Health Coordinating Service 190
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 committee.
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. Satch-well
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 educa-tional
pamphlets issued. Subjects: "Disinfection, Drainage, Drinking
Water, and Disinfectants"; "Sanitary Engineering"; "Methods of
Performing Post-morten Examinations"; "Limitation and Preven-tion
of Diphtheria." Annual appropriation, $200.
1880. Much of the activity this year was devoted to efforts to control diph-theria.
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.
1881. General Assembly passed a law requiring regulation of vital statistics
at annual tax listing; law ineffective. Annual appropriation, $200.
8 Twenty-Ninth Biennial Report
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 "Pre-ventive
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 superin-tendents
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 reported
—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 inaugu-rate
public health work to say nothing of carrying it on without some
money at least.
The State Medical Society adopted a resolution at its conjoint session
held in Raleigh requiring the President of the Medical Society to
appoint a committee "to go before the Legislature 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
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 dis-ease
had been smuggled in, was one of chief concern to the Board.
Much interest and discussion in the Board membership and through-out
the state this year centered about the necessity for providing
some safe method of drinking water and sewage disposal.
1888. Yellow fever epidemic in Florida and refugees to Western North Caro-lina
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
North Carolina Board of Health 9
water supply and sewage disposal. The Board published an exhaustive
paper by Dr. H. T. Bahnson of Salem, President of the Board, en-titled:
"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 January. The
epidemic appeared first in Russia about November 1, 1889. By Decem-ber
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 reelected 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 contagious
diseases, (2) the protection of school children from epidemics, (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 re-moved.
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.
1895. Dr. Albert Anderson and Dr. W. T. Pate were elected bacteriologists
for the Board. Annual appropriations, $2,000.
1896. Board passed a resolution requiring chemical and bacteriological exami-nations
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 exclu-sively
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
10 TWE.NTY-Nl>TU BlE.NXIAL REPORT
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 supplies.
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 ap-propriation,
$2,000.
1900. State Board of Agriculture, on request of State Board of Health, agreed
to examine samples of w'ater 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 physi-cians
w^hich commissioners elected to serve with them. Term of office
of county superintendent of health made two years. Annual appropria-tion,
$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 pay-ing
Department of Agriculture for services of examiner. Dr. C. W.
Stiles, U.S. P.H.S., before the State Medical Society at Hot Springs,
called attention to prevalence of hookworm 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 preva-lence
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 dealing 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; imposed
w^ater 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 treatment
of tuberculosis founded; $15,000 appropriated for permanent improve-
NoKTH Cakolixa Board of Health 11
ments 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 Officer;
(2) collection of vital statistics of towns having a population 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 having 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 permanent 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 organizations in public
health work. Bulletin increased from 3,500 edition to 10,500 edition.
Addresses on public health work delivered to Conference of County
Superintendents of Schools, State Federation of Women's Clubs,
State Press Association, and Sanitary Sunday observed in April. Dr.
John A. Ferrell elected, February, Assistant Secretary for Hook-worm
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 composed of
chairman board of county commissioners; county superintendent of
schools, mayor of county town, and two physicians selected by the
three county officials to serve with them. Legislature 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 antitoxin 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 co-operation
with press of state developed; regular weekly press articles
prepared and sent to papers; increase in numbers of popular pam-phlets
for distribution. Hookworm this year largely educational
through the school forces and investigative through county dispen-saries;
thousands of children found infected and treated. Strong
sentiment began to make itself felt for better health work by coun-ties,
four counties employing whole-time county health officers.
Guilford 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 Sanatorium
increased to $12,500, with $20,000 voted for permanent improvements.
Annual appropriation, $22,500.
12 Twenty-Ninth Biennial Report
1912. Bulletin increased to 40,000 edition; number of popular pamphlets
dealing with different diseases increased; press work improved; edu-cational
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 importance of health prob-lems
and the bearing of this subject upon the proper apportionment
of health funds; instrumental in passing a resolution to the effect
that pellagra was an interstate problem, not a state problem, and re-questing
the Federal Government 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 appro-priated
to supplement 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, depend-ing
on whether part-time or full-time service. Educational efforts of
Board continued and enlarged. Hookworm work along same line as
year before increased in amount. Dr. John A. Ferrell resigned as
Assistant Secretary to accept position with the central office of the
Rockefeller Sanitary Commission in Washington, D. C. Dr. C. L.
