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LIBRARY OF THE UNIVERSITY OF NORTH CAROLINA, Endowed by the Dialectic and Philanthropic Societies. Alcove Shelf ^^r^S- This book must not be token from the Library building. Form No. 471 SEVENTH BIENNIAL REPORT OF THE NORTH CAROLINA lBO/\t^tS OF HH/\LTH 1897-1898 RALEIGH : Edwards & Broughton, Printers and Binders. 1899. MEMBERS OF THE BOARD. ELECTED BY THE MEDICAL SOCIETY OF THE STATE OF NORTH CAROLINA. George Gillett Thomas, M. D., President Wilmington. Term Expires 1899. S. Westray Battle, M. D. Asheville. Term Expires 1899. W, H. Harrell, M. D Williamston. Term Expires 1899. John Whitehead, M. D _ Salisbury. Term Expires 1899. APPOINTED BY THE GOVERNOR. C. J. O'Hagan, M. D - Greenville. Term Expires 1899. J. D. Spicer, M. D. * Goldsboro. Term Expires 1899. J. L. Nicholson, M. D. Richlands. Term Expires 1899. A. W. Shaffer, Sanitary Engineer Raleigh. Term Expires 1899. Richard H. Lewis, M. D., Secretary. ...Raleigh. Term Expires 1899. * Resigned. 7f ^X LIST OF COUNTY SUPERINTENDENTS OF HEALTH IN THE STATE OF NORTH CAROLINA DECEMBER 31, 1898. Alamance—Dr. W. R. Goley, Graham. Alexander—Dr. T. F. Stevenson, Taylorsville. Alleghany— Anson—Dr. E. S. Ashe, Wadesboro. Ashe—Dr. L. C. Gentry, Grumpier. Beaufort—Dr. Joshua Tayloe, Washington. Bertie—Dr. H. V. Dunstan, Windsor. Bladen—Dr. Newton Robinson, Elizabethtown. Brunswick—Dr. D. B. McNeill, Supply. Buncombe—Dr. I. A. Harris, Jupiter. Burke—Dr. J. L. Laxton, Morganton. Cabarrus—Dr. J. S. Laflferty, Concord. Caldwell—Dr. A. A. Kent, Lenoir. Camden- Carteret—Dr. F. M. Clarke, Beaufort. ,Caswell— Catawba—Dr. D. M. Moser, Conover. Chatham—Dr. H. T. Chapin, Pittsboro. Cherokee—Dr. S. C. Heighway, Murphy. Chowan— Clay—Dr. W. E. Sanderson, Haysville. Cleveland—Dr. R. C. Ellis, Shelby. Columbus—Dr. J. F. Harrell, Whiteville. Craven—Dr. L. Duffy, Newbern. Cumberland—Dr. J. Vance McGougan, Fayetteville. Currituck—Dr. H. M. Shaw, Shawboro. Dare— Davidson—Dr. John Thames, Lexington. DAViE^Dr. James McGuire, Mocksville. Duplin—Dr. F. H. Arthur, Magnolia. Durham—Dr. John M. Manning, Durham. Edgecombe—Dr. L. L. Staton, Tarboro. Forsyth—Dr. John Bynum. Winston. Franklin—Dr. E. S. Foster, Louisburg. Gaston—Dr. J. H. Jenkins, Dallas. ' ; Gates—Dr. R. C. Smith, Gatesville. Graham— Granville—Dr. G. A. Coggeshall, Oxford. LIST OF SUPERINTENDENTS OF HEALTH. Greene—Dr. Joseph'E. Grimsle}% Snow Hill. Guilford—Dr. A. E. Ledlietter. Greensboro. Halifax—Dr. I. E. Green, Weldou. Harnett—Dr. 0.|;L. Denning, Dunn. Haywood—Dr. J. Howell Way. Waynesville. Henderson—Dr.'J. G. Waldrop, Hendersonville. Hertford—Dr. John W. Tayloe, Union. Hyde— Iredell—Dr. Henry F. Long, Statesville. Jackson—Dr. J. H. Wolff. Sylva. Johnston—Dr. L. D. Wharton, Smithfield. Jones—Dr. S. E. Koonce, PoUocksville. Lenoir- Lincoln—Dr. L. A. Crowell. Crimsic. McDowell—Dr.'B. A. Cheek, Marion. Macon—Dr. F. L. Siler. Franklin. Madison—Dr. Jas. K. Hardwicke, Marshall. Martin—Dr. W. H. Harrell. Williamston. Mecklenburg—Dr. M. C. Strong, Charlotte. Mitchell—Dr. C. E. Smith, Bakersville. Montgomery- Moore—Dr. Gilbert McLeod. Carthage. Nash—Dr. H. Brantley, Spring Hope. New Hanover—Dr. W. D. McMillan, Wilmington. Northampton—Dr. H. W. Lewis. Jackson. Onslow—Dr. E. L. Cox, Jacksonville. Orange—Dr. C. D. Jones, Hillsboro. Pamlico- Pasquotank—Dr. I. Fearing, Elizabeth City. Pender—Dr. George F. Lucas, Currie. Perquimans—Dr. C.^C.Winslow, Winfall. Person—Dr. J. A. Wise, Roxboro. Pitt—Dr. E. A. Moye, Greenville. Polk—Dr. W. S. Green, Mill Spring. Randolph—Dr. Dr. T. T. Ferree, Ashboro. Richmond—Dr. W. M. Fowlkes, Rockingham. Robeson—Dr. H. T. Pope, Lumberton. Rockingham—Dr. Sam Ellington, W^entworth. Rowan—Dr. W. L. Crump, Salisbury. Rutherford—Dr. W. A. Thompson. Rutherfordton. Sampson—Dr. R. E. Lee, Clinton. Stanly— Stokes—Dr. W. L. McCanless, Danbury. Surry—Dr. John R. Woltz, Dobson. Swain—Dr. A. M. Bennett, Brvson Citv. LIST OF SUPERINTENDENTS OF HEALTH. Transylvania—Dr. M. M. King. Brevard. Tyrrell— Union—Dr. J. E. Ashcraft, Monroe. Vance—Dr. W. J. Judd, Henderson. Wake—Dr. R. B. Ellis. Raleigh. Warren—Dr. T. B. Williams, Ridgeway. Washington—Dr. W. H. Ward, Plymouth. Watauga—Dr. W. B. Council, Boone. Wayne—Dr. Jas. H. Powell. Goldsboro. Wilkes—Dr. J. W. White. Wilkesboro. Wilson—Dr. C. B. Walton, Wilson. Yadkin—Dr. M. A. Royall. Yadkinville. Yancey—Dr. J. L. Ray, Burnsville. LETTER OF TRANSMISSION. North Carolina Board of Health, Office of the Secretary, Raleigh, January 3, 1899. His Excellency, Daniel L. Russell, Governor of North Carolina. Sir:—In compliance with Section 3, Chapter 214, Laws of 1893, I have the honor to present this, the Seventh Biennial Report of the North Carolina Board of Health. Very respectfully yours, RICH'D H. LEWIS, M. D., Secretary and Treasurer. SEVENTH BIENNIAL REPORT NORTH CAROLINA BOARD Of HEALTH. 1897=1898. The first of the past two years was not marked by anything out of the usual in sanitary matters, but 1898 unfortunately brought with it small-pox, which has from time to time appeared iu various sections of the State, although generally in a very mild form. The Board in the exercise of its advisory functions has as-sisted as far as possible the local authorities in its man-- agement. On the whole the management of the Super-intendents has been good, and the disease has been kept within comparatively narrow limits. The ijidications, however, for the coming year are not reassuring, owing to the general indifference to vaccination—the most im-portant element always in the contest with this disease, and peculiarly so in rural communities like our own where an effective quarantine is extremely difficult and often practically impossible. But although we move in a quiet way, we believe that our efforts are slowly, it is true, but surely making an impression on the minds and habits of our people. They are unquestionably more wide-awake to the fact that some diseases are pre-ventable and more interested in* the work of prevention than formerly. A thorough inspection of the w^atersheds and works 8 NORTH CAROLINA BOARD OF HEALTH. of the public water supplies of the State was made by the Engineer of the Board, and an analysis, both chemi-cal and bacteriological, of the waters made. This report published in the Bulletin was received with much inter-est, and the knowledge that they were watched doubt-less had a good effect upon the water companies, for while "soulless corporations,'' there is a good deal of ordinary human nature in their managers. The Monthly Bulletin has appeared regularly and promptly during the past twenty-four months, and be-comes more aud moreuseiul^s a.medium of communi-cation with all the physicians in the State and, in a limited way, of instruction to the people. This modest publication of the Board seems to be read, both at home and abroad, it appears, as in a letter from the sanitary editor of one of the great papers of the country asking to be put on the mailing list, the state-ment was made that the writer had been told that it was the best in the United States. We make no such claim, but merely refer to the matter in order that your Excellency and the General Assembly may know that the work of your agents for the protection of the peo-ple's health meets with approval. For lack of money the publication and distribution of literature in the form of pamphlets of a popular char-acter on the more important subjects in sanitation have been kept in abeyance. This we have found probably our most effective agency in educating the people in hy-giene, and trust that it can be resumed in the near future. For the work of the Board in detail the reader is re-ferred to the following pages. MEETINGS OF THE BOARD. MINUTES OF THE ANNUAL MEETING AT MORE-HEAD CITY IN 1897. Atlantic 'Hotel, MoREHEAD City, N. C, June 8, 1897. The Board met in annual session at -t.SO p. m., with President Thomas in the chair. Present: Drs. C. J. O'Hagan, J. D. Spicer, Geo. G. Thomas. W. H. Har-rell. Col. A. W. Shaffer and Dr. Richard H. Lewis. On motion of Dr. C. J. O'Hagan, Drs. Thomas and Lewis were unanimously reelected President aud Sec-retary, respectively. On motion of Dr. Harrell it was ordered that the mu-nicipal water supplies of the State be examined chemi-cally and bacteriologically during the current year ; and, that the Engineer of the Board at his convenience collect, pack, and ship samples of the same ; and at the same time make an inspection of, and report on the various water works and watersheds. Also that the Treasurer purchase necessary books for the Engineer. Upon a statement by the Secretary that the issue of the 20, 000 Health Pamphlets, ordered at the last annual meeting at Winston, had not been made for various reasons, Dr. O'Hagan moved that in view of the pres-ent embarassed condition of the State Treasury, their publication be postponed to a more favorable time. Carried. At the suggestion of the Secretary, the ^200 a year heretofore allowed him for clerical help, in view of the suspension of the distribution of Health Pamphlets, was, on motion, discontinued. lO NORTH CAROLINA BOARD OF HEALTH. Col. Shaffei^ called attention to the fact that members of the Board being State officers were required by law to take the statutory oath of office, and it was there-upon agreed that each member should make this oath before his Superior Court Clerk and forward it to the Secretary of the Board, to be filed with the proper State official. Adjourned to meet again at 10 p. m. RICH'D H. LEWIS, Secretary. Night Session. The Board reconvened with the same members pres-ent as at the afternoon session. Col. Shaffer was duly appointed to audit the accounts of the Treasurer at his convenience after his return to Raleigh. The continuance of the publication of the Bulletin was discussed, and, upon motion, it was ordered con-tinued in a form to be juodified by the Secretary. On motion of Dr. Nicholson, the issue of the Bulletin was ordered increased to a number sufficient to allow one copy for every registered physician in the State. On motion, Goldsboro was selected as the place for the next Health Conference, the time to be fixed by the President and Secretary after consultation with the local health officials. On motion of Col. Shaffer, the Secretary was desig-nated to attend the next meeting of the National Con-ference of State and Provincial Boards of Health at Nashville, Tenn. On motion of Dr. Nicholson, Col. Shaffer was desig-nated to attend meeting of Sanitary Engineers. On motion, the Board adjourned to meet at Goldsboro. RICH'D H. LEWIS, Secretary. CONJOINT SESSION WITH THE MEDICAL SOCIETY OF THE STATE OF NORTH CAROLINA. MOREHEAD CITY, JUNE 9, 1897. The conjoint session was called to order by the Presi-dent, Dr. G. G. Thomas, who said: The State Board of Health is so thoroughly in the hands of the Secretary that an address from your President seems an imposition on your time. I wish that the entire membership would stay, for the questions of sanitation are certainly as interesting and as im-portant as surgery or medicine. This Board, you know, works un-der great diflBculties, often against the adverse criticism of politi-cians. It looks now to those of us who are studying the signs of the times that we are now getting nearer the promised land. Several years ago, as you are aware, the Health Conference was instituted, and only a lack of means has made the conferences so few in num-ber. We believe that they have accomplished a great deal. If they haven't taught any great lesson to the people, they have made them think. In every community we have entered, we feel sure that we have left some seeds which will grow into a harvest of indefinite size. I have only one thing I wish to say, and that is in regard to the extension of the State Law in regard to communicable diseases. Last year at a meeting of the Board at Winston, I took occasion to remark that it would be a good thing to add measles to the list of quarantinable diseases. This is not a move that will commend itself to the general practitioner, and more especially to the elders in the profession. I say it with all becoming respect and reverence for these gentlemen. They generally agree with what I have heard said of a surgeon in one of the Confederate camps who went into the hospital and found a great number of country lads who had never been ex posed to the poison of measles, and they were very sick. Another day brought an increase, and another day still more, and the sur-geon wanted to know what in the world their mothers meant when they did not see that they had had measles in their childhood. That i2 NORTH CAROLINA BOARD OF HEALTH. expression. I am sorry to say. is coininon among the profession, not-withstanding the fact that the death rate is large. I do not know the statistics of the last epidemic, but I know that there are many saddened households left by that last march through the country. According to Stevenson and Murphy, mortality in Gfreat Britain and "Wales amounted to the lai^e number of from six to ten thou sand deaths in different epidemics. This does not take into account the number of people who were left with serious pulmonary trouble, and otherwise disabled. I believe in towns of any size it is possible to quarantine measles as easily as scarlet fever. It does not require so much care to quarantine from scarlet fever, now that it is recog-nized that the law is fixed. I know that the ravages of measles were marked by a great deal of disaster, coming as it did at a very inoppor-tune season—in winter. I think it would be wise for the conjoint session to consider whether measles should not be added tc the list of diseases that must be quarantined. So far as other diseases, whcoping-cough, mumps, chicken pox. etc.. are concerned, they might wait later. People wall have to be educated up to this, and present education will not allow stringent measures to be adopted, but I think it will be a i^rogressive stej) if the Board of Health adds measles to the list of quarantinable diseases. I believe that the time is coming when we will have to take this step. Dr. O'Haga^'^.—I think my friend mu.st have meant something personal when he mentioned the Confederate surgeon. I think the first step that ought to be taken should be to make it compulsory with every family to see that they had measles. Such, I have no doubt, is directly antagonistic with your views on the subject. If my friend Dr. Thomas had had to go through with the terrible or-deal of bringing three regiments through in 1861, and didnt agree with me in this, he would at least sympathize with me. This is pre-liminary to my idea of putting measles on the black list. I do not think it will do. The prevailing feeling is that it is not a very for midable disease. The popular \aew will not support it; and I do not think it is best to i^ush things too far, for there is danger of kick-ing. There is a wholesome di-ead of scarlet fever in 1 he popular mind, and they don't object to any restrictions on that, and also on diphtheria. Typhoid fever can be quarantined, but we must not interfere with measles and whooping cough ; they belong to the do-mestic faculty, and we must not intrude ui>on the premises of their rights. There is a matter of great importance for discussion now and that is the utter inefficiency of the County Superintendents of Health, and the carelessness and indifference to making monthly reports even remotely or approximately correct. I am tolerably well ac-quainted with the work of the County Superintendent of Health in SEVENTH BIENNIAL REPORT. I 3 our county, and I think you will ^gree with the statement I am about to mak?. I regret to say that politics enters too much in the choice of these Superintendents; they go into it for what they can make out of the office, and that is not a great deal. As to getting reliable statistics, their labors are utterly useless., Those from my county are not worth one cent, and I have no doubt that you gen-tlemen from the other counties will corroborate my statement. I do not know how it is to be remedied. It is almost impossible to get any reliable information. However, ve are just at the beginning of this work, and I hope we will improve, but I have no suggestions to make in I'egard to the improvement. Young men are optimistic and old men are pessimistic. I think the first step toward getting any correct data or any legislation upon it, would be to urge upon the County Superintendent of Health the imjDortance of absolute accu-racy in the monthly reports. I know that those from my own county are utterly worthless, and I have no doubt that it is true from all others, with the exception, perhaps, of Wilmington. Dr. Btrroughs.—I have listened to the remarks in regard to the quarantining of measles, and I have listened to what Dr. O'Hagan has said. I think that measles is a disease of more gravity than most physicians regard it, and it is the duty of the Board of Health to ([uarantine measles wlienever practicable. Measles gets into a community; it prostrates the majority of the inhabitants, and I know of no better way of illustrating the use of quarantine than by giving you an instance of two schools of which I have the honor to be tlie physician. One has about one hundred and forty to one hun-dred and sixty girls, and the other two hundred tc two hundred and twenty five young ladies. Measles last year got into this school of older girls, and 63 of them had it and were kept from their studies. ^ Several developed pneumonia in connection with catarrhal bron-chitis. It kept them from their classes, and some of them had to be sent home, and it demoralized the whole .school. The other .school quarantined against the Normal and Collegiate Institute, in which the measles appeared, and I visited first the school that had no measles. As a result the smaller school, though only 89 yards away and with 150 girls, developed not a single case. They were allowed to go on with their work. I think something of this kind could be done in keeping it from household to household. It is carelessness on the part of the health officers to allow measles to become scat-tered over a town. If you have a thorough quarantine at first, the disease will be easy to control. Unless you come in contact with it. you don't get it. If you would quarantine it just as you do scarlet fever v.e would not have .«o many constitutions undermined and so many ca.-;es of catarrh and pneumonia, laying the way for invasion by tubercular bacilli. I am in favor of quarantining measles. 14 NORTH CAROLINA BOARD OF HEALTH. Dr. Murphy.—I am inclined to agree with both gentlemen. I have had pretty much the sanfe experience that Dr. O'Hagan has had. I have gone through with two epidemics of it in the hospital for the insane. I had the irajDression that measles was contagious, and that all would have it, so I made no effort to quarantine. About that time, I visited the Georgia hosi^ital, where they have about two thousand patients. The doctor told me that some of his nurses had measles and they were trying to keep it from spreading. I said that that was useless. He said he was going to do it anyway, and sometime afterwards I asked him the result, and he said they had not had another case. So it seems to be of some use. In that hospital there are qui^ a number of buildings and they are all miired up, and I don't even now understand how he did it, but he is a truthful man. Dr. Munroe.—While I think that measles should be quaran-tined, and that inside of five years we will quarantine measles, I doubt whether the public mind is educated up to that point yet. In regard to the mortuary statistics, the trouble is to get competent men, In our section of the State, notwithstanding the registered physicians elect them, there is always a political scramble for the place. No reputable physician is going to try for it, and I believe that the people in the jail and in the poor house ought to have the best medical attention from the best medical talent in North Caro-lina. ^Dr. McDowell.—There are only half a dozen physicians in a county that report to these County Superintendents of Health, and how are they going to make any report that way '? They don't make any reports of contagious diseases or any mortuary statistics to health officer. I want to know if that is not our fault, I mean that ' we don't have better statistics. I know I have done very little re-porting. If there is a case of scarlet fever, we telegraph him, and the quai'antine takes place immediately. I think we ought to have a better organized county medical society in every county, and the work that came before them would be worth a great deal to the State Board of Health. It is with the physicians at large that this lies. I don't think the Superintendent of Health does anything now except attend to the poor house and jail. It seems to me that we as individual physicians could uphold the State Board of Health if we would pay the proper attention to our duties along this line. In these counties, it is a right hard matter to visit all parts of it and get the statistics and the number of cases of various diseases, and all this and the regulation of health matters, including the water supply, will rest with the physicians in the various localities. It might be easy to quarantine measles in a town, but if you try it in a country town the difficulties will increase. You never know any- SEVENTH BIENNIAL REPORT. 1 5 body has measles until the eruption appears. All the other children are- in school with this child, and who is going to be quarantined ? All his playmates and associates in school have flocked around him to sympathize with him because he is not feeling well, and have all become poisoned. Every child there has come in contact with him. You do not see but about one in ten who has measles, and it is almost impossible to quarantine. In a family where the daily bread is dependent on the labor of the father or the mother or some of the larger children, none of whom have had measles, what are you going to do ? In factory towns where most of the children work in factories, suppose you have them quarantined, how are you going to feed all these people ? How are you going to take care of them ? With the mother and larger children working for their daily bread, it seems to me that in a town of one hundred families of this kind, with two or three thousand inhabitants, you will have a hard time to support these people, and it seems to me to be almost impossible to quarantine in small towns. Dr. Burroughs.—It is no more trouble to quarantine a small town than it is any other. If you quarantine the first' cases, you can get hold of the others pretty soon. As soon as the people realize that measles is a contagious disease and that the children who have it will be stopped from school, they will recognize it as such and send for a doctor at once, and the thing will be easily put under control. In regard to mortuary and vital statistics. There is no way of getting them without further legislation. You must have township cemeteries, and a man in charge of each who would give a certificate of death for each one buried. There is no other way of reaching the mortuary statistics but by having township and not church and private burying grounds. Dr. Thomas.—I want to say a little more about this quarantine. If you didn't quarantine in diphtheria and scarlet fever, you would have just as wide spread an epidemic as you would in measles. The public mind has more dread of these two because they are more mortal. I still believe a great deal could be done in the counties if the physician^ who by law constitute the County Board of Health would have readings and discussions of these questions and urge the Superintendents to more work. Your mortuary statistics will be more thoroughly quoted. In our organization the thing had to be done in years and years; it is not a thing which can be done in months. I believe that now the work of this Society and the Board of Health is being appreciated by the people of North Carolina. I would like for the question to be still further agitated. The reading of the Annual Report of the Secretary was then called for, and was as follows : l6 NORTH CAROLINA BOARD OF HEALTH. REPORT OF THE SECRETARY OF THE NORTH CAROLINA BOARD OF HEALTH FOR THE YEAR 189f>-'9T. Richard H. Lewis, M. D., Raleigh, N. C. Since our last annual meeting the Board has accom-plished rather more work than during any period of the same length in its history. A statement of most of this in detail will be found in the Sixth Biennial Report cov-ering the part of 1896 belonging to our society year, and therefore it would be a work of supererogation to do more now than simply recapitulate what was done. Owing to the extent of this work the appropriation for 1896, together with the balance on hand from 1895, was more than exhausted, so that a good deal of the ex-pense had to be met out of the appropriation for the current year. In consequence of that fact w^e have not been able to undertake, since the first of January last, anything outside the usual routine. Practically, there-fore, a full statement of all the work for our past fiscal year will be found in the Biennial Report. With the exception of the convict camps which had to be omitted for want of money to pay the necessary expenses incident thereto, all the State Institutions were visited and inspected by Committees from the Board ap-' pointed by the President for the purpose, viz t The North Carolina Asylum for the Insane, the Institution for the Deaf. Dumb and the Blind at Raleigh, the Penitentiary, the State Capitol, the University, the College of Agri-culture and the Mechanic Arts, the State Normal and Industrial College—twice, once to specifically advise as to the best method of sewage disposal and once to make a general inspection—the Agricultural and SEVENTH BIENNIAL REPORT. 1 7 Mechanical College for the Colored Race, the School for the Deaf and Dumb and the State Hospital, at Morgan-ton, the Eastern Hospital at Goldsboro and the Oxford Orphan Asylum. In addition, upon request, the Board advised the proper authorities as to the best method of sewage disposal for a new building recently erected for the medical department at Davidson College; and the County Commissioners of Johnston County in regard to the removal of the jail to another site. Believing the purity of all drinking water, and espe-cially of the public water supplies, to be of paramount importance to the public health, and realizing that many of the municipal supplies* in our State, owing to the source of supply, were peculiarly liable to contami-nation, the Board at the last annual meeting ordered an examination made of them. This was done, not with the expectation of doing anythiag like thorough work (our limited appropriation forbidding that) but for the moral effect upon the water companies that would be produced by the simple knowledge of the fact that the State, having more regard for the lives and health of its citizens, their consumers, than for the size of their dividends, had an eye upon them. In obedience to this order a bacteriological examination was made of all the municipal supplies in the State. Of the fifteen, four were found to contain intestinal bacilli, and four to be suspicious, and were so reported by the Secretary to the Board at a meeting held in Charlotte on October 15, •96, at the time of the Health Conference there. As the result of this report, the Secretary was instructed to have made immediately another bacteriological and a chemical analysis of all the infected and suspicious waters; and he was further ordered, in those cases where the water was shown to be still bad, to notify the Superintendent of Health, the Mayor and the man- 1 8 NORTH CAROLINA BOARD OF HKALTH. ager of the water works of the fact, and call upon them in the interest of the public health to remedy the trou-ble, and, if he did not receive satisfactory assurance within thirty days that this had been done, to have the analyses published in the local papers for the informa-tion of the people using said waters. While seven or eight sent samples for the bacteriological examination — the Board furnishing the sterilized bottle—only two sent samples for the chemical examination. This second ex-amination revealed the gratifying fact that the intesti-nal bacilli had disappeared in every instance, and the condition of the various waters was much improved. In view of the difficulties of one kind and another en - countered by your Secretary in obtaining samples rightly packed and shipped in the investigations referred to, he would respectfully suggest that in case of another such examination that the samples be collected, packed and shipped by a member of the Board. Although this would add materially to the expense, it would, in his opinion, be money well spent as the works, including watershed, could at the same time be inspected. Besides these examinations of municipal water sup-plies, bacteriological analyses were made of three seri-ously suspected wells, one at the Oxford Orphan Asy-lum, one in Asheville, and one in Burlington, and the water of each was found to be unfit for use. Samples of water from a well in Oxford, one in Rowan County, and one in Winston, containing insects and worms visible to the naked eye were sent to the Secretary for an opinion. He being no entomologist, requested Dr. H. V. Wilson, the able Professor of Biology in the University, to make the identification for him. This he courteously and cheerfully did without charge, and deserves the thanks of the Board. In order to take stock and strike some kind of balance, SEVENTH BIENNIAL REPORT. 1 9 SO to speak, your Secretary addressed a circular letter to several hundred physicians residing in the eastern section of the State, asking their opinion as to what effect in the matter of improving the drinking water and preventing sickness and death had been produced by the pamphlet on Drinking Water in its Relation to Malarial Diseases which, together with other Health pamphlets, had been widely distributed in 1895. Only fifty-six replies were received up to the end of the year and the evidence was, in the nature of the case, far from ideal in quality, but it nevertheless plainly showed that in a great many instances a better domestic water sup-ply had been provided, and that much good had been accomplished in the saving of health and life. In October last Dr. R. H. Whitehead, of the Medical Department of the University, kindly offered through the Board to make for any physician desiring it, free of charge, the serum diagnosis test for typhoid fever and ' ' to make the laboratory useful in any other way so far as my (his) time will permit." His generous offer was accepted with thanks, and notice thereof with directions was given through the Bulletin, a copy of which is mailed monthly to every member of the State Medical Society. Very few, however, we regret to learn, availed themselves of the offer. With the beginning of 1896 a new departure in the collection of vital statistics was made for the purpose of securing more trustworthy reports, by requesting report-ers to sign at the bottom of each monthly report a certi-ficate to the effect that the report included "the whole number of deaths occurring in the corporate limits dur-ing the above month." Since that time twenty-four of the twenty-seven towns making mortuary reports have certified to the accuracy of their reports. A con-sideration of these more reliable statistics has confirmed 20 NORTH CAROLINA BOARD OF HEALTH. thp fact to which attention was called in the Fifth Bien-nial Eeport, that the death rate from tuberculosis was very much higher among the negroes than among the whites—to be exact the proportion in 1896 was 3.33 to 1. The statement made in the same report that the negro seemed to be much less susceptible to diphtheria than the white man, the number of deaths from that disease recorded in the two years 1893- '94 being whites 22, col-ored 0, was also confirmed by the figures of 1896, the deaths from diphtheria during that year being, respec-tively, 13 and 1. As has been the case every two years since the Board was organized, the meeting of the Legislature was an-ticipated with more or less uneasiness. Subsequent events, however, did not justify the feeling, for no hos-tility to the Board and its work materialized. It is true that the law was so amended- as to take the election of the County Superintendent of Health out of the hands of the County Board of Health and give it to the County Commissioners, and at the same time give them abso-lute control of the salary of the Superintendent, but while, looking at the matter from every point of view the change, in our best judgment, was inadvisable, still the reasonableness of the contention that the body pay-ing an official should have the selection of that official and the fixing of his salary, looked at from the point of view of the business man, can not be denied. \Yith this exception the Act Relating to the Board of Health was not interferred with. In the matter of new legis-lation along sanitary fines an attempt was made to have laws enacted for the Prevention of Bhndness, for Com-pulsory Vaccination, and for the Protection of Public Water Supplies, bills for the two latter being prepared by your Secretary, at the request of the Hon. Thos. H. Sutton, one of the Members of the House from Cumber- SEVENTH BIENNIAL REPORT. 2 1 land. The first named was still-born, the 'second was promptly defeated, and the last, while it was reported favorably by the Committee on Public Health, and was endorsed by every one approached on the subject, could not be gotten up, owing to the press of other business in the last month of the session. In this connection we feel that our acknowledgments ai'e due to many en-lightened friends of all parties, and to none more than to Dr. Abner x\lexander, of Tyrrell, who was always keenly alive to the value and importance of our health and medical laws. In conclusion it is due His Excellency, (xoveruor Rus-sell, that we should express our appreciation of his evi-dent desire to keep politics out of the Board, as shown by the truly non-partisan appointments of members to fill the vacancies caused by the expiration of the pres-ent incumbents. We trust that this may ever remain so, whatever the political faith of our Chief Executive, and that the usefulness of the Board may remain un-impaired. MINUTES OF THE ANNUAL MEETING AT CHAELOTTE IN 1898. BuFORD Hotel, Charlotte, N. C, May 3, 1898. Annual meeting of the Board. Present: Drs. O'Ha-gan. Battle and Nicholson, Col. Shaffer and the Secre-tary. In the absence of the President, Dr. O'Hagan was called to the chair. The minutes of the last annual meeting were read and approved. The report of the Engineer of the Board, Col. Shaffer, 22 NORTH CAROLINA BOARD OF HEALTH. on the public water supjDlies of the State, was read and discussed. On motion, the Secretary was instructed, after con-sultation with the Engineer, to devote one issue of the Bulletin, or so much thereof as may be necessary, to the publication of said report, together with the chemical and bacteriological analyses of the samples of the vari-ous water supplies; and to send a copy to the Mayor and Board of Aldermen of the respective towns. On motion, the President and Secretary were appointed delegates to the annual meeting of the National Con-ference of State and Provincial Boards of Health, and Col. Shaffer as delegate to the American Public Health Association. On motion, it was ordered that the public institutions of the State be inspected, and their sanitary condition be reported on by committees of two from the Board, to be appointed by the President. Col. Shaffer, who was appointed a committee of one to audit the account of the Treasurer, reported it cor-rect. On motion, the Board adjourned to meet at the Con-joint Session to-morrow at 12 m. RICH'D H. LEWIS, Secretary. CONJOINT SESSION ^YITH THE MEDICAL SOCI-ETY OF THE STATE OF NORTH CAROLINA AT CHARLOTTE, MAY 4, 1898. The special hour having arrived, the Conjoint Session of the Board of Health was announced, and in the ab-sence of the President, Dr. S. Westray Battle, of the Board, was called to the chair. The Secretary read his report, which, after a full dis-cussion, was ordered printed. SEVENTH BIENNIAL REPORT. 