Pridgen succeeded Dr. Ferrell. The movement for improved county
health work had by this time resulted in ten counties electing whole-time
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. Preceding 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 appropriation
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.
Pridgen resigned as Director Hookworm Eradication, and Dr. W. P.
Jacocks succeeded him. Annual appropriation, $40,500.
1915. General Assembly makes state vital statistics law conform to national
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. Edu-cational
work greatly extended: Bulletin 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
NoETH Carolina Board of Health 13
Bureau of Rural Sanitation, with Dr. G. M. Cooper at its laead, suc-ceeds,
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
vaccinations 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-supporting
moving picture health show. Many saw this show during the year and,
seeing, believed in health work as never before. BuUettn 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 publishing scores. Continued Bureau of
Rural Sanitation, giving three anti-typhoid injections to 48,000,
making 100,000 immunized in summers of 1915 and 1916. Did com-plete
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 Cumber-land
and Swain counties for about eight months. Laboratory of
Hygiene buys land and erects its own building. Annual appropria-tion,
$55,500.
1917. The General Assembly passed the following important health legisla-tion:
Chapter 263, entitled "An act to prevent and control the occur-rence
of certain infectious diseases in North Carolina"; Chapter 244,
entitled "An act to provide for the physical examination 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, designat-ing
certain powers and duties and otherwise providing for the
enforcement of this act"; Chapter 66, entitled "An act to provide for
the sanitary inspection 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, administrative ma-chinery,
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 direction of Dr. B. E. Washburn, was estab-lished.
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 Chapter 276.
The United States Public Health Service in February, 1917,
detailed Dr. K. E. Miller to study county health work in different
sections of the country and to estaiblish for demonstration purposes,
in Edgecombe County, department of health on an economic basia
easily within the financial reach of the average county.
14 . Twenty-Ninth Biennial Report
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 begun so satisfac-torily
in 1915 was continued. Free vaccination of the people, however,
was interfered with by the difficulty in securing medical officers to
do the work, the preparedness program of the Government having
caused many physicians and nurses to enter the army and navy;
nevertheless, a total of 30,000 citizens of the 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 hygienic
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 extension 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 Medical Corps of the Army. For this reason, and for
the further reason 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 exhibit. Arrange-ments
were made for the preparation of newspaper 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 per-mitted
under the laws of the state to be paid to the Laboratory 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 had to do
with preparedness. The State Health Officer visited Washington, 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
NOKTH C-UIOLINA BOARD OF HEALTH 15
conferences with respect to preparedness measures, provisions for the
control of venereal diseases, arrangements for coordinating the
control of infectious diseases in the civilian population with their con-trol
in cantonments, and to arrange, if possible, with the Public
Health Service and the Surgeon-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 Medical
Advisory Boards and in interesting physicians in entering the medi-cal
service of the Army and Navy, and, later in the year, in inducing
the physicians of the state to become members of the Volunteer Medi-cal
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 inter-ests
looking to a 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 w^ork.
The Laboratory during this year began the distribution of a high
grade of diphtheria antitoxin.
The Bureau of Medical Inspection of Schools, under the direction
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 arrange-ment
in the form of adeno^ 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 determina-tion
of the state to enforce its health laws, and a fairly satisfactory
compliance with the laws regarding the reporting of communicable
diseases was brought about.
The Bureau of Venereal Diseases, paid for by the Federal appro-priation,
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 journalistic work, Miss Herring having
been engaged by the War Department for educational work.
Perhaps the most outstanding feature of the health work during
the year 1918 was the epidemic of influenza. The epidemic began early
in October and caused in October alone 6,056 deaths; in November
16 Twenty-Ninth Biennial Report
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.
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 Laboratory for this year
was $21,032.48.
1919. The General Assembly passed the following important health legisla-tion:
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"; Chapter 215, entitled "An act to
amend Chapter 671, Public-Local Laws of 1913, relating to the injunc-tion
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 member of the Board. Mr.
H. E. Miller, an engineer and a graduate of the University of Michi-gan,
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 pre-paring
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 educa-tional
work of the Board. After a few months she returned to the Fed-eral
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 Epi-demiology,
resigned to accept a position with the city of Wilmington.
Dr. F. M. Register, whole-time health officer of Northampton County,
succeeded Dr. Crouch as director of the bureau.