23 ANNUAL REPORT OF THE SECRETARY OF THE NORTH CAROLINA BOARD OF HEALTH, 1897-'98. By Richard H. Lewis, M. D., Rai/EI«h, N. C. The past year has of necessity been less active than the years immediately preceding. Our work being largely educational, prosecuted chiefly by the free dis-tribution among the people of health pamphlets on sani-tary subjects, has been—temporarily we hope—sus-pended for want of funds to pay for the printing. To meet this difficulty, as far as possible, it will be remem-bered that the Board ordered at its last annual meeting at Morehead in June last, that the character of the Monthly Bulletin be somewhat changed by omitting certain statistical tables and inserting in lieu thereof reading matter that might be of more interest and profit. Not being able to mail a copy to everybody, it was thought best—as the physicians, especially those liv-ing in the country, largely control public sentiment in all medical and kindred matters—to send it free of charge to every registered physician in the State. Owing to the inability, in spite of earnest efforts, to secure a complete list of the physicians, the execution of this or-der was postponed until the September issue. Since that time the Bulletin has been mailed regularly to every doctor whose name was on the register a year ago. In this connection it would be proper to allude to the complaints generally made by County Superintend-ents of the failure on the part of the physicians to re-port to them, and the plan adopted to overcome this ap-parent indifference. Hoping that the failure to report was more the result of thoughtlessness or forgetfulness rather than actual indifference, and that a monthly re-minder might help matters, I have since the November 24 NORTH CAROLINA BOARD OF HEALTH. issue printed on the last page of the Bulletin the usual blank, with the request to the reader to fill it out and mail it to his County Superintendent by the 3d of the month for use in making up his report to me. While it sometimes happens, owing to press of work with the State printer, that the Bulletin does not reach its destination as early as it should, it doubtless generally does on or before the 3d, but we fear that it has brought no material improvement. INSPECTION OF WATER SUPPLIES. Believing that the mere analysis of the waters of the public supplies of the State ordered by the Board at the Winston meeting two years ago had been of benefit by the intimation it conveyed to the water companies that some one had an eye on them, it was decided at the Morehead meeting to repeat the work, but more thor-oughly. The plan first adopted of having the sample of water taken and shipped by the local health officer hav-ing been found in more than one instance unsatisfactory, and an inspection of the works and watersheds by a re-sponsible and disinterested person being deemed desira-ble. Col. A. W. Shaffer, the Engineer of the Board, was requested to make such inspections, and while doing so to take and ship in a proper manner samples of the various waters to the State Experiment Station for a chemical, and to the bacteriologists of the Board for a biological analysis. Col. Shaffer did this work in bis usual thorough and painstaking manner, and I regret to say, found not a few things deserving of criticism. In the course of his examinations he made it a point to learn water rates. He found that they were from iri to 75 cents per 1,000 gallons to small consumers, with, in some cases, a required minimum consumption amounting to not less than Si per month. This, of course, means prohibition of the use of the public sup- SEVENTH BIENNIAL REPORT. 25 ply to the poor except where pubhc fountains are pro-vided. Although these supplies in our State are not as a rule, first-class, the water in nearly every instance is safer than that of the wells, and it should be within the reach of all. If there is anything more than another except air, to which every man is entitled, it is an abundance of good water. I doubt if the Board could do a better work than to inaugurate and prosecute a crusade for free water—at any rate, water as cheap as possible—for those of our people in the larger towns not blessed with an abundance of this world's goods. YELLOW FEVER. The epidemic of this disease occurring last summer and fall on the Gulf while, fortunately, it did not ex-tend to our borders, was a constant' source of anxiety to the authorities of our city of Wilmington, which was liable to infection. During the prevalence of the epi-demic, the follovv^ing correspondence, which explains it-self, occurred: Raleigh. N. C, September 22, 1897. Dr. R. H. Lewis, Secretary State Board of Health, Raleigh, N. C. Dear Sir: I am directed by the Governor to enclose you this letter from Surgeon-General Williams for j'our consideration and advice in the matter. The Governor would suggest that while this invitation, if extended. might be productive of inducing some men of means to make their homes in Western Carolina, it might also result in bringing into our State large numbers of people without the means of subsistence while here and whose expenses in returning might have to be paid by our people. Very truly yours. J. E. ALEXANDER, Private Secretary. AsHEViLLE. N. C, September 18, 1897. His Excellency, Daniel L. Russell, Governor. Dear Sir: If it meet with your approbation, I should be pleased to telegraph United States Marine Surgeon-General Wj'man offering the 26 NORTH CAROLINA BOARD OF HEALTH. mountain plateau of Western North Carolina as a refuge for tlie refugees from the fever-stricken districts. Very respectfully, your obedient servant, JOHN H. WILLIAMS, Surgeon-Oeneral N. C. S. G. Raleigh, N. C, September 23, 1897. His Excellency, D. L. Russell, Governor of North Carolina. Deak Sir : The letter of Surgeon-General Williams asking your ap-probation of the extension of an invitation to persons in the fever infected districts of the South to take refuge on "the mountain plateau of Western North Carolina," submitted to me for my '• consid-eration and advice in the matter," was received this p. m. Having duly considered the svibject, I would respectfully say. in my opinion it would be unwise to extend the invitation. While I do not think that at this season of the year and at the elevation of our moun-tain plateau there would be any appreciable danger of conveying the disease of yellow fever to the residents, I do believe that it would be practically impossible to detain the refugees upon the plateau suflBoi-ently long to prove that they were not infected, and that, therefore, there would be a distinct risk of some of them going to certain sections of our State that are susceptible to the disease—notably our city of Wilmington—and sowing the seeds of a serious epidemic. One section of the State might have to pay very dearly for the advertisement of another—to say nothing of the economical suggestion you make that a number of helpless people might have to be cared for at our expense. The suggestion of Dr. Williams, looked at from the point of the whole State, is, to my mind, clearly unwise. Very respectfully yours, RICHARD H. LEWIS, Secretary. The principal lesson drawn from the epidemic was the unsatisfactory character of our present quarantine ar-rangements. The friction developed between the United Marine Hospital Service and the State quarantine officials was such as to satisfy nearly every one except some of the said State officials that National supervision and control of our maritime and interstate quarantine is greatly to be desired. This being an extremely important matter and the President of the Board, a resident of our prin-cipal seaport, and for maay years on the Quarantine SEVENTH BIENNIAL REPORT. 27 Board of the same, holding identical views with myself on the subject, I thought it well in two numbers of the Bulletin to advocate those views, viz: National quaran-tine by the Marine Hospital Service. The past winter having been a very mild one—not sufficiently cold per-haps to kill the germs—it is to be feared that the dis-ease may reappear with hot weather. Then, too, the communication with Cuba, that may be brought about by the war, is not reassuring. But, if, as a result of the war, the city of Havana can be put under the con-trol of those who will enforce the proper sanitary regu-lations, its present menacing character as the breeding ground par-excellence of this disease, may be abolished. SMALL-POX. In the December Bulletin attention was called to the prevalence of small-pox in South Carolina and Georgia near our border, and Superintendents of those coun-ties near the infected districts were exhorted to make the most of any scare that might exist among their peo-ple and vaccinate as many of them as possible. The first case occurring in our State w^as reported in Wilmington on February 12th, in the person of a negro coming from South Carolina. In a few days another case, also a negro from South Carolina, occurred. Both recovered. In Charlotte there have been four cases —all negroes—with two deaths, origin of the disease also South Carolina. A young man from Georgia introduced the disease into his family in Clay County. Every member of the family, to the number of ten including himself, had it but none died. On March 2, a case in the person of a negro child from Alabama was reported near Gibsonville, in Alamance. On March 30th I was notified by the Superintendent of Health of a case in Salisbury ; origin, Knoxville, Tenn. On April Ittth the 28 NORTH CAROLINA BOARD OF HEALTH. Health Officer of Asheville notified me of a case there in a negro man ten days from Jacksonville, Fla. As there seems to have been no small-pox in that city, he probably contracted it en route through South Carolina. A few days later another case was reported from Ashe-ville— a negro woman who, in the eruptive stage of the disease, had fled from South Carolina for fear of the pest house, and had been in hiding several days before being discovered. There have been, altogether, 21 cases of small-pox in North Carolina since February 12th—10 white and 11 colored, with two deaths among the latter. With the exception of its extension to members of the immediate family of one case in Charlotte and of the Clay County case, there was no spread of the disease whatever. This speaks well for the faithfulness and efficiency of those having the responsibility of its pre-vention, and is very gratifying. But at the same time we should return thanks to the kind Providence that rules the affairs of men, for in some instances the au-thorities, owing to the determined, not to say violent, resistance of the people—the ignorant classes—were not able, or at any rate failed, to carry out the precaution-ary measures required; as, for example, in Wilmington, where the compulsory vaccination ordered was so vio-lently resisted by the negroes as to cause the abandon-ment of the attempt. In Charlotte, however, the au-thorities were more successful. Acting Mayor Brevard sent a man who refused to be vaccinated to jail, and in consequence, and for other reasons, 17,000 it is estimated, were vaccinated. The unreasoning prejudice of iguo- , ranee is extremely difficult to meet, and sometimes re-quires a resort to methods that are very obnoxious to Americans. So we should make all due allowances for such failures. SEVENTH BIENNIAL REPORT. 29 HEALTH CONFERENCE. The usual Annual Health Conference with the People was held in Goldsboro on October 14tli. An excellent programme was prepared, but owing to the unavoidable absence of several of those who had promised papers, it was not as full as usual. Notwithstanding this and the rivalry of a popular theatrical troupe, the attendance aud interest shown were gratifying, and we were as-sured that it had done good. Our former associate, Dr. Venabie, kindly helped us out most materially with a valuable and interesting illustrated talk on ''Bread." FORMALDEHYDE DISINFECTION. The importance of disinfection, thorough disinfection, in sanitation being so overwhelming, and believing dis-infection by formaldehyde gas to be practically the best method, I devoted the November issue of the Bulletin to that subject. Every physician in the State received a copy in regular course, and I hope the interest of many was quickened; but knov/ing how often we are prevented from doing what we like for want of the nec-essary materials, I thought it well to send a copy to all the druggists in the State whose address could be ob-tained— more than 300—together with a letter request-ing them to keep in stock the necessary apparatus for this method of disinfection, and asking tliem to let the jDublic, and especially physicians, know that they had the apparatus. PURE FOOD AND DRUG CONGRESS. In obedience to orders from the President of the Board, I attended the meeting of the above in Washington, March 2-4. A large number of delegates representing practically every interest involved were present, and 30 NORTH CAROLINA BOARD OF HEALTH. seemed to be much in earnest. The Pure Food bill, which had already been introduced in the House by Mr. Brosius, of Pennsylvania, was amended by the Con-gress. A Committee was appointed to work for it, and, but for tlie war with Spain, some much-needed legisla-tion on this line might have been obtained. COUNTY SUPERINTENDENTS OF HEALTH. It is with much regret that I have to announce the failure of ten counties to elect Superintendents since the power to elect was transferred by the last Legisla-ture from the County Board of Health to the Board of County Commissioners. This is very discouraging. It is a retrogression that it is to be deplored. As the election, under the amended law, takes place annually on the first Monday in May, I mailed to the Boards of Commission-ers referred to the following letter: Raleigh, April 27, 1898. Board of County Commissioners— CrEXTLEMEX : Not having any reports from your County Superintend-ent of Health for some time, I fear that j^ou overlooked his election. I would respectfully call your attention to the fact tliat the law (chap-ter 214, Laws 1893,) is mandatory on the subject. As amended by tlie Legislature of 1897 the Superintendent •'shall be chosen by the boai-d of county commissioners of each county annually, on the first I\Ion-day in May of each year, and the said board of commissioners shall fix the compensation of said county superintendent of health." It is very important to the health interests of the people that tliere should be such an oflicial in each county (it being another name for county physician), and inasmuch as your honorable Board has abso-lute control of the selection of the ofiicer and of his remuneration, I hope you will comply with the law and elect a Superintendent on Mon-day nest. Please have your Secretary send me his name and address, and oblige. Yours truly, RICHARD H. LEWIS, M. D., Secretary. In conclusion, I feel it my dutv once more, to call upon the members of the Society and of the profession of the State in general, to lend us their invaluable aid in advanc- SEVENTH BIENNIAL REPORT. 3 1 ing our work. That work is, and must be for many years to come, chiefly educational. As intimated in the begin-ning of this report, in all medical and sanitary matters there is no influence comparable to that of the family physician. If every physician would make it his busi-ness to insist on his patients carrying out the ordinary sanitary precautions, the result in one year's time would be very great. Gentlemen, we count on your help in this glorious work of preventing disease and saving life. DISCUSSION. Dr. Lewis.—I would be glad to have any expressions of opinion in regard to the management of this health business, or suggestions as to what I might do to ad-vance the cause of sanitation. Our hands are tied largely by the want of money in the State Treasury, which prevents the printing and distribution of the health pamphlets, which has been one most effective mode. Dr. Fletcher.—I do not know that this is the time to do it, but I would like very much to see one thing in force, and that is some sort of compulsory vaccination law in North Carolina. Most of our towns have com-pulsory laws, but it is difficult to get them enforced. If we had a law similar to that in effect in some other States requiring every child before entering school to be successfully vaccinated, I think it would be a step in the right direction, and in a few years we would get everybody vaccinated. I don't know whether it is wise or expedient to burden Dr. Lewis with this. Dr. Lewis.—I would like to say that I prepared a bill on that subject and had it introduced in the last Legis-lature, and that it was treated with absolute contempt. The only lever we would have upon the people would be to prevent the children from going to school if they T,2 NORTH -CAROLINA BOARD OF HEALTH. were not vaccinated, dne practical difficulty on educa-tional lines now is to get the children to go to school at all. Dr. Haigh.—T requested our representative, Judge Sutton, before he left for Raleigh, to introduce such a bill, and he told me that he had gone to the Secretary and asked him to write it. There is one point about this matter that I think we might strike at right now. Why is it that the people are refusing to have their chil-dren vaccinated? Formerly there was no objection to it at all, and the virus we used was human virus and passed from the animal through the human system. The re-sult of that was a modified ^condition. We got a virus that did not produce such violent results as the bovine virus does now. The point I want to make is this: The great fear has been all this year, especially from the violent results of the vaccination, that they will lose their arms and that the children will die. What is the cause of it ? I do not know that I am right, but I do know this to be a fact. In using the virus, I have as far as I could selected those points having no color stain, and where I have done that, I have gotten a fuil vac-cine result, and very little erysipelas and inflammation. I believe that you can go back to the origin of this. There has been such a demand for virus that they have been dipping too many points into one pock, and in that way, instead of getting pure virus, they have got pus mixed with it, the result of inflammation. If some-thing could be done along that line, we would not pro-duce this condition and set up such inflammation. Some of the points I sent back and asked to have them ex-changed for pure ones, where not so many points had been dipped into the same pock. I think it has had a great deal to do with it. I do not think I vaccinated over a hundred people. I could not do anything with SEVKNTH BIENNIAL REPORT. them. I think if the matter could be taken entirely under control of the Board of Health, and have our Secretary get all the virus for the State from some one point where he was perfectly sure that it was good, and then send it out to the counties, w^ would get better results than we do now. I am quite sure as long as the results are as they are now, that the people will object to it. Dr. Le^^s.—In regard to the State Board furnishing the virus, I wish to say that some years ago we had a scare in a supposed case at Wadesboro. I "whooped it up" and tried to scare everybody to death, advertised that I had reliable virus on hand, and invested the Board's money in 100 points. I could work off only about thirty. Dr. Minor.—One point I would like to mention, and that is the tendency to advocate humanized virus. In my experience, the patients have always refused to be vaccinated unless I assured them that I had bovine virus. Dr. Haigh.—I was not advocating the humanized virus. I was saying that there was no objection to that but that it was in a modified form as compared to bo-vine virus. Dr. Burroughs.