Dr. E. J. Wood resigned this year, effective at the end of his term,
North Carolina Board of Health 17
and Governor Bickett appointed Dr. E. J. Tucker of Roxboro for 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 1st 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 Vaughan, Director of the Bureau of
Infant Hygiene, resigned. The bureau was reorganized under an under-standing
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 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 contin-gent
upon the approval of both participating agencies, the American
Red Cross and the State Board of Health. In December Miss Rose M.
Ehrenfeld 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 appointed to suc-ceed
him.
The typhoid campaign carried on during the summer through pre-vious
years was continued in the summer of 1919, using third-year
medical students, furnished either with automobile or motorcycles
for getting about. Campaigns were carried out in the following coun-ties:
Bertie, Cabarrus, Chatham, Chowan, Columbus, Craven, Hert-ford,
Iredell, Johnston, Lincoln, Onslow, Pasquotank, 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 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 statistics law, making the
fees for local registrars 50 cents instead of 25 cents for each certifi-cate
properly filed with the State Board of Health.
On January 1 Dr. B. E. Washburn, who had had general direction
of the cooperative county health work and who had rendered most
acceptable service, was recalled by the International Health Board and
2
IS Twenty-Ninth Biennial Report
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 Public
Health Service and the International Health Board to demonstrate
the possibilities and advantages of the eradication of malaria from
certain towns and cities in the eastern part of the state was begun.
The terms of cooperation were that the International 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, Farmville, and Greenville, the budget for each
municipality being respectively: Goldsboro, $13,670.98; Farmville,
$5,000, and Greenville, $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 appoint-ment
of city health officer of Charlotte, N. C.
In the winter and spring of 1920 the North Carolina Landowners
Association, under the progressive leadership of Mr. W. A. McGirt,
of Wilmington, undertook a very extensive educational campaign
against malaria, which v/as carried on through the public 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 chil-dren
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 reason-able
to believe that the campaign was one of the most successful
public health educational attempts yet undertaken.
In June it was found advisable to separate the Bureau of Epidemi-ology
and the Bureau of Vital Statistics which had, on account of the
scarcity of health officers, been placed under the directorship of a
single bureau chief, Dr. F. M. Register. Dr. Register was appointed
Director of the Bureau of Vital Statistics and Dr. J. S. Mitchiner
was appointed Director of the Bureau of Epidemiology.
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 prostitution. This group
of workers was withdrawn in September on account of differences-
North Carolina Board of Health 19
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 Public
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 lec-tures
and a moving picture truck began work in Cumberland County
in August, and from its very beginning 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 continued
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 pub-lic
health literature.
The funds available during this fiscal year amounted to $342,-
284.33, of which $176,152.61 was state appropriation and the remain-der
from outside sources.
The appropriation for the State Laboratory of Hygiene for this
year was $25,000; in addition to this, the Laboratory collected 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.
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 amendent to the State-wide Privy Law was also
enacted. A bill was introduced in this session of the General Assem-bly
under the initiative of Hon. Emmet H. Bellamy requiring a
physical examination 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 legislation was but a step in the right direction and was,
therefore, rather loosely drawn and left many things to be desired.
20 Twenty-Ninth Biennial Report
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 BuUetin 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 indus-try
into government.
The Bureau of Venereal Diseases, in charge ol Dr. Millard Knowl-ton,
established as a part of the war-time activities of the Board in
cooperation with the Bureau of Venereal Diseases of the Federal Gov-ernment,
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 1st 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 Ameri-can
Red Cross Society abrogated the agreement 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 reor-ganized
April 1 as the Bureau of Maternity and Infancy, for its main-tenance
the state receiving $27,259.66 annually from the United
States Government in accordance with the Sheppard-Towner Act for
the promotion of the welfare of mothers and infants, Dr. K. P. B.
Bonner, of Morehead City, was secured as the director of the reor-ganized
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 nine-teen
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 providing for an
North Cakolixa Boakd of Health 21
independent board of directors for the State Sanatorium for Tuber-culosis,
removing the direction of that institution 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 included 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. Mitchiner was assigned to the
Bureau of Medical Inspection of Schools, after the consolidation 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 continued throughout
the year, but proved to be ineffective and unsatisfactory.
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 unex-pired
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 educational capacity in
1920, the International Health Board was requested to participate
in this work and to provide a director for that service. The Interna-tional
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 Oflficer, was
invited by the Committee of Municipal Health Department Practice 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 working out a basis or set
of principles through which city health departments 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
22 Twenty-Ninth Biennial Report
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. Ranltin assumed his duties and established
official headquarters in New York City for the work of the com-mittee.