—A great deal of prejudice lingering in the mind of the public is from using humanized virus. Poisoned arms gave our people a great deal of trouble during the Civil war. I will just say for the benefit of the Society that they have had small-pox in South Carolina in close proximity to Asheville, and we strongly advised the vaccination of the whole town and quarantining against these places be-fore Christmas. I went before the local Board of Health and strongly urged the importance of vaccinating the 34 NORTH CAROLINA BOARD OF HEALTH. whole town, especially the school children, before the opening of the schools, but they didn't. I vaccinated about 3, 800 since the last week in Novem-ber, and I haven't made but one visit to see one person in that whole 3,800. Since we got that case of small-pox, I haven't vaccinated very many, because I already had them vaccinated. Since the scare came, I have vac-cinated about 600. 1 used the National vaccine points, and 90 per cent of them have taken. Dr. Anderson. —In regard to the vaccine lymph in tubes. I wanted to be careful, and I wrote to Dr. Gallo-way, asking what he would advise, and to send me 100 points he could recommend, and he telegraphed to Chicago for these lymph tubes. We found them satis-factory, and recommend their use. Dr. Fletcher.—1 want to say a word just along the line of Dr. Haigh's remarks. It is only recently that the tubes have come out, bat I found that many times the points would not take. Since I began to use the tubes, in 360 cases of primary vaccination with tubes, every one of them took. We had a few bad arms with severe inflammation, and some of them did not get well imme-diately. Some of them vaccinated in January are not well yet. We did not have erysipelas, but the arm was red and swollen to the elbow, and even the muscles be-low the elbow were swollen. It does not appear to be safest in every way, but :it takes more effectually than the points. Dr. O'Hagan.—It is a little singular that the remark-able discovery of Jenner, the value of which has been demonstrated time and time again, should find antago-nists not only among the ignorant, but often among in-telligent people ; yet it is unfortunately so. A mode of overcoming this prejudice is yet to be discovered. You may talk what you please about virus and ivory points, SEVENTH BIENNIAL REPORT. 35 neither does it matter what variety of vaccine you use, you will find some cases where the peculiarity of the in-dividual makes vaccination undesirable. I never saw a fiddler vaccinated in my life, and I have vaccinated many thousands of people. It makes little difference what kind of vaccine you use, or under what favorable circum-stances you proffer to the masses of the people such an invaluable protection as this is, somehow or other, tney will not accept it. I have been in the habit of preach-ing vaccination for the last thirty or forty years. Every year of my life I buy a few vaccine points and inform my patients that I have them there. I don't propose to vaccinate gratuitously. I do not propose to go around peddling these points and try to make the people pay me a dollar to vaccinate them, but I try to show the in-estimable value of vaccination. I do not know anything in the world that will make them be vaccinated except a good small-pox scare. I do not know which way is best. I have vaccinated from arm to arm and have had delightful results, and again I have had very unpleasant ones. The President tells me he has used the lymph tubes in Newbern, and has had unpleasant results, and so here it goes. In 1854 we had a terrible epidemic in our county, and I wrote to Wilmington for vaccine, and in reply received a very ugly little scab, but I vaccinated a grep,t many and never had a single bad result. I have seen the most careful vaccination from the most reliable virus fol-lowed by remarkable consequences. The main question is to get the people to accept the protection. I know nothing in the world that will induce them to do so but a good first-class case of small-pox. Dr. Duffy.—Dr. O'Hagan refers to the liquid virus, with which I had some little experience. I can't say, I am sorry, just where it was put up. I think it was 36 NORTH CAROLINA BOARD OF HEALTH. somewhere in Chicago. You may be famihar with it. You will find it in sealed glass tubes ; a rubber tube comes with them. You break off both ends of the glass • tube and attach the rubber tube to one end, and then by gently blowing through the latter, you get out a drop ot the virus. Be careful to first disinfect the arm with alcohol. At first I took a razor, and without drawing-blood, got off the epidermis and put a little drop of the virus upon one spot. I found that all of it, in almost every case, would strike in. I had very sore arms, and no matter how little I put, it seemed to give very sore arms. After some little experimenting with it as to how to do it, instead of putting it in one spot, I put it in three spots. It seemed to me that three small spots gave me less trouble than one, no matter how little I used. One thing I want particularly to refer to, and that is the manner of dressing the arms. A great deal of the trouble in vaccination in my experience has come from the patient's hurting the arm in some way. It is diffi-cult to avoid. The vaccination shields are not very good, for they slip around and are about as bad to press on the arm as anything else. I have tried bandages, going aroLind under the pit of the arm to get some attach-ment, and all proved unsatisfactory until I took a piece of rubber adhesive plaster, about the size and shape of an ordinary envelope, and having attached tapes to the edges of it, fastened it to the arm opposite the vesicle. Then by placing rolls of absorbent cotton under the tapes next to their points of attachment they were lifted up and they could be tied over the dressing without exert-ing too much pressure. You can untie the tapes and dress the arm as often as may be desired. Dr. Murphy.—I understood the Secretary to ask for advice to help him out. I don't know v/hether the Sec- SEVENTH BIENNIAL REPORT. 37^ retary expects to vaccinate or Dot, but it seems to me that we have wandered off from the subject of advice. So far as I am concerned personally, I feel that we have our health affairs in the best hands in which we could put them, and I endorse fully what the Board of Health has done, and I recommend that they continue the Health Conferences about through the State. I would be glad to have them up in our part of the State this vear. Dr. ,— I appreciate the value of vaccination as a preventive of small -pox, but whereas the results we get from vaccination are better than small-pox, I must confess that the popular prejudice against vaccination is not wholly without justification. In our experience during last summer—I speak for myself and my asso-ciate— we used all the care we knew how to use. Thor-oughly believing in the aseptic treatment of wounds, we would prepare the arm aseptically, both scrul)bing the arm, at the point to be vaccinated, with hot water and then rinsing with alcohol, and with a sterilized knife making a slight abrasion, would dip the point into sterilized water and make the application of the virus. When through, we dressed the arm with a little steril-ized gauze, this dressing to be removed again when the sore began to manifest itself. While we could not al-ways follow up the after treatment of these cases, in quite a good per cent we did follow it. True, we did not lose any lives or any arms, but it must be confessed we did have quite a number of very bad arms. I know in the person of my own little daughter, whose case I watched carefully, she was for three days violently ill. She was carefully educated and trained as to the neces-sity of not scratching the place and thereby infecting it, and in spite of the care which had been taken, she had a high temperature and suffered a great deal of pain. 38 NORTH CAROLINA BOARD OF HEALTH. had constitutional disturbances and extensive eruption and was, in other words, quite sick. In one or two cases we were for a while really in great fear for their lives. Now I say this, that while I believe in vaccina-tion and think it ought to be done and urge it, it seems to me that something ought to be done and some steps taken to secure a virus which is less active, and which will not produce such violent constitutional and local symptoms. When we can do that, I believe the public prejudice will to a great extent rapidly fade away. I am glad to hear what my friend Dr. Haigh said in regard to the selection of points, and I shall bear it in mind. I hope he will solve the difficulty. We thought possibly the trouble was that the virus was not suffi-ciently attenuated, had not passed through a large enough number of animals, but that was purely hypo-thetical with us, but certainly something was the mat-ter. We used the National points. I would not vacci-nate one of my children with an Alexander point, though others may be as bad. Dr. Kent.—When the doctor called out this discussion, I had hoped it would take a different turn. I have list-ened with a great deal of pleasure to the discussion of vaccination for small-pox, and yet I feel, as County Su-perintendent, that it has not been of as much value to me as if it had taken that turn. I am disposed yet to call out a different line of discussion, and endeavor as County Superintendent to derive some benefit from it. We meet around us far more evils that we know than those that we know not of. We know typhoid fever, we kuow measles, we all know consumption. We have them to do battle with almost continually, and if from our discussion here I can be better able to prevent a sin-gle case of typhoid fever in my county during the com-ing season, I believe I would be more benefitted by the SEVENTH BIENNIAL REPORT. 39 knowledge of how to do that, than I would by any knowledge of better vaccine virus, and for that reason, I desire to give the discussion that kind of a turn. Some weeks ago I had a gathering of the physicians in my count}'" for the purpose of discussing what we might do to prevent the prevalence of typhoid fever in my county during the coming season. We discussed various means that we knew of, and resolved that we would appoint ourselves each a committee of one to do what he might in his especial community among his patrons to teach them how to live, and how to clean up the hot-beds of this disease around their houses, and how to obtain pure drinking water. And if any of the members here can make any suggestions to me that will enable me to more practically teach the people what to do to prevent the spread of typhoid fever during the coming season, I will certainly be greatly obliged. Dr. Reynolds.—I do not rise to discuss typhoid fever, but I have a few words to say about vaccination, and with your permission, I will return to that topic of dis-cussion for a few minutes. It seems to me that a man when he is vaccinated has to have some constitutional disturbance, a sore arm, and be made sick, before he is successfully vaccinated. You might put the vaccine on a man's arm and have a little scar and a little irritation, and 1 would not call that man successfully vaccinated. I would not think he would be. I remember having vaccinated one child in Novem-ber, and it failed to take. I vaccinated it again in De-cember, and it failed to take. I got that point from Dr. Burroughs, I vaccinated again in April with lymph, all in different places, and that took, and it set up a fire in all three places. I had three scars on that child's arm. I can state positively that I did not get any lymph in the other scars on that child's arm. I think Dr. 40 NORTH CAROLINA BOARD OF HEALTH. Glenn, who has gone around with me considerably, has witnessed a case similar to this one. Dr. Glenn.—I have seen a case like this where the scars would light up. It seems to be latent virus. I saw it in my own family. My brother was vaccinated more than a mouth ago. It did not take, and about six or eight days ago, I vaccinated him again with a lymph tube. Wheu I left Asheville, that vaccination, which was more than an inch distant, and I am sure I did not touch it, was worse than the last place. I remember another case, that Dr. Reynolds called attention to first. Before this case of my brother's, I remember one vacci-nated in December that lit up like that, and I am sure that it never came in contact with the virus the second time. It seems to be latent virus. There is not enough to cause successful vaccination, but when a little more is added, it makes all the places light up anew. Dr. Lewis.—When I was in Washington, I availed myself of the opportunity to visit the National Vaccine Establishment. I was very much gratified with the con-dition of affairs. Everything is in first-class order, and precautions are all carried out. Dr. Burroughs.—In my business I have not used the tubes, but I am very favorably impressed with the re-ports. It seems to be more certain than the points, though I am satisfied with the points of the National Vaccine Company. I never heard of previous vaccina-tion being set up a second time. These cases the Ashe-ville gentlemen report are entirely new to me. In regard to what Dr. Kent says, my impression is that he will get pure drinking water if he will filter it. If he will destroy all the fecal matter from the typhoid patients, he will greatly lessen the disease in his county. In every case you have, destroy all the excreta, and look after the water supply. Therein is the key to health, therein is protection. That is all of it in a nut shell. SEVKNTH BIENNIAL REPORT. 4I Dr. Minor.—Wc all know that typhoid fever is en-demic to many regions of the countr}^ I think where the most trouble comes in is with the jDOor, uneducated classes. You ought to teach them first, if nothing else, that the well should be done away with. Where the well can not be done away with, you must teach them that it ought to have a sacred meaning, and have no close connection with the water-closet. You must teach them that the water-closet, or privy rather, must be water tight. Most of these privies have in them nothing but leaky tubs which are a constant source of contamination. The water supply, the well, and the privy are some of the things that must be looked after. Impress upon them the necessity of keeping these places clean. Scare them, tell them they are liable to die at any minute if they don't look out. Don't wait until typhoid fever comes into the house, but try to make them take cure. Keep on, and after awhile you will see the barrels water-tight instead of open, and they will set to work and clean up around the wells and their premises generally. Dr. Albert Anderson.—To accomplish these results, we have been talking in Wilson about how to introduce water into our houses. Our medical society formulated plans and advised our Board of Aldermen to adopt them. Dr. W. S. Anderson.—It is simply this: We had the water and sewerage system introduced about two years ago, and up to the present time, only about 200 families use them. The plan was to leave the putting in of the fixtures to private enterprise. The result was that plumbers charged the people so much that they would not take the water. I thought they charged tt)0 much, and I sent and got a catalogue and price list and found my suspicions were true, that they were charging an enormous per cent. So we got our local society to 42 NORTH CAROLINA BOARD OF HEALTH. appoiDt a committee to investigate the sanitary condi-tions of our town, and that committee reported to the society that the water was doing no good at all as a sani-tary measure. We recommended that the town investigate as to the cost of the material, and that the town buy the mate-rial in large quantities in order to secure the cheapest rates, and put it in to the people at cost, and let the people pay cash for the material. They haven't de-cided yet what they will do, but we think they will get with this uew Board that is just coming in, and that we will get the people of the town to do that, and in not a great while hence we will have the public water taken by all the people Then there will be a large number of people who can not take it even at cost. We proposed to the town that they go forward and put it in to these people on credit and take their notes for it. because at the present water rent it would pay for it-self in three years, if the poor fellow never pays it back. The town is not in the monej'^-making business on the people of the town. We think that in that way we can get the full benefit for which the water supply was in-tended originally, and make it so cheap that all the peo-ple of the town will take it. Dr. Lewis.—I think it would be well for the session to pass a resolution endorsing the Caffery Bill. I do not know what the sentiment is, but so far as I am con-cerned, and so far as anyone I have talked with is con-cerned, I think our opinion is that the JSIational control of maritime quarantine had better be placed under the Marine Hospital Service, where the men are selected by c(5mpetitive examination and not for political reasons, instead of under a National Department of Health, where the President appoints a Commissioner of Health with a salary of $6,000, who has the power of appoint- SEVENTH BIENNIAL REPORT. 43 ing an assistant Commissioner. The practical difficulty with this plan in the first place is that politics would surely come into it, and the Commissioner of Health would be selected, not as an expert, but as a man po-litically desirable, who would probably, even if he should prove competent, have to give place to a new and inexperienced successor just about the time he had thoroughly learned the business. The Caffery Bill, which was introduced by Senator Caffery, from Louisiana, and chiefly advocated by Sen-ator Vest, from Missouri, is a bill that enlarges the pow-ers of the Marine Hospital Service, and confides to them this National supervision. Dr. Carr.—I think if the Secretary would offer a reso-lution the Society would adopt it. We wish to carry out his wishes, for we know he is right. Dr. Minor.—I realize fully that Dr. Lewis under-stands it, but I do not. l have seen lately in the press, and in the medical press, too, such conflicting opinions that it would seem to nie until a full statement of both bills could be presented to us, we might be acting im-properly in proceeding to recommend what we do not fully understand. I can not vote on a thing till I know more about it. Dr. Long.