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 assistant 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.
Iseley, who had been employed in county health department work,
and Dr. Roy C. Mitchell resigned. Miss Rose Ehrenfeld 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 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 conducted
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 de-partment
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 Foundation. 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. N. 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 accepted and took
office October 1. Dr. G. M. Cooper, who had for sixteen months admin-istered
the work of the Board as Acting State Health Officer, con-tinued
with the service and was assigned to the Bureau of Health
Education, succeeding Dr. M. L. Townsend, who resigned. On August
North Carolina Board of Health 23
6 Dr. Richard H. Lewis died. Dr. Lewis liad served as a member of
the Board since 1885, and from 1892 to 1909 he served as Secretary
of the Board. Since 1909 he liad been a member of the executive com-mittee.
Dr. Lewis held his membersliip on the Board by appointment
from the Governor. 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 election
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. Laugh-inghouse.
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 President of the
Board for a long time. Governor McLean appointed Dr. C. C. Orr,
of Asheville, to succeed Dr. Way. At the first meeting of the State
Board of Health following the death of Dr. Way, 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 mid-wife
classes in about thirty counties of the state. The nurses gave spe-cial
instruction to midwives in groups, and the county authorities en-acted
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 on modern health subjects was
exhibited in many sections of the state.
1929. With aid secured from the International Health Board, the Life Exten-sion
Division was added to the activities of the Board this year. Dr.
Frederick R. Taylor, of High Point, w^as made director of this division.
Dr. Taylor carried this work before the medical profession in all sec-tions
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 reorganization plans
for the oral hygiene work to include more lectures and more educa-tional
demonstration work. Dr. Branch made contacts with several
of the colleges of the state and training schools for teachers.
24 Twenty-Ninth Biennial Report
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 to 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 many years a member of the Board, died. On Decem-ber
16 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 Legis-lature
abolishing the State Board of Health as then constituted. This
bill was passed and became law during the session 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 establish-ment
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 perma-nency
of the policies of the Board, although shortening the terms of
office and making it impossible for the Board to become a self-per-petuating
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 ap-pointed
by the Governor. It was recommended 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
NoBTH Carolina Board ok Health 25
Health Officer, but it can only become effective upon the approval of
the Governor. The term of the State Health Officer, along with mem-bers
of the Board of Health, was restricted to four years.
Following the adjournment of the Legislature, the Governor ap-pointed
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, Kin-ston;
Carl V. Reynolds, Asheville; S. D. Craig, Winston-Salem; L. B.
Evans, Windsor.
It will be noted that Dr. Parrott was the only member of the out-going
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 member-ship
on the Board before being elected to the position of State Health
Officer, and under the provisions of the new law the executive com-mittee'
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 meeting 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 consolidations,
on account of reduced appropriations for the Board work. The serv-ices
of Dr. D. A. Dees and Mr. R. B. Wilson were dispensed with,
effective July 1. The Board reorganized the staff and made many con-solidations.
The new reorganization follows:
The Board reorganized the work into divisions, making many con-solidations
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 divi-sion
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
26 TWK.NTY-NlNTH BlE.XNIAL REPORT
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 members con-tinued
their service just as the Board was constituted at the close of
1931.
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 annual
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 satis-factory
results, although on account of reduced appropriations 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 low-est
of any previous year, although progress in the elimination of these
diseases has not been so satisfactory 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 unemploy-ment
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 maternal mortality
remains high, and indications are that with decreased 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 expenditures
made by the Board of Health for the fiscal year ending June 30, 1930.
1933. The events of outstanding importance to the Board of Health this year
was the death of Dr. C. A. Shore, which occurred on February 10. For
twenty-five years Doctor Shore had been director of the State Labora-tory
of Hygiene. He had built the work of the laboratory during these
NoKTH Carolina Board of Health 27
years up to a point where its prestige and usefulness was equal to that
of any other public health laboratory in America.
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. He held the confidence and esteem of the medical profession
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 wiiolesome
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 Labora-tory,
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 Epidemi-ology,
was made director of the laboratory work. Doctor Hamilton,
on assuming his duties as director of the Laboratory, resigned the
duties of director of County Health Work and of Epidemiology, but
retained, how^ever, 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 Control 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 w^as
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 Charlotte, for a four-year term, expiring in
1937. Mr. Stowe succeeded Mr. J. A. Goode, a druggist of Asheville.
Dr. Carl V. Reynolds succeeded Dr. Burrus as President of the Board.
On July 1 Drs. Knox and Stimpson returned to the Board work and
resumed their places after satisfactorily concluding their year's schol-arship
work at Harvard and Hopkins, respectively.
The year was not marked by any widespread outbreak of epidemic
disease, and notwithstanding a continuation of the financial depres-sion,
the work of the State Board of Health held up fairly well. The
28 Twenty-Ninth Biennial Report
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 Department 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 employ-ees.
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 Ofllcer 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 OflScer to serve under the new, or reorganized, 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 recur-ring
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 members 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 attend
to the duties of the oflSce. The following sketch concerning Dr. Par-rott
and his work, written by the Editor, was published in the Health
Bulletin:
"The death of Dr. James M. Parrott, State Health Oflacer 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 impos-sible
and unbelievable to think that he is dead. Nearly thirty years
ago I 'took' the State Board examination for license to practice medi-cine.
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 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 execu-tive
in charge. Although he came to the Board work without previous
North Carolina Board of Health 29
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 professionalization of public health work.
"Before he had been here sixty days, he realized that all depart-ment
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 profession, which hurt him;
but it may be said to his credit that he stood four-square for compe-tently
trained men as public health officials.
"On assuming office, he realized that he had some very unpleasant
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 armor 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 every-thing
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 expected 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 respon-sibility.
He knew all during that last year that, in justice to himself
and his family, he should resign and be relieved 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 questionable 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
program of far-reaching importance to the people of the state. It
could not be. His big brain is forever inactive. His profound knowl-edge
of the public health needs of the people is left for his successor
to acquire for himself.
"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 January, 1935, concerning Dr. Reynolds and his
30 Twenty-Ninth Biennial Report
work. It is herewith reproduced in order that this chronological record
may be complete.
"Doctor 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 suc-cessful
Asheville physician who died when Doctor Reynolds was
only three years old. Doctor Reynolds obtained his literary education
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. Doc-tor
Reynolds located in Asheville for the practice of medicine, special-izing
in pulmonary tuberculosis. His skill in combating 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.
"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
Epidemiologist.
Dr. M. V. Ziegler, of the United States Public Health Service, who
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. Pox, who had completed a postgraduate course
North Carolina Board of Health 31
in the Public Health School of Harvard University, was made Direc-tor
of the Division of County Health Work.
Dr. R. T. Stimpson, who had also successfully completed a post-graduate
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 Goldsboro, 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 succes-sor
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 fol-lowing
May 1.
1935. Dr. Carl V. Reynolds served as Acting State Health Officer, the Gov-ernor
having deferred the approval of his election the previous No-vember
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 election 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 Wednesday,
May 8, Dr. Grady G. Dixon was reelected to succeed himself to mem-bership
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 physi-cians
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
32 Twenty-Ninth Biennial Report
Health Service at Washiiigton. It was a year which noted much
activity in public health work all throughout the state, and the per-fection
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 disablement 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 Legislature. The Industrial Commission ap-preciating
that a problem of preventive medicine was involved, en-gaged
in a series of conferences 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 administration of the
occupational 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 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 Sanatorium for Tuberculosis
Medical Staff was selected as the Director of the division. Mr. M. F,
Trice, formerly of the Division of Sanitary Engineering of the State
Board of Health, was made Engineer of this new division.
1936. 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 depart-ment
at the University of North Carolina and the selection of Dr.
Milton J. Rosenau as its director. This new department, 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 fol-lowing
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. Rosenau as its direc-tor.
This development has been made possible by the coordination of
the staffs of the faculties of the North Carolina 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 University
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 fac-ulty
he had been head of the famous Harvard School of Public Health
for many years.