—I do not think any of us can go wrong when we know that one bill proposes to put the control under competent scientific men. I think we must have some National legislation in regard to this. If we can get it and keep it under scientific control and get Uncle Sam's help, too, I am in favor of it, but if it is to be changed every four years, I am not, and we can not go * wrong if we take a stand against it. Dr. Lewis.—I would like to call attention to the fact that this bill is introduced by Senator Caffery, of Louis-iana. The quarantine of New Orleans is superior to any 44 NORTH CAROLINA BOARD OF HEALTH. in America or anywhere, and notwithstanding that fact and that the Senator from Louisiana is a Democrat and a States' Kights man, he has introduced this bill. The most ardent advocate of the bill is Senator Vest, who yields to none in his jealous watch over the reserved rights of the States. The following resolution was then adopted without a dissenting voice : Resolved. That the North Carolina Board of Health and the Medical Society of the State of North Carolina in conjoint session assembled endorse the Caffery Bill, enlarging the powers of the United States Marine Hospital Service, and respectfully request our Senators and Representatives to support the same. The session was then adjourned. THE PUBLIC WATER SUPPLIES OF THE STATE. At the annual meeting of the Board at Morehead in June, 1897, "it was ordered that the municipal water supplies of the State be examined chemically and bac-teriologically during the current year : and that the En gineer of the Board be requested at his convenience to collect, pack and ship samples for the same, and at the same time to make an inspection and report on the vari-ous water works and watersheds.'* Colonel Shaffer having carried out the above instructions, submitted his report to the recent meeting of the Board in Charlotte — the first since the completion of the work—and the Sec-retary was ordered to publish it in the Bulletin. ' It may be remembered by some of our readers that this. work of systematically investigating all the public water supphes of the State was first undertaken in ] 896, and was limited to simply an analysis of the water. SEVENTH BIENNIAL REPORT. 45 While that examination was very incomplete, owing to the extremely small appropriation by the State, it un-doubtedly had a good effect on the water companies. We are all more particular if we know we are watclied. Realizing this, the Board felt that some of its little money could not be put to a better use, and so the ac-tion indicated above was taken. The reader will understand, of course, that we do not suppose that an annual inspection and analysis will make puie water, but it Vvill make far parer water by causing the water companies themselves to take a more active interest in the matter. Neither would any num-ber of analyses insure pure water, for the reason that it must be already infected before the pathogenic bacteria can he found. Frequent inspections of the watershed, however, and thorough filtration would be much more effective. It is far safer and easier to prevent disease germs from getting into the water than to get them out after they have taken possession. And inasmuch as a number of our supplies are taken from small streams whose restricted watersheds are inhabited, the danger of infection is much greater than vrhere the origin of the supply is different. After a careful consideration of the matter, we have come to the conclusion that the best thing water companies obtaining their supply from such watersheds can do to insure the purity of their water, is to employ some reliable man whose sole duty it shall be to thoroughly patrol the watershed, going over it and visiting every residence thereon at least twice a week, and promptly reporting every case of fever or diarrhoeal disease, that it may be immediateJy investi-gated and such precautions taken as may be necessary. We are glad to say that this suggestion, made in a con-versation with one of the owners, has already been adopted by the Charlotte Water Company. If this thor- 46 NORTH CAROLINA BOARD OF HEALTH. ough and continuous inspection should be supplemented by approved filtration, we believe that the danger of in-fection would be reduced to a practical minimum. It is apparent, we think, that it would be clearly to the in-terest of the water companies, for- the occurence of typhoid fever traceable to their water would reduce their receipts far more than carrying out the above sugges-tion for a number of years. Besides, the effect of such careful protection of the water against infection would give confidence to the people, and would be immediately and continuously beneficial to their business. The reader of the report will doubtless be struck with the high price charged for water, especially to small consumers, which, of course, includes all the poorer classes. In several instances a minimum consumption amounting to S12 per annum is required, which is prac-tically prohibitory to the poor. While no doubt some of the companies find it a hard matter to "make buckle and tongue meet," this should not be. We have no control over the price charged, but we feel it our duty to say that high-priced water is not in the interest of public health. Pure water in abundance, at a price within the reach of all, is one of the most power-ful agencies for promoting the health of any commu-nity. It is for this reason that we believe so strongly in municipal ownership. We can not expect those who have invested their money in such enterprises for the purpose of securing dividends to look at the matter from the eleemosynary point of view—they have a right both in law and equity to make such charges as will insure them a reasonable return on their investment. But when the water works are owned by the people as a whole, the object of the management will not be divi-dends but health, comfort, beauty, and safety from fire. The general tendency is toward municipal ownership, SEVENTH BIENNIAL REPORT. 47 and we trust that it will spread in North Carolina. It pays. Wilson owns its own works and sells water at ten cents per 1,000 gallons at a profit. It should be noted in connection with the chemical analyses that where the albuminoid ammonia is too high, that it is nearly always due to vegetable matter in the stream in the form of leaves, etc., and that it is not dangerous in itself. In regard to the bacteriological tests, it should be said that while they are not as elabo-rate and complete as they might be, they are made by good men, and are carried far enough to show whether or not there is reason to suspect the water of being in-fected. In conclusion, we wish to put ourselves on record as favoring the use of public water supplies as against the water of wells, provided the companies will conscien-tiously use every reasonable effort to insure the purity of their supplies. The water of the public supply may sometimes be dangerous, but that from wells in closely-built cities and towns with surface privies, and more especially cess-pools, is much more apt to be so. The chemical analyses were all made for us without charge b^ the North Carolina Agricultural Experiment Station, and we desire to make our acknowledgments to Acting-Director Withers for his valuable aid in this respect. The comments on all chemical analyses are made by the chemist. REPORT OF COL. A. W. SHAFFER, ENGINEER OF THE BOARD. GOLDSBORO. GOLDSBORO, August 3, 1897. One saini>Je taken from intake on Little River at the power house, and one from the tap in front of Hotel Kennon, on Railroad street, 4 48 NORTH CAROLINA BOARD OF HEALTH. both for bacteriological analysis, taken, packed and delivered to Dr. Anderson, of Wilson, in his presence. Samples for chemical analysis have been since procured by yourself. This visit to Goldsboro has been fully reported heretofore. The following is the report referred to: "I reached the city about noon, and was glad to find awaiting me the President, Dr. George G. Thomas, and the Biologist, Dr. Ander-son, Drs. Spicer and Hill conferring with us cordially. "We visited the water works on Little River in company with the mayor, and found the works small, but filter working well, and sup" ply tinted with the juniper and cypress through which it passes, but clear, and free from green scum, bad odor or taste, which had been reported to exist there. We took samples from the intake and re turned to the city ; took another from the tap in front of Dr. Hill's drug store, in the hotel building, and Dr. Anderson packed both in ice and carried them with him that night to Wilson. "Through the courtesy of the mayor we were enabled to ride over the town and view its watershed and drainage. We found no sew ers, but we never saw a town so well adapted by nature for efficient sewering at a moderate expense—say Waring's system. There is ample grade and fall in every direction, with no rock or hard sub soil to penetrate, and would discharge into Neuse River within a mile of the corj^orate limits, two to three miles below the intake on Little River. "The water bearing stratum of Goldsboro lies barely ten feet be-low the surface, and in wet seasons the water in the wells rises to within four to slx feet of the surface. The waste water of the town empties into shallow surface ditches, and is liable to percolate through the sandy crust to the wells, from which a large majority of the citizens of Goldsboro obtain their water for all purposes. "I think that so far as the health of the town is concerned, there is greater danger than with no water works, because of the lack of sewerage to carry off the waste. "Briefly stated, Goldsboro is situated upon a plateau of open, sandy loam, elevated about twenty feet above, and distant about one mile from Little River on the northwest, and Neuse River on the south. The water bearing stratum under the town averages eight to twelve feet below the surface, and there are localities in which the well water can be reached from the surface with a long, handled gourd. Having no sewers, the city is drained by shallow surface ditches, alternately wet and dry from atmospheric causes; always more or less charged with the waste and sewage of buildings, and the use of the street and lawn taps connecting with the river supply, the shallow wells being the common receptacle and reservoir of all. "If typhoid germs breed and multiply under these conditions, SEVENTH BIENNIAL REPORT. 49 then Goldsboro is an ideal propagating ground, though the waters at the intake be as pure and hmpid as those of Pison, Gihon or Hid-dekel, that sprang from the garden of Grod. "Works belong to private parties, who sell water to small con-sumers at 40 cents per 1,000 meter gallons." N. B.—Since the above report was made the people of Goldsboro have voted bonds for sewering the city. CHEMICAL ANALYSIS. Sample from Intake. Total solid matter in solution 3.3 gr. per U.S. gal. Hardness .-- 1.4 deg. Clarke's sc. Equiv. to cal.car , 0.33 gr. per U. S. gal. Chlorine... 0.33 gr. per U.S. gal. Free ammonia 0. 106 parts per mil. Album, ammonia 0. 170 parts per mil. The chemical analysis indicates that this is not a good water for drinking purposes. Sample from Faucet in City. Total solid matter in solution 3.3 gr. per U.S. gal. Hardness 1.4 deg. Clarke's sc. Equiv. to cal.car 3.3 gr. per U. S. gal. Chlorine 0.33 gr. per U. S.gal. Free ammonia 0. 043 parts per mil. Album, ammonia 0. 233 parts per mil. The chemical analysis indicates that this is not a good water for di'inking purposes. BACTERIOLOGICAL EXAMIIfATION BY DR. ANDERSON. One sample, until fcered, was collected from the intake at the river. This showed 300 bacteria to the C. C. of benign form. The other sample, faltered, was collected from a faucet on Railroad street, and this contained only 53 bacteria to the C. C. The last sample repre sents the water used by the city, which is good. WILSON. Wilson, November 8, 1897. Two samples taken from tap in drug store adjoining Dr. Anderson on Main street—one delivered personally to Dr. Anderson and the other sent to Experiment Station at Raleigh. 50 NORTH CAROLINA BOARD OF HEALTH. Visited power-house, intake and watershed with Dr. Anderson These are about a mile from town. The works have no filter and the town no sewerage. The intake is about one hundred yards from the works, on the run of Toisnot Swamp, with a flow of water over the dam 10 inches deep and 12 feet wide, clear, but full of floating: leaves, and tinted slightly by decaying vegetation. The canal drain mg the swamp is about one thousand feet in length, and the area of the swamp about one and a half square miles, with ever recurring living springs along its margin—a very slight run crossing the road a mile above the intake. If an open, dry ditch could be maintained around the margin of the swam^), the banks of the canal and the run of the swamp cleared—say twelve feet wide on each side—and the run of the swamp opened and kept clear from dead leaves, fall-ing branches, trunks of rotten trees and water grasses that obstruct the flow, they would have as near an ideal reservoir as swamp lands ever afford. The works are owned and operated by the town ; sell water to small consumers at ten (10) cents per 1,000 meter gallons, and reali2e a profit upon the cost of'plant and its operation. CHEMICAL ANALYSIS. Total solid matter in solution 3. 33 gr. per U. S. gal. Hardne.ss 1.7 deg. Clarke's sc. Equiv to cal.car ._. 0.58 gr. per U. S. gal Chlorine 0. 33 gr. per U. S. gal. Free ammonia 0. 0449 parts per mil. Album, ammonia 0. 2155 parts per mil. The high percentage of albuminoid ammonia indicates vegetable contamination. BACTERIOLOGICAL EXAMINATION BY DR. ANDERSON. The bacteriological examination of sample of water collected from the Wilson public water supply, November 10, 1897, showed 150 bac-teria to the C. C. All tests used in making the examination showed the water good. NEWBERN. Nbwbern, November 10, 1897. Took two samples water from the running public hydrant at the corner of Main street, near the Hotel Chattawka; one sent to Dr. Anderson at Wilson, the other to Experiment Station at Raleigh. Water derived from six bored, or artesian wells; no watershed or SEVENTH BIENNIAL REPORT. 5 1 filter. Works owned and operated by private corporation, and water sold to .small consumers at 50 cents per 1,000 meter gallons, with a minimum of 100 gallons per day. CHEMICAL ANALYSIS. "> Total solid matter in solution 10. 25 gr. per U. S. gal. Hardness 10.01 deg. Clarke's sc. Equiv.to cal.car 7.58 gr. per U.S. gal. Chlorine 0.5 gr. per U. S.gal. Free ammonia - 0. 0100 parts per mil. Album, ammonia .. 0.020 parts per mil. There is no indication of organic contamination. BACTERIOLOGICAL EXAMIXATIOA' BY DR. AXDERsOK^. The sample of vvater received from the Newbern public water sup-ply, November 10, 1897, showed only 83 bacteria to the C. C. in mak-ing a bacteriological examination. All tests used show this water to be very good. WILMINGTON. WiLMiJfGTON, November 11, 1897. Took two samples water from tap in Mr. Munds's drug store on Main street ; packed, addressed and deposited them in exj^ress oflBce, and withdrew them after conference with and upon advice of the President of the Board to be retaken upon the completion of the artesian well now boring upon the site of the power house, or other production of acceptable water. Owing to the liability of infection by the city sewage in the ebb and flow of the tide, it is earnestly recommended that the intake be removed above tide water, in the event of the failure of the artesian well now boring. The works are owned and operated by private parties, and the water is sold to small consumers at 20 cents per 1,000 meter gallons. FAYETTEVILLE. Fayetteville, November 12, 1897. Two samples of water taken from the running public hydrant at the corner of Hotel Lafayette on Main street. One to Dr. W. T. Pate, at Gibson Station, and the other to the Experiment Station at Raleigh. 52 NORTH CAROLINA BOARD OF HEALTH. This water is derived from the great spring on Haymount Hill, and used for drinking purposes chiefly. Other water is taken from the run of Cross Creek, used for general purposes, and for drinking where Haymount water- can not be obtained. No sample taken from Cross Creek water. The works are owned and operated by private parties, and the water sold to small consumers at 25 cents per 1,000 meter gallons, but not less than §1 per month. CHEMICAL ANALYSIS. Total solid matter in solution 2.83 gr. per U. S. gal. Hardness 1.8 deg. Clarke's sc. Equiv.to cal.car. 0.67 gr.per U.S.gaL Chlorine.--- 0.5 gr.per U.S. gal. Free ammonia 0. J361 parts per mil. Album, ammonia 0. 0375 parts per mil. The chemical examination shows no indication of organic con-tamination. BACTERIOLOGICAL EXAMINATION BY DR. PATE. The quantitative analysis gave 180 bacteria per cubic centimeter. The qualitative tests showed no suspicious organisms. Sample good. ASHEVILLE. ASHEVILLE, November 19, 1897. Two samples taken from tap in Asheville hotel. One to Dr. Albert Anderson at Wilson ; the other to the Experiment Station, Raleigh. Through courtesy of Dr. Fletcher, visited the filter within the city, the stand-pipe and reservoir on Beaucatcher Mountain, and the power house and intake five miles out on the left bank of Swan-nanoa River. This is the best plant in the State. Four large filters are enclosed in brick walls ; the reservoir is an abandoned rock quarry, cleaned out and cemented, safe against the intense cold that destroyed the stand-pipe a few years ago, and the power house, dam and forebay are of solid rock masonry. The water is conducted to the city through two lines of pipes, one 10 and the other 16 inches in diameter, over two mountain spurs into the stand-pipe and the reservoir. This most expensive of the municipal water works of the State is the property of the city of Asheville, selling its water to small con sumers at 15 cents per 1,000 meter gallons, and supplying the street sprinkling, the sewer flushing, the public hydrants and the public fountains free. SEVENTH BIENNIAL REPORT. 53 The only settlement on this watershed is at Black Mountain, 16 miles away, and very small. CHEMICAL ANALYSIS. Total solid matter in solution 3. 16 gr. per U. S. gal. Hardness •- ". - - 1.4 deg. Clarke's sc. Equiv.to cal.car 0.33 gr. per U.S. gal. Chlorine 0.16 gr.per tj. S.gal. Free ammonia 0. 013 parts per mil. Album, ammonia 0. 0335 parts per mil. A very pure water. BACTERIOLOGICAL EXAMINATION BY DR. ANDERSON. The sample from the Asheville public water supply was received November 30, 1897. In the bacteriological analysis of this water no harmful bacteria were found. CHARLOTTE. Charlotte, November 33, 1897. Took two samples water from the running tap at Van Ness's gro-cery on North Tryon Street. One to Dr. W. T. Pate, Gfibson Sta-tion, the other to Experiment Station, Raleigh. By courtesy of Dr. Brevard, joint owner with Mr. Eli Springs, I visited the power- houses, reservoirs and part of the watershed. The latter consists largely of cultivated land. Not a favorable watershed for first-class water without thorough filtration. There are how ever, four filters in use. The supply is derived from two streams. Both average about one and a half miles from the principal square in town at the intersection of Trade and Tryon streets. Both are conducted to a settling basin near the power-house, from, which the water is conveyed to the filters. This plant is owned and operated by private parties, and water is sold to small consumers at 50 cents per 1,000 meter gallons. There exists an inchoate contract for the sale of the plant to the city. Note.—The management proposes to reduce the rent to private consumers. CHEMICAL ANALYSIS. Total solid matter in solution 5.91 gr.per U.S. gal. Hardness 3.8 deg. Clarke's sc. Equiv. to cal. car 8.33 gr.per U.S. gal. Chlorine 0.416 gr.per U.S. gal. Free ammonia - - 0. 36 parts per mil. Album, ammonia 0. 1877 parts per mil. 54 NORTH CAROLINA BOARD OF HEALTH. The chemical analysis indicates vegetable organic contamination. BACTERIOLOGICAL EXAMINATION BY DR. PATE. The quantitative examination gave 435 bacteria to the C. C. This sample forms gas in both glucose and lactose bouillon, but 1 did not succeed in isolating the fermenting bacteria. SECOND BACTERIOLOGICAL EXAMINATION MADE FOR WATER COMPANY BY DR. PATE. I have the honor to report as follows on sample of water sent me from the public water supply of Charlotte June 3, 1898: Sample shipped without ice. Is is clear ; no sediment. Contains only 130 bacteria to the C. C. of water. No fermentation in lactose or glucose bouillon, e\en after several days' growth. This analvsis indicates a safe drinking water. CONCORD. Concord, November 83. 1897. Two samples of water taken from tap at Marsh's drug store in presence of Mayor Crowell—one to Dr. W. T. Pate at Gibson Sta tion, the other to Experiment Station at Raleigh Visited power-houses (two—both inside city) with Mayor Crowell. The city is built upon the crest of a long ridge, and the supply of one station is taken from the Reed Grold Mine shaft on one water-shed, and the other from surface springs on the opposite side, both very exactly on the watershed of the town. At the first I found a pond of perhaps an eighth of an acre, about a hundred feet above the shaft, the overflow passing the station within ten or twelve feet. On the other watershed, directly opposite, was the other power-house, beside a walled and covered spring. The power-house contained a small Worthington pumping engine, furnishing power to run the pump and the electric light plant of the town. The Concord plant is owned and operated by a private party ; has a stand-pipe, but no reservoir or filter, and the water is sold to small consumers at 50 cents per 1,000 meter gallons. chemical ANALYSIS. Total soUd matter in solution 9. 66 gr. per U. S. gal. Hardness 6.1 deg. Clarke's sc. Equiv. to cal. car 4. 35 gr. per U. S. gal. Chlorine 1.16 gr. per U. S. gal. Free ammonia 0. 0449 parts per mil. Album, ammonia 0. 05 parts per mil. SEVENTH BIENNIAL REPORT. 55 The chemical analysis dees not show any indications of organic contamination. BACTERIOLOGICAL EXAMINATION BY DR. PATE. The quantitative examination gave 350 bacteria to the C. C. This water ferments both glucose and lactose at 4'3 degrees in 36 hours. Quantity of bacteria low—quality suspicious. CONCORD. SECOND INSPECTION. Concord, May 5, 1898. I have the honor to report that pursuant to the direction of the Board, made at Charlotte conference on the 4th inst., I visited Con cord, N. C, and took new samples of the municipal water, one for the North Carolina Experiment Station, at Raleigh; the other for Dr. W. T. Pate, Biologist, Gibson, N. C, forwarding same to each on the 5th inst. I also visited and carefully inspected the pump houses and water-sheds of the two stations, from which the water is obtained, in com-pany with Mayor Crowell and the owner, Mr. Fetzer. I found the ground about the walled sirring had be^n raised about the spring and graded off so as to make a watershed of about fifty (50) feet all around it, and the surface was clear and free from grass and weeds, but not inclosed. Some additional machinery, of an im-proved pattern—mostly electrical—had been placed in the power-house, but no closet or stables had been removed from the water-shed. Mayor stated, however, that an ordinance removing them, to go into effect June 1, had been passed. At the station on the opposite side of the ridge on which the town stands, known as the Reed Gold Mine Shaft Station, I found the pump and connecting pipes repaired and the pond freshly drawn off. Another dam had been con.structed across the run of the spring about ttvo hundred and fifty (250) feet above the shaft—covering an area of about three thousand feet—the overflow of which was car ried by a side-hill ditch to a wooden box receptacle about fifty (50) feet from the power-house, to be utilized for street sprinkling, the sprinklers taking it direct from the box. The watershed of this station is exactly as I found it in November last—barring the change of the pond. No closets or stables have been removed. All of the stables, and most of the closets discharge upon the surface, but others discharge in unwalled and uneemented pits and "old wells," the latter of which are presumed to connect 56 NORTH CAROLINA BOARD OF HEALTH. directly with the water-bearing strata within a radius" of three hun-dred yards of the pumping stations. Mayor Crowell is deeply interested in a plentiful supply of pure water and a limited sewerage within the financial capacity of the town. He afforded me every possible facility for inspection and .stated that the town council had lately adopted an ordinance for the removal of the closets and stables from the watershed, and as-sured me that if not rescinded at a subsequent meeting, he would see that the pits and vaults, after cleaning, should be well limed before filling, but the measure had met strong opposition, and there was danger of a reconsideration and rescinding of the ordinance before it goes into effect on June 1, 1898. I saw and conversed with some of the members of the town council, and gathered from their remarks that while all wanted pure water and plenty of it, they were disinclined to credit the contamination theory, and feared a "job," by which oppressive taxes would be inflicted without corre-sponding benefits. The wells on the dividing ridge are about forty feet in depth. How they will cleanse and purify those used for closet vaults, or whether they will fill them up without cleaning, or continue their use as heretofore, is yet an unsolved problem. I regret to have to state that the situation at Concord is not greatly improved from the situation of my November report, and I doubt whether it will be greatly improved until the water supply is taken from a source above and beyond the town limits. The Mayor assured me that such a source existed about two miles out, with ample sup-ply for many years of rapid annual increase. CHEMICAL ANALYSIS. Total solid matter in solution 9. 58 gr. per U. S. gal. Hardness 3.6 deg. Clarke's sc. Equiv.to cal.car 3.16 gr. per U.S. gal. Chlorine .0.79 gr. per U.S. gal. Free ammonia 0. 0073 parts per mil. Album, ammonia 0.0175 parts per mil. A very pure water. BACTKRIOLOGICAIi EXAMINATIOjN' BY DR. PATE. Sample of water collected May 5, 1898, by A. W. Shaffer, S. E., from tap at Johnson's drug store. Concord N. C. This sample contains only 92 bacteria to the C. C. of water. No fermentation in lactose or glucose bouillon in 48 hours. This indicates fair drinking water, and is by far the best sample that we have had from this supply. SEVENTH BIENNIAL REPORT. 57 • SALISBURY. Salisbury, November 24, 1897. Took two samples water from flowing hydrant of E. K. James, on Inniss street. One to Dr. Albert Anderson, at Wilson; the other to Experiment Station, Raleigh. Water derived from Cane Creek, rising about six miles above town and flowing along the base of Dunn's Mountain, from which a large part of its water comes. Watershed, cleared land on one side and mountain growth on the other. No residential obstructions. Power house and intake tw^o miles out; stand-pipe in town; no sewerage; pump run by Worthington engine; no filter; aU in good condition. E. B. Neave, Superintendent. Plant owned and operated by private parties, and water sold to small consumers at 30 cents per 1,000 meter gallons. CHEMICAL ANALYSIS. Total solid matter in solution 9.16 gr. per U. S. gal. Hardness 3.8 deg. Clarke's sc. Equiv.to cal. car 3.33 gr.per U. S.gal. Chlorine 1.66 gr. per U. S. gal. Free ammonia 0. 0566 parts per mil. Album, ammonia 0. 0725 parts per mil. The chemical analysis does not give any indications of organic contamination. BACTERIOLOGICAL EXAMINATION BY DR. ANDERSON. In the bacteriological analysis of sample of water sent from Salis-bury, received on the 26th of November, there were revealed some bacteria of a suspicious nature. There were 180 bacteria to the C. C. GREENSBORO. Greensboro, November 25, 1897. Took two samples water from running tap at Holton's drug store, in Hotel McAdoo Building, on Main street. One sent to Dr. Albert Anderson, at Wilson ; the other to the Experiment Station, Raleigh. Thanksgiving Day; everybody gone abirding; did not go to plant or watershed. Couldn't find anybody who knew anything about it. Plant owned and operated by private parties, and water sold to the small consumers at 40 cents per 1,000 meter gallons. 58 NORTH CAROLINA BOARD OF HEALTH. CHEMICAL ANALYSIS. Total solid matter in solution 5.66 gr. per U. S. gal. Hardness 3. 4 deg. Clarke's sc. Equiv. to cal. car 2.0 gr. per U. S. gal. Chlorine 0. 25 gr. per U. S. gal. Free ammonia - 0.0126 parts per mil. Album, ammonia 0. 0737 parts per mil. The chemical analysis does not give any indication of organic eon taminalion. BACTERIOLOGICAL EXAMINATION BY DR. ANDERSON. On November 26 I received sample of water from the Grreensboro public water supply. The bacteriological analysis showed 150 bac-teria to the C. C. This water is good. WINSTON. Winston, November 26, 1897. Took two samples from public hydrant in City Hall. One sent to Dr. W. T. Pate, Gibson Station ; the other to Experiment Station- Raleigh. Supply derived from two springs. No watershed ; no filter and no sewerage. Plant owned and operated by private parties and water sold to small consumers at 40 cents per 1,000 meter gallons. Rained all day. No ice accessible. CHEMICAL ANALYSIS. Total solid matter in solution 4. 08 gr. per U. S. gal. Hardness . 2. 1 deg. Clarke's sc. Equiv. to cal. car. 0.91 gr. per U.S. gal. Chlorine 0.766 gr. per U.S. gal. Free ammonia 0. 0233 parts per mil. Album, ammonia 0. 0435 parts per mil. The chemical analysis gives no indication of contamination. BACTERIOLOGICAL EXAMINATION BY DR. PATE. Shipped without ice. The quantitative examination gave 880 bac-teria to the C. C. The Qualitative examination reveals no suspicious bacteria. SEVENTH BIENNIAL REPORT. 59 SALEM. Salem, November 26, 1897. Took two samples water frcm tap at Dr. Shaffner's drug store, on Main street. One for Dr. W. T. Pate, at Gibson ; the other to Ex periment Station, Raleigh. Water supply derived from springs in southwest part of town. No watershed, no filters and no sewerage. Plant owned and operated by private parties, and water sold to the small consumers at 50 cents per 1,000 meter gallons. Rained all day, No ice accessible for bacteriological specimen. CHEMICAL ANALYSIS. Total solid matter in solution. 5. 08 gr. per U. S. gal. Hardness - . - 1.9 deg. Clarke's so. Equiv. to cal. car. 0. 78 gr. per U. S. gal. Chlorine 1.25 gr. per U.S. gal. Free ammonia 0. 24 parts per mil. Album, ammonia 0. 1935 parts per mil. The chemical analysis indicates that this water is very dangerous. There seems to be contamination from sewage. BACTERIOLOGICAL EXAMINATION BY DR. PATE. The quantitative examination gave 1,360 bacteria per C. C. This sample was sent by express without ice. ^ The qualitative examination gave no indication of the presence of suspicious organism. As soon as the attention of the management of the Salem Water Comjjany was called to the report of the State Chemist on their water they expressed their inability to explain the apparent condi-tion of the water, and at once asked that four new analyses, repre-senting the four sources of supply, be made. This was done, but all four samples turned out chemically excellent water. The apparent contamination of the first sample has never been explained. The following are the supplementary analyses: Total solid 'matter in solution 2. 92 gr. per U. S. gal. Hardness 2. 5 deg. Clarke's sc. Equiv. to cal. car 1.25 gr. per U. S. gal. Chlorine 0.46 gr. per U. S. gal. Free ammonia _ . 0. 051 parts per mil. Album, ammonia 0. 050 parts per mil. This sample shows no indication of organic contamination. 6o NORTH CAROLINA BOARD OF HEALTH. Total solid matter in solution 3. 35 gr. per U. S. gal. Hardness 3.3 deg. Clarke's sc. Equiv.to cal.car 1.92 gr. per U. S. gal. Chlorine.... 0.67 gr. per U. S. gal. Free ammonia 0. 0316 parts per mil. Album, ammonia 0. 0500 parts per mil. This sample shows no indication of organic contamination. Total solid matter in solution 3.17 gr. per U.S. gal. Hardness 3.3 deg. Clarke's sc. Equiv. to cal. car 1.O8 gr. per U. S. gal. Chlorine 0.25 gr. per U. S. gal. Free ammonia 0.0500 parts per mil. Album. ammonia 0. 0487 parts per mil. This sample shows no indication of organic contamination. Total solid matter in solution 1.17 gr. per U. S. o-al. Hardness.. 1.8 deg. Clarke's^sc. Equiv. to cal. car 0.67 gr. per U.S. gal. Chlorine.-.. 0.308 gr. per U. S. gal. Free ammonia 0.044 parts per mil. Album, ammonia 0. 0813 parts per mil. This sample shows no evidence of organic contamination. DURHAM. Durham, December 3, 1897. Took two samples water from flowing pubhc hydrant, corner Cochrane and Main streets. One to Dr. Albe-t Anderson, Wilson ; the other to Experiment Station, Raleigh. Water supply taken from a stream nine miles out, at its junction with Eno River. Reservoir five miles out. Filter and sewerage here. Did not visit watershed, as it would consume another day. Works owned and operated by private parties, who sell water to small consumers at 25 cents per 1,000 meter galions, or |3 per quar-ter, with privilege of 12,000 gallons. CHEMICAL ANALYSIS. Total solid matter in solution 3.67 gr. per U. S. gal. Hardness 1.9 deg. Clarke's sc. Equiv.to cal.car. 0.75 gr. per U.S. gal. Chlorine 0.375 gr. per U.S. gal. Free ammonia 0. 173 parts per mil. Album, ammonia 0.0505 parts per mil. SEVENTH BIENNIAL REPORT. 6l I While the chemical analysis will not condemn this water, it places it under suspicion of being contaminated with organic matter. BACTERIOlrOGICAL EXAMIXATIOX BY DR. ANDERSOIs^. There were 316 bacteria to the C. C. found in sample of water from Durham public water supply, received and put in culture De-cember 3, 1897. The water is fairly good. HENDERSON. ' JEiEj^DBRSOJf, December 3, 1897. Took two samples water from running public hydrant on public square. One sent to Dr. W. T. Pate, Gribson Station; the other to Experiment Station, Raleigh. Water taken from wells; no watershed, no filter, and no sewerage. Plant owned and operated by private parties, and water sold to small consumers at 40 cents per 1,000 gallons meter measure. CHEMICAL ANALYSIS. Total solid matter in solution 3. 25 gr. per U.S. gal. Hardness 1.5 deg. Clarke's so. Equiv.to cal.car 0.42 gr. per U. S. gal. Chlorine _ . . 0. 25 gr. per U. S. gal. Free ammonia 0. 067 parts per mil. Album, ammonia 0. 02037 parts per mil. BACTERIOLOGICAIi EXAMINATION'^ BY DR. PATE. The quantitative examination gave 184 bacteria per C. C. The qualitative tests indicate safe drinking water. RALEIGH. Raleigh, December 7, 1897. Two samples water taken from running public hydrant in front of Metropolitan Hall on Fayetteville street. One to Dr. Albert Anderson, at Wilson; the other delivered in person to Experiment Station, Raleigh. Water supply taken from Walnut Creek, one mile south of city. Intake a mile above, and a fourth of a mile above Rhamkatte road. Stream rises at Gary, eight miles west of city. Watershed visited, inspected and fully reported on heretofore. Condemned Yates dam still dominates the waters. The company filter their water, and the city is sewered. 62 NORTH CAROLINA BOARD OF HEALTH. Plant owned and operated by private parties who sell water to the small consumers at 40 cents per 1,000 meter gallons, conditioned that it amount to $12 per annum, or 30,000 gallons per annum. DETAILED REPORT ON WATERSHED. "I have the honor to report upon the watershed of the Raleigh AVater Company, visited and inspected in company with Dr. .James McKee, Superintendent of Health of the city; W. M. Russ, Mayor; and Alexander M. McPheeters on the part of the comiaany, on the 24th inst. Commencing at Cary, we found two open, unboxed privies on the bank of the main ditch, and a pig pen on another, the contents of the latter flowing directly into the main ditch at a distance of about two hundred feet. "The main ditch contained a very slight run of water, the product of a heavy shower the previous night. There is no living tributary at Cary, the ditch carrying no water except surface water during, and a few hours after, a storm—twenty four hours after which it is as "dry" as the town ordinance. The first evidence of a living stream appears about a mile below the town. "We found all the streams running muddy water from the rains of the previous night, until we reached the Hugh Campbell Spring Branch, a bold, crystal stream flowing from two fine springs on the place. "The watershed from Cary to Raleigh is largely covered and pro-tected by a natural growth of forest and hedge, briars, cane and shrub, and we found little to criticise until we reached the "Little Yates Mill," of L. D. Castleberry, on the Avent Ferry road in Swift Creek Township. The dam of this mill backs water over five to six acres, filled with mud and decomposed vegetation, with a rank growth of grass, reeds, shrubs and weeds. As the water is very shallow and the mud very deep the site can be of no considerable value for mill purposes, and afforded no evidence of late use. Such a deposit in the main run of the water supply must of necessity con-taminate the water that flows from that point, creating a nuisance that ought to be abated if possible. "I am informed by Dr. McKee that this dam was reported detri-mental to the health of the people of Raleigh and declared to be a nuisance in December, 1895. 1 have since found such report and declaration, bearing date December 21, 1895, and signed by him oflB-eially as Superintendent of Health of the city of Raleigh, and the signature of Dr. P. E. Hines. preceded by the following: 'I endorse the above recommendation.^ "The intake of the company is situated upon the Grimes farm above the bridge on the Rhamkatte road, about a mile southwest of the corporate limits of the city. The surplus water flows over a SEVENTH BIENNIAL REPORT. 63 natural ledge of gneissoid granite brought to a dead level so as to carry off all floating foreign matter at every point, always provided it first escape the wide mouth of the intake, set in the current and facing up stream, like a saurian bobbing for flies. A proper adjust-ment of this intake would greatly relieve the filter at the pump-house and remove an ever-present source of adverse criticism." CHEMICAL ANALYSIS. Total solid matter in solution 4.58 gr. per U. S. gal. Hardness 2.1 deg. Clarke's sc. Equiv. to cal.car 0.92 gr. per U.S. gal. Chlorine... 0.30 gr. per U.S. gal. Free ammonia - . . 0. 031 parts per mil. Album, ammonia 0. 0787 parts per mil. The chemical analysis shows no indication of contamination from organic matter. BACTERIOLOGICAL EXAMINATION BY DR. ANDERSON. 1 found 240 bacteria to the C. C. in sample from the Raleigh pub-lic \^ ater supply, some of which were of a suspicious nature. The order of the State Board of Health is executed. All which is respectfully submitted, A. W. SHAFFER, S. E. As showing the spirit in which the efforts of the Board to secure purer water for the people were met by the municipal authorities, we take pleasure in printing the following from the Mayors of Charlotte and Concord, respectively. We are also glad to say that the w^ater companies seemed disposed to do what they could to insure pure water to their patrons. But we should add in this con-nection that there is apt to be a difference of opinion as to "what they could"' might mean, and that conse-quently, as pure water is a vital matter, the precautions, etc., to be taken by operators of public water supplies, should be defined with reasonable exactness by law. In view of this we prepared and had introduced in the last General Assembly the appended bill. It met with favor 5 64 NORTH CAROLINA BOARD OF HEALTH. from the Committee on Public Health, and all others to whose attention it was called, but owing to the mul-titude of other bills of more interest to the Members, it could never be gotten before the House. Charlotte, N. C, February 10, 1898. Dr. Rich'd H. Lewis, Raleigh, N. C. Dear Sir:—Your letter in regard to the condition of our city water received and noted. Your instructions are being carried out, and I also will have the watershed patrolled. Dr. Brevard, who is President of the Water Company, will be in Raleigh on the 22d of this month, and will call on you in regard to this matter. Any ad-vice you can give him in regard to.the jjermanent improvements of this plant we will be glad to carry out. Yours very tr\ily, E. B. SPRINGS, Mayor. Concord, N. C, February 12, 1898. Br. Richard H. Lewis, Raleigh, iV. C. Dear Doctor:—Your favor of 3d instant received, inclosing the chemical and bacteriological analyses of our city drinking water, and I thank you for Ihe suggestions made about the necessity of keeping the watersheds as clear as practicable. I assure you I am exerting myself to keep the watershed free from filth. But when you remember that the watersheds of our two water supplies are dotted thickly over with residences, etc., you will see how hard it is to keep it clean and free from filth {)ol]ution. There is one thing I desire your opinion on—that is "dry wells," so called, into which sewerage from water-closets empty. It is reported that there are three or four on the watersheds here. I am preparing an ordinance to abolish them, and shall ask the Board of Aldermen at our next meeting to pass it. I desire, therefore, that you give me your opin-ion on these "dry-wells" or cess- pools, so I can have it before the Board who, by the advice you may give, can vote intelligently on the i3roposed ordinanee. I will thank you for your opinion about this matter as early as practicable. I am convinced that these wells or pools should not be tolerated, and if you agree with me I feel sure our Board will pass the ordinance. Mr. Fetzer, the Manager of the Waterworks Company, is having the spring—one of the^^sources of water supply—drained and im-proved. SEVENTH BIENNIAL REPORT. 65 The report of your Engineer—about literally landing in human excrement—Mr. Fetzer thinks might be misunderstood. He says some thoughtless person had made this deposit—only one—near the well, and that was all of it. I will thank you for suggestions at any time, and pledge you my prompt efforts in carrying them out. Yours very truly, J. S. CROWELL, Mayor of Concord. Answer, February 14, 1898: Cess-pools absolutely condemned. Change of water supply suggested. Begged to do all in his power to get his people vacci-nated. This very important matter will be brought again to the attention of our law-makers in the hope that it may meet w^ith favorable action at their hands : AN" ACT TO PROTECT PUBLIC WATER SUPPLIES. The General Assembly of North Carolina do enact : Section 1. In the interest of the x>uhlic health, every person or company selling water to the public °for drinking and household purposes, shall take every reasonable precaution to protect from contamination and assure the healthfulness of such water ; and any provisions in any charters heretofore granted to such persons or coiii|janies in conflict with the proxisions of this act are hereby re-pealed. Sec. 2. Those water companies deriving their supply from lakes or ponds, or from small streams not more than fifteen miles in length, shall have made a sanitary inspection of the entire watershed, not less under any circumstances than once in every three calendar months, and a sanitary inspection of any particular locality on said watershed at least once in each calendar month, whenever, m the opinion of the Board of Health of the city or town to which the water is supplied, or when there is no such local Board of Health, in the opinion of the County Superintendent of Health, or in the opinion of the State Board of Health, there is reason to apprehend the infection of the water by that particular locality'. Said com-panies shall have made a sanitary inspection of any particular local-ity on said watershed at least once in each week, whenever, in the opinion of the Board of Health of the city or town to which the water is supplied, or when there is no such local Board of Health, in the opinion of the County Superintendent of Health, or in the 66 NORTH CAROLINA BOARD OF HEALTH. opinion of the State Board of Health, there is special reason to ap prehend the infection of the water from that particular locality by the germs of typhoid fever or cholera. The inspection of the entire watershed as herein provided for shall include a particular examination of the premises of every in-habited house on the watershed, and in passing from house to house a general inspection for dead bodies of animals or accumula tions of filth. It is not intended that the term "entire watershed" shall include uninhabited fields and wooded tracts that are free from suspicion. The inspection shall be made by an employee of, and at the ex. pense of said water company, in accordance with reasonable instruc-tions as to method to be furnished by the secretary of the State Board of Health. The said sanitary inspector shall give in person to the head of each household on said watershed, or in his absence to some mem ber of said household, the necessary directions for the proper sani tary care of his premises. It shall further be the duty of said in spector to deliver to each family residing on the watershed such lit-erature on pertinent sanitary subjects as may be supplied him bj' the municipal health oflQeer, or by the Secretary of the State Board of Health. Sec. 3. In case of those companies obtaining their supply of water from rivers or large creeks, having a minimum daily flow of ten mil lion gallons, the provisions of section 3 shall be applied to the fifteen miles of watershed draining into the said river or creek next above the intake of the water works. Sec. 4. Failure on the part of any water company to comply with the requirements of sections 2 and 3 shall be punished by a deduc-tion from any charges for water against the city or town supplied of twenty five dollars for each and every such failure: Provided, That in no one year shall the sum of such forfeitures exceed five hundred dollars. Where the water works are owned and operated by the city or town, failure on the part of the municipal official having in charge the management of the water works to comply as above, shall be a misdemeanor, and punishable by a fine of not less than ten nor more than twenty-five dollars, or by imprisonment for not less than ten nor more than thirty days: Provided, The said official do not prove to the satisfaction of the court that in spite of reasonable effort and diligence on his part he was prevented, directly or indirectly, by his superiors from doing his duty in this respect, in which ease said su-perior officer or officers shall be deemed guilty of a misdemeanor, and punishable by a fine of not less than fifty nor more than two hundred dollars, or by imprisonment for not less than one nor more than six months. SEVENTH BIENNIAL REPORT. 67 Sec. 5. Every city or town having a public water supply shall, at its own expense, have made at least once in every three months by one of its own officials a sanitary inspection of the entire watershed of its water supply, and it shall be the duty of the said official mak-ing such inspection to report to the Mayor any violation of this act. Sec. 6. Every person residing or owning property on the water shed of a lake, pond or .stream from which a public supply is ob-tained, shall carry out such reasonable instructions as may be fur-nished him in the manner set forth in section 2, or directly by the municipal health officer or by the State Board of Health. Failure to do so shall be deemed a misdemeanoi', and shall be punishable by a fine of not less than two dollars and costs, nor more than twenty- five dollars and costs, or by ir:prisonment for not less than ten nor more than thirty days. Sec. 7. The charters of all cities and towns having public water supplies are hereby amended so as to give said cities and towns the same police powers on the watersheds of said public water supi^lies as they now possess within their corj^orate limits: Provided, These police powers shall apply only to violations of this act. Sec. 8. The Mayor of each city or town ha^^ng a public water sup ply shall have jurisdiction of all violations of this act, and the same shall be reported by the inspector of the city or town and of the water company to and tried by him, except where the water works are owned and operated by the city or town, in which case the mat-ter shall be tried by some other justice of the peace or by the supe-rior court, according as the penalty imposed fixes the jurisdiction, upon complaint of the municipal health officer, the Ccunty Superin-tendent of Health, the Secretary of the State Board of Health, or any resident of said city or town. See. 9. Every water company, whether owned by private individ-uals or corporations, or by the municipality, shall have made, not less frequently than once in every three monhs, at its own expense, both a chemical and a bacteriological examination of a sample of its water drawn from a faucet used for drinking purposes, packed and shipped in accordance with the instructions to be furnished by the Secretary of the State Board of Health, and shall transmit a copy of the same to the Mayor, the municipal health officer and the Sec retary of the State Board of Health. Sec. 10. As a check and a guarantee of the faithful performance cf the requirements laid down in the preceding sections of this act, the State Board of Health shall make or have made by its author-ized agents such inspections of the watersheds an4 such chemical and bacteriological examinations of the public water supplies of the State as may be deemed necessary to insure their purity. Should such inspections or examinations show conditions danger- 68 NORTH CAROLINA BOARD OF HEALTH. ous to the public health, the Secretary of the said State Board of Health shall notify the Mayor,
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Title | Biennial report of the North Carolina State Board of Health |
Other Title | Report of the North Carolina State Board of Health. |
Creator | North Carolina. State Board of Health. |
Date | 1897; 1898 |
Subjects |
North Carolina. State Board of Health--Statistics--Periodicals Public health--North Carolina--Statistics--Periodicals Public Health--North Carolina |
Place | North Carolina, United States |
Time Period |
(1876-1900) Gilded Age |
Description | Report covers two calendar years (13th-18th); (19th) covers Dec. 1, 1920-June 30, 1922; thence each covers July 1-June 30 years.; Printer: 13th (1909/10)-18th (1919/20) by Edwards & Broughton; 19th (1921/22)-20th (1923/24) by Bynum; 21st (1925/26)-<44th (1970/72)> unnamed. |
Publisher | Raleigh :The Board,1911- |
Agency-Current | North Carolina Department of Health and Human Services |
Rights | State Document see http://digital.ncdcr.gov/u?/p249901coll22,63754 |
Physical Characteristics | v. ;24 cm. |
Collection | Health Sciences Library, University of North Carolina at Chapel Hill |
Type | text |
Language | English |
Format | Reports |
Digital Characteristics-A | 234 p.; 13.14 MB |
Series | Biennial report of the North Carolina State Board of Health |
Digital Collection |
North Carolina Digital State Documents Collection N.C. Public Health Collection |
Digital Format | application/pdf |
Related Items | Printer: 13th (1909/10)-18th (1919/20) by Edwards & Broughton; 19th (1921/22)-20th (1923/24) by Bynum; 21st (1925/26)-<44th (1970/72)> unnamed. |
Audience | All |
Pres File Name-M | pubs_biennialreportof07nort.pdf |
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Full Text | LIBRARY OF THE UNIVERSITY OF NORTH CAROLINA, Endowed by the Dialectic and Philanthropic Societies. Alcove Shelf ^^r^S- This book must not be token from the Library building. Form No. 471 SEVENTH BIENNIAL REPORT OF THE NORTH CAROLINA lBO/\t^tS OF HH/\LTH 1897-1898 RALEIGH : Edwards & Broughton, Printers and Binders. 1899. MEMBERS OF THE BOARD. ELECTED BY THE MEDICAL SOCIETY OF THE STATE OF NORTH CAROLINA. George Gillett Thomas, M. D., President Wilmington. Term Expires 1899. S. Westray Battle, M. D. Asheville. Term Expires 1899. W, H. Harrell, M. D Williamston. Term Expires 1899. John Whitehead, M. D _ Salisbury. Term Expires 1899. APPOINTED BY THE GOVERNOR. C. J. O'Hagan, M. D - Greenville. Term Expires 1899. J. D. Spicer, M. D. * Goldsboro. Term Expires 1899. J. L. Nicholson, M. D. Richlands. Term Expires 1899. A. W. Shaffer, Sanitary Engineer Raleigh. Term Expires 1899. Richard H. Lewis, M. D., Secretary. ...Raleigh. Term Expires 1899. * Resigned. 7f ^X LIST OF COUNTY SUPERINTENDENTS OF HEALTH IN THE STATE OF NORTH CAROLINA DECEMBER 31, 1898. Alamance—Dr. W. R. Goley, Graham. Alexander—Dr. T. F. Stevenson, Taylorsville. Alleghany— Anson—Dr. E. S. Ashe, Wadesboro. Ashe—Dr. L. C. Gentry, Grumpier. Beaufort—Dr. Joshua Tayloe, Washington. Bertie—Dr. H. V. Dunstan, Windsor. Bladen—Dr. Newton Robinson, Elizabethtown. Brunswick—Dr. D. B. McNeill, Supply. Buncombe—Dr. I. A. Harris, Jupiter. Burke—Dr. J. L. Laxton, Morganton. Cabarrus—Dr. J. S. Laflferty, Concord. Caldwell—Dr. A. A. Kent, Lenoir. Camden- Carteret—Dr. F. M. Clarke, Beaufort. ,Caswell— Catawba—Dr. D. M. Moser, Conover. Chatham—Dr. H. T. Chapin, Pittsboro. Cherokee—Dr. S. C. Heighway, Murphy. Chowan— Clay—Dr. W. E. Sanderson, Haysville. Cleveland—Dr. R. C. Ellis, Shelby. Columbus—Dr. J. F. Harrell, Whiteville. Craven—Dr. L. Duffy, Newbern. Cumberland—Dr. J. Vance McGougan, Fayetteville. Currituck—Dr. H. M. Shaw, Shawboro. Dare— Davidson—Dr. John Thames, Lexington. DAViE^Dr. James McGuire, Mocksville. Duplin—Dr. F. H. Arthur, Magnolia. Durham—Dr. John M. Manning, Durham. Edgecombe—Dr. L. L. Staton, Tarboro. Forsyth—Dr. John Bynum. Winston. Franklin—Dr. E. S. Foster, Louisburg. Gaston—Dr. J. H. Jenkins, Dallas. ' ; Gates—Dr. R. C. Smith, Gatesville. Graham— Granville—Dr. G. A. Coggeshall, Oxford. LIST OF SUPERINTENDENTS OF HEALTH. Greene—Dr. Joseph'E. Grimsle}% Snow Hill. Guilford—Dr. A. E. Ledlietter. Greensboro. Halifax—Dr. I. E. Green, Weldou. Harnett—Dr. 0.|;L. Denning, Dunn. Haywood—Dr. J. Howell Way. Waynesville. Henderson—Dr.'J. G. Waldrop, Hendersonville. Hertford—Dr. John W. Tayloe, Union. Hyde— Iredell—Dr. Henry F. Long, Statesville. Jackson—Dr. J. H. Wolff. Sylva. Johnston—Dr. L. D. Wharton, Smithfield. Jones—Dr. S. E. Koonce, PoUocksville. Lenoir- Lincoln—Dr. L. A. Crowell. Crimsic. McDowell—Dr.'B. A. Cheek, Marion. Macon—Dr. F. L. Siler. Franklin. Madison—Dr. Jas. K. Hardwicke, Marshall. Martin—Dr. W. H. Harrell. Williamston. Mecklenburg—Dr. M. C. Strong, Charlotte. Mitchell—Dr. C. E. Smith, Bakersville. Montgomery- Moore—Dr. Gilbert McLeod. Carthage. Nash—Dr. H. Brantley, Spring Hope. New Hanover—Dr. W. D. McMillan, Wilmington. Northampton—Dr. H. W. Lewis. Jackson. Onslow—Dr. E. L. Cox, Jacksonville. Orange—Dr. C. D. Jones, Hillsboro. Pamlico- Pasquotank—Dr. I. Fearing, Elizabeth City. Pender—Dr. George F. Lucas, Currie. Perquimans—Dr. C.^C.Winslow, Winfall. Person—Dr. J. A. Wise, Roxboro. Pitt—Dr. E. A. Moye, Greenville. Polk—Dr. W. S. Green, Mill Spring. Randolph—Dr. Dr. T. T. Ferree, Ashboro. Richmond—Dr. W. M. Fowlkes, Rockingham. Robeson—Dr. H. T. Pope, Lumberton. Rockingham—Dr. Sam Ellington, W^entworth. Rowan—Dr. W. L. Crump, Salisbury. Rutherford—Dr. W. A. Thompson. Rutherfordton. Sampson—Dr. R. E. Lee, Clinton. Stanly— Stokes—Dr. W. L. McCanless, Danbury. Surry—Dr. John R. Woltz, Dobson. Swain—Dr. A. M. Bennett, Brvson Citv. LIST OF SUPERINTENDENTS OF HEALTH. Transylvania—Dr. M. M. King. Brevard. Tyrrell— Union—Dr. J. E. Ashcraft, Monroe. Vance—Dr. W. J. Judd, Henderson. Wake—Dr. R. B. Ellis. Raleigh. Warren—Dr. T. B. Williams, Ridgeway. Washington—Dr. W. H. Ward, Plymouth. Watauga—Dr. W. B. Council, Boone. Wayne—Dr. Jas. H. Powell. Goldsboro. Wilkes—Dr. J. W. White. Wilkesboro. Wilson—Dr. C. B. Walton, Wilson. Yadkin—Dr. M. A. Royall. Yadkinville. Yancey—Dr. J. L. Ray, Burnsville. LETTER OF TRANSMISSION. North Carolina Board of Health, Office of the Secretary, Raleigh, January 3, 1899. His Excellency, Daniel L. Russell, Governor of North Carolina. Sir:—In compliance with Section 3, Chapter 214, Laws of 1893, I have the honor to present this, the Seventh Biennial Report of the North Carolina Board of Health. Very respectfully yours, RICH'D H. LEWIS, M. D., Secretary and Treasurer. SEVENTH BIENNIAL REPORT NORTH CAROLINA BOARD Of HEALTH. 1897=1898. The first of the past two years was not marked by anything out of the usual in sanitary matters, but 1898 unfortunately brought with it small-pox, which has from time to time appeared iu various sections of the State, although generally in a very mild form. The Board in the exercise of its advisory functions has as-sisted as far as possible the local authorities in its man-- agement. On the whole the management of the Super-intendents has been good, and the disease has been kept within comparatively narrow limits. The ijidications, however, for the coming year are not reassuring, owing to the general indifference to vaccination—the most im-portant element always in the contest with this disease, and peculiarly so in rural communities like our own where an effective quarantine is extremely difficult and often practically impossible. But although we move in a quiet way, we believe that our efforts are slowly, it is true, but surely making an impression on the minds and habits of our people. They are unquestionably more wide-awake to the fact that some diseases are pre-ventable and more interested in* the work of prevention than formerly. A thorough inspection of the w^atersheds and works 8 NORTH CAROLINA BOARD OF HEALTH. of the public water supplies of the State was made by the Engineer of the Board, and an analysis, both chemi-cal and bacteriological, of the waters made. This report published in the Bulletin was received with much inter-est, and the knowledge that they were watched doubt-less had a good effect upon the water companies, for while "soulless corporations,'' there is a good deal of ordinary human nature in their managers. The Monthly Bulletin has appeared regularly and promptly during the past twenty-four months, and be-comes more aud moreuseiul^s a.medium of communi-cation with all the physicians in the State and, in a limited way, of instruction to the people. This modest publication of the Board seems to be read, both at home and abroad, it appears, as in a letter from the sanitary editor of one of the great papers of the country asking to be put on the mailing list, the state-ment was made that the writer had been told that it was the best in the United States. We make no such claim, but merely refer to the matter in order that your Excellency and the General Assembly may know that the work of your agents for the protection of the peo-ple's health meets with approval. For lack of money the publication and distribution of literature in the form of pamphlets of a popular char-acter on the more important subjects in sanitation have been kept in abeyance. This we have found probably our most effective agency in educating the people in hy-giene, and trust that it can be resumed in the near future. For the work of the Board in detail the reader is re-ferred to the following pages. MEETINGS OF THE BOARD. MINUTES OF THE ANNUAL MEETING AT MORE-HEAD CITY IN 1897. Atlantic 'Hotel, MoREHEAD City, N. C, June 8, 1897. The Board met in annual session at -t.SO p. m., with President Thomas in the chair. Present: Drs. C. J. O'Hagan, J. D. Spicer, Geo. G. Thomas. W. H. Har-rell. Col. A. W. Shaffer and Dr. Richard H. Lewis. On motion of Dr. C. J. O'Hagan, Drs. Thomas and Lewis were unanimously reelected President aud Sec-retary, respectively. On motion of Dr. Harrell it was ordered that the mu-nicipal water supplies of the State be examined chemi-cally and bacteriologically during the current year ; and, that the Engineer of the Board at his convenience collect, pack, and ship samples of the same ; and at the same time make an inspection of, and report on the various water works and watersheds. Also that the Treasurer purchase necessary books for the Engineer. Upon a statement by the Secretary that the issue of the 20, 000 Health Pamphlets, ordered at the last annual meeting at Winston, had not been made for various reasons, Dr. O'Hagan moved that in view of the pres-ent embarassed condition of the State Treasury, their publication be postponed to a more favorable time. Carried. At the suggestion of the Secretary, the ^200 a year heretofore allowed him for clerical help, in view of the suspension of the distribution of Health Pamphlets, was, on motion, discontinued. lO NORTH CAROLINA BOARD OF HEALTH. Col. Shaffei^ called attention to the fact that members of the Board being State officers were required by law to take the statutory oath of office, and it was there-upon agreed that each member should make this oath before his Superior Court Clerk and forward it to the Secretary of the Board, to be filed with the proper State official. Adjourned to meet again at 10 p. m. RICH'D H. LEWIS, Secretary. Night Session. The Board reconvened with the same members pres-ent as at the afternoon session. Col. Shaffer was duly appointed to audit the accounts of the Treasurer at his convenience after his return to Raleigh. The continuance of the publication of the Bulletin was discussed, and, upon motion, it was ordered con-tinued in a form to be juodified by the Secretary. On motion of Dr. Nicholson, the issue of the Bulletin was ordered increased to a number sufficient to allow one copy for every registered physician in the State. On motion, Goldsboro was selected as the place for the next Health Conference, the time to be fixed by the President and Secretary after consultation with the local health officials. On motion of Col. Shaffer, the Secretary was desig-nated to attend the next meeting of the National Con-ference of State and Provincial Boards of Health at Nashville, Tenn. On motion of Dr. Nicholson, Col. Shaffer was desig-nated to attend meeting of Sanitary Engineers. On motion, the Board adjourned to meet at Goldsboro. RICH'D H. LEWIS, Secretary. CONJOINT SESSION WITH THE MEDICAL SOCIETY OF THE STATE OF NORTH CAROLINA. MOREHEAD CITY, JUNE 9, 1897. The conjoint session was called to order by the Presi-dent, Dr. G. G. Thomas, who said: The State Board of Health is so thoroughly in the hands of the Secretary that an address from your President seems an imposition on your time. I wish that the entire membership would stay, for the questions of sanitation are certainly as interesting and as im-portant as surgery or medicine. This Board, you know, works un-der great diflBculties, often against the adverse criticism of politi-cians. It looks now to those of us who are studying the signs of the times that we are now getting nearer the promised land. Several years ago, as you are aware, the Health Conference was instituted, and only a lack of means has made the conferences so few in num-ber. We believe that they have accomplished a great deal. If they haven't taught any great lesson to the people, they have made them think. In every community we have entered, we feel sure that we have left some seeds which will grow into a harvest of indefinite size. I have only one thing I wish to say, and that is in regard to the extension of the State Law in regard to communicable diseases. Last year at a meeting of the Board at Winston, I took occasion to remark that it would be a good thing to add measles to the list of quarantinable diseases. This is not a move that will commend itself to the general practitioner, and more especially to the elders in the profession. I say it with all becoming respect and reverence for these gentlemen. They generally agree with what I have heard said of a surgeon in one of the Confederate camps who went into the hospital and found a great number of country lads who had never been ex posed to the poison of measles, and they were very sick. Another day brought an increase, and another day still more, and the sur-geon wanted to know what in the world their mothers meant when they did not see that they had had measles in their childhood. That i2 NORTH CAROLINA BOARD OF HEALTH. expression. I am sorry to say. is coininon among the profession, not-withstanding the fact that the death rate is large. I do not know the statistics of the last epidemic, but I know that there are many saddened households left by that last march through the country. According to Stevenson and Murphy, mortality in Gfreat Britain and "Wales amounted to the lai^e number of from six to ten thou sand deaths in different epidemics. This does not take into account the number of people who were left with serious pulmonary trouble, and otherwise disabled. I believe in towns of any size it is possible to quarantine measles as easily as scarlet fever. It does not require so much care to quarantine from scarlet fever, now that it is recog-nized that the law is fixed. I know that the ravages of measles were marked by a great deal of disaster, coming as it did at a very inoppor-tune season—in winter. I think it would be wise for the conjoint session to consider whether measles should not be added tc the list of diseases that must be quarantined. So far as other diseases, whcoping-cough, mumps, chicken pox. etc.. are concerned, they might wait later. People wall have to be educated up to this, and present education will not allow stringent measures to be adopted, but I think it will be a i^rogressive stej) if the Board of Health adds measles to the list of quarantinable diseases. I believe that the time is coming when we will have to take this step. Dr. O'Haga^'^.—I think my friend mu.st have meant something personal when he mentioned the Confederate surgeon. I think the first step that ought to be taken should be to make it compulsory with every family to see that they had measles. Such, I have no doubt, is directly antagonistic with your views on the subject. If my friend Dr. Thomas had had to go through with the terrible or-deal of bringing three regiments through in 1861, and didnt agree with me in this, he would at least sympathize with me. This is pre-liminary to my idea of putting measles on the black list. I do not think it will do. The prevailing feeling is that it is not a very for midable disease. The popular \aew will not support it; and I do not think it is best to i^ush things too far, for there is danger of kick-ing. There is a wholesome di-ead of scarlet fever in 1 he popular mind, and they don't object to any restrictions on that, and also on diphtheria. Typhoid fever can be quarantined, but we must not interfere with measles and whooping cough ; they belong to the do-mestic faculty, and we must not intrude ui>on the premises of their rights. There is a matter of great importance for discussion now and that is the utter inefficiency of the County Superintendents of Health, and the carelessness and indifference to making monthly reports even remotely or approximately correct. I am tolerably well ac-quainted with the work of the County Superintendent of Health in SEVENTH BIENNIAL REPORT. I 3 our county, and I think you will ^gree with the statement I am about to mak?. I regret to say that politics enters too much in the choice of these Superintendents; they go into it for what they can make out of the office, and that is not a great deal. As to getting reliable statistics, their labors are utterly useless., Those from my county are not worth one cent, and I have no doubt that you gen-tlemen from the other counties will corroborate my statement. I do not know how it is to be remedied. It is almost impossible to get any reliable information. However, ve are just at the beginning of this work, and I hope we will improve, but I have no suggestions to make in I'egard to the improvement. Young men are optimistic and old men are pessimistic. I think the first step toward getting any correct data or any legislation upon it, would be to urge upon the County Superintendent of Health the imjDortance of absolute accu-racy in the monthly reports. I know that those from my own county are utterly worthless, and I have no doubt that it is true from all others, with the exception, perhaps, of Wilmington. Dr. Btrroughs.—I have listened to the remarks in regard to the quarantining of measles, and I have listened to what Dr. O'Hagan has said. I think that measles is a disease of more gravity than most physicians regard it, and it is the duty of the Board of Health to ([uarantine measles wlienever practicable. Measles gets into a community; it prostrates the majority of the inhabitants, and I know of no better way of illustrating the use of quarantine than by giving you an instance of two schools of which I have the honor to be tlie physician. One has about one hundred and forty to one hun-dred and sixty girls, and the other two hundred tc two hundred and twenty five young ladies. Measles last year got into this school of older girls, and 63 of them had it and were kept from their studies. ^ Several developed pneumonia in connection with catarrhal bron-chitis. It kept them from their classes, and some of them had to be sent home, and it demoralized the whole .school. The other .school quarantined against the Normal and Collegiate Institute, in which the measles appeared, and I visited first the school that had no measles. As a result the smaller school, though only 89 yards away and with 150 girls, developed not a single case. They were allowed to go on with their work. I think something of this kind could be done in keeping it from household to household. It is carelessness on the part of the health officers to allow measles to become scat-tered over a town. If you have a thorough quarantine at first, the disease will be easy to control. Unless you come in contact with it. you don't get it. If you would quarantine it just as you do scarlet fever v.e would not have .«o many constitutions undermined and so many ca.-;es of catarrh and pneumonia, laying the way for invasion by tubercular bacilli. I am in favor of quarantining measles. 14 NORTH CAROLINA BOARD OF HEALTH. Dr. Murphy.—I am inclined to agree with both gentlemen. I have had pretty much the sanfe experience that Dr. O'Hagan has had. I have gone through with two epidemics of it in the hospital for the insane. I had the irajDression that measles was contagious, and that all would have it, so I made no effort to quarantine. About that time, I visited the Georgia hosi^ital, where they have about two thousand patients. The doctor told me that some of his nurses had measles and they were trying to keep it from spreading. I said that that was useless. He said he was going to do it anyway, and sometime afterwards I asked him the result, and he said they had not had another case. So it seems to be of some use. In that hospital there are qui^ a number of buildings and they are all miired up, and I don't even now understand how he did it, but he is a truthful man. Dr. Munroe.—While I think that measles should be quaran-tined, and that inside of five years we will quarantine measles, I doubt whether the public mind is educated up to that point yet. In regard to the mortuary statistics, the trouble is to get competent men, In our section of the State, notwithstanding the registered physicians elect them, there is always a political scramble for the place. No reputable physician is going to try for it, and I believe that the people in the jail and in the poor house ought to have the best medical attention from the best medical talent in North Caro-lina. ^Dr. McDowell.—There are only half a dozen physicians in a county that report to these County Superintendents of Health, and how are they going to make any report that way '? They don't make any reports of contagious diseases or any mortuary statistics to health officer. I want to know if that is not our fault, I mean that ' we don't have better statistics. I know I have done very little re-porting. If there is a case of scarlet fever, we telegraph him, and the quai'antine takes place immediately. I think we ought to have a better organized county medical society in every county, and the work that came before them would be worth a great deal to the State Board of Health. It is with the physicians at large that this lies. I don't think the Superintendent of Health does anything now except attend to the poor house and jail. It seems to me that we as individual physicians could uphold the State Board of Health if we would pay the proper attention to our duties along this line. In these counties, it is a right hard matter to visit all parts of it and get the statistics and the number of cases of various diseases, and all this and the regulation of health matters, including the water supply, will rest with the physicians in the various localities. It might be easy to quarantine measles in a town, but if you try it in a country town the difficulties will increase. You never know any- SEVENTH BIENNIAL REPORT. 1 5 body has measles until the eruption appears. All the other children are- in school with this child, and who is going to be quarantined ? All his playmates and associates in school have flocked around him to sympathize with him because he is not feeling well, and have all become poisoned. Every child there has come in contact with him. You do not see but about one in ten who has measles, and it is almost impossible to quarantine. In a family where the daily bread is dependent on the labor of the father or the mother or some of the larger children, none of whom have had measles, what are you going to do ? In factory towns where most of the children work in factories, suppose you have them quarantined, how are you going to feed all these people ? How are you going to take care of them ? With the mother and larger children working for their daily bread, it seems to me that in a town of one hundred families of this kind, with two or three thousand inhabitants, you will have a hard time to support these people, and it seems to me to be almost impossible to quarantine in small towns. Dr. Burroughs.—It is no more trouble to quarantine a small town than it is any other. If you quarantine the first' cases, you can get hold of the others pretty soon. As soon as the people realize that measles is a contagious disease and that the children who have it will be stopped from school, they will recognize it as such and send for a doctor at once, and the thing will be easily put under control. In regard to mortuary and vital statistics. There is no way of getting them without further legislation. You must have township cemeteries, and a man in charge of each who would give a certificate of death for each one buried. There is no other way of reaching the mortuary statistics