North Cakolina Bo.mid of Health 33
"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 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 departments 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, National, State and local in
modern conditions of living are an absolute necessity. There are large
numbers of young physicians who with proper postgraduate 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 throughout 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 addi-tion
to adding a division of field training of public health nursing in.
connection with the new department of public health at the State Uni-versity,
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 Assistant 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, look-
34 Twenty-Ninth Biennial Report
ing 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 Assistant Medical
Director in that division and Mr. C. R. Matbeson 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 textile industry in the state involving five plants
had been studied, in cooperation with the United States Public Health
Service, a granite cutting establishment investigation made, and a
foundry study inaugurated. There were 525 asbestos textile workers
and 46 granite cutters examined during the investigatory work. In
addition, preemployment examinations have been made of approxi-mately
400 workers. All persons examined have X-ray films made of
their chests. During this w^ork nearly 300 atmospheric dust samples
were analyzed. During the period, the physician and the engineer
attended a four weeks' special course on Industrial Hygiene given by
the Public Health Service in Washington. The division has installed
a complete oflice equipment, as well as portable equipment necessary
for successful execution of this important w^ork. 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 Cripppled Children, prepared by
the State Board of Health and submitted to the United States Chil-dren'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 serv-ice,
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 direction 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
North Carolina Board of Heajlth 35
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 tremendous 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 estab-lished
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 number
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 organi-zations.
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. Woi-th 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 materially 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 education in Boston. Dr. Roy
Norton, who had been with the Division of County Health Work for
about a year, and who was formerly health officer of Rocky Mount,
succeeded Dr. Worth. Miss Mabel Patton, a qualified nurse, joined the
staff of the Division of Preventive 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 results 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 Gov-
36 Twenty-Ninth Biennial Report
ernor 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 succeeded remarkably well in interpreting
technical problems to the lay readers in hundreds of articles in
the daily and weekly press of the state. Dr. G. M. Leiby, who had been
Assistant District Health Officer in the Haywood-Jackson-Swain Dis-trict
with headquarters at Bryson City, joined the sub-staff of the
Department 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 a consultant in the Department of Epidemiology in the field of
venereal disease control. Miss Margaret Thompson, who holds a mas-ter's
degree in home economics and nutrition work from the Uni-versity
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 contribu-tion
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 welcome
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 pur-pose
of building a new plant for the State Laboratory on the grounds
adjacent to the present State Board of Health building on Caswell
Square, Raleigh. A PWA grant of about $130,000 additional was
received and work on the buildings 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 decisions concern-ing
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 inspection and
control unit was established in the Department of Epidemiology July
1, 1937. Effective also in 1937 was the new plan of the Division of
Vital Statistics with reference to the notification of birth registration
certificates to parents. Instead of waiting 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 adopted of sending to each parent whose
North Carolina Board of Helvlth 37
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 privilegese 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 reelected by
the State Medical Society or re-appointed by the Governor, for addi-tional
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 accomplished.
This year two outstanding events may be recorded. First, the Zachary
Smith Reynolds Foundation decided to donate its income 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 oflScials of the foundation to Dr. Reynolds was a
check of $100,000. This philanthropy 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 economic conditions and the promotion of human happiness,
philanthropists such as Rockefeller led the way. This gift of the
Reynolds 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 effective
system through which the venereal diseases may be eventually con-trolled
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 La-
Follette-Bulwinkle Bill, sponsored and carried through the lower
House of the United States Congress by Representative A. L. Bul-winkle
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 additional funds for
work in syphilis control. The proceeds of these 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 preg-nancy
to prevent the birth of hopelessly syphilitic babies. It is proba-bly
a fact that the benefaction of the Smith Reynolds Foundation is
38 Twenty-Ninth Biennial Report
the largest single gift for this particular 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 diseases as yellow fever, typhoid and syphilis.
The School of Public Health Administration of the State University
at Chapel Hill has made such material progress that it became nec-essary
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 per-suaded
to accept the professorship. The State Board of Health reluc-tantly
agreed to Dr. Norton's transfer in view of the fact that the
School of Public Health Administration is of such far-reaching impor-tance
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 pro-fessors
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 education 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 Carolina 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 returned 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 Medi-cine
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.
There were no expiration of terms of service of the membership
of the State Board of Health this year, therefore no changes in per-sonnel
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
NoKTH Carolina Board of Health 39
faculty for a special course to train local technicians which was
largely attended.
An important piece of field work which met with widespread appre-ciation
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 principals
attended these Institutes which were of a practical character. The
Institute 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 general supervision of Doctors Reynolds
and Cooper of the State Board of Health, and it was carried out under
the health education division of the Board, and Dr. J. Henry High-smith
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 miscellaneous items.
Dr. Roy Norton, who for nearly two years had been assistant di-rector
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 remainder of the year.
Beginning with July 1 of this year, the following counties set up
whole time health department organizations: Alamance, Alleghany,
Ashe, Davie, Polk and Union. On September 1, Catawba, and Septem-ber
16, Cleveland. On November 1, Currituck became a member of
the district health department with Dare and other counties.
1939. In the Division of Sanitary Engineering, John D. Faulkner returned
to the department to resume his work after taking a year of public
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 reap-pointed
by the Governor.
On August 7, Dr. John S. Anderson was appointed as a member 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
40 Twenty-Ninth Biennial Report
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 consultant,
resigned his position with the Division of Epidemiology to accept the
position of director of venereal disease control in the City of Wash-ington,
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 October 15, by Dr.
T. P. Vestal, a native of Randolph County, formerly 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 Highsmith
resigned her position as health educator, effective October 1. Mrs.
Highsmith's resignation was very 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 ma-tured
after two or three years' efforts, attended by frequent con-ferences
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 Edu-cation
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 supple-mentary
grant of $50,000 by the Rockefeller Foundation and the
General Education Board to be spent over a five year period, com-mencing
July 1, 1939. The official designation of this organization is
the North Carolina School Health Coordinating Service. The or-ganization
as a whole consists of an Advisory Committee and a full-time
operating staff. The Advisory Committee consists of five mem-bers:
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. Charles E. Spencer,
physical education; Miss Olive Brown, physical education; Miss Mac-
Veigh 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. Preliminary plans involving the
selection of trained personnel and numerous other organization
North Carolina Board' of Health 41
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 during 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 requirements 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 prevalence 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 general and $51,829.11 venereal
disease by the United States Public Health Service, $130,290.49 by
the Zachary Smith Reynolds Foundation, and $123,578.15 from fees
received by the Laboratory in water taxes, etc., and other mis-cellaneous
items.
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 con-structive
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. ShoJ'e 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 allocation 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 Shore Memo-rial
Building was dedicated with appropriate 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. Kellog, 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 Inter-national
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 institu-
42 Twenty-Ninth Biennial Report
tioiis 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. MacNider, 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 Caro-lina,
Mr. E. C. Derby, Resident 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 con-sists
of approximately 280 acres of which 100 acres is under cultiva-tion,
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 laboratory 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.
On April 1, John D. Faulkner was transferred from the Division
of Sanitary Engineering to the Division of Epidemiology to have
charge of rodent control work.
John Andrews who had effectively headed the milk sanitation pro-gram
in the Division of Sanitary Engineering resigned to accept an
important position with the United States Public Health Service in
Washington. R. F. Hill, Jr., finished his year of specialized training
in sanitary and public health engineering at the University of North
Carolina 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 sewerage 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 assist-ance
in registration. Social Security benefits requiring proof of num-ber
and age of 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.
North Carolina Boaed of Helalth 43
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 Dur-ham
Health Department. Gates County joined the district to be com-posed
of Hertford and Gates, the work to become effective July 1,
1940.
In the Division of Industrial Hygiene, there was issued a profusely
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 ventilation 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 approx-imately
July 20, 1940, and were made possible by 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 generously, that certain pro-cedures
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 E)pidemiology. Dr,
Sykes had previously served for several years as county health oflacer
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 progi'am. 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 divi-sions
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
44 Twenty-Ninth Bienniax Report
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 micro-scopes
and sixteen of the larger clinics were given fluoroscopes.
On January 1, Dr. Emmett S. Lupton was employed as assistant
director in the Division of Preventive Medicine. Dr. Lupton had just
completed his internship 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 increasing number of
infants and expectant mothers among the poorer 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
ito 60,000 monthly copies during the year.
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 during the year. Early in Jan-uary
it was required by the Children's Bureau that standards to form
the basis of a merit system should be submitted before the alloca-tion
of Children's Bureau funds for the winter quarter would be
forthcoming. By the middle of January, 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 modifi-cations
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
official to work out further 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 Administra-tion
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 particu-lar
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 con-
North Carolina Board of Health 45
sidered 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."
Late 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 country. One of the first con-siderations
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 popula-tion
as possible, especially those liable for military service. On Octo-ber
16, 1940, which was registration day under the Selective Service
Draft, the North Carolina 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 examination
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 necessary 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 Gov-ernment,
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 $1,380,174.90. Of this amount $370,-
057.67 was appropriated by the Legislature, $162,813.81 by the
Zachary Smith Reynolds Foundation for syphilis control work,
$229,872.28 by the United States Children's Bureau, $318,148.38 general
and $175,557.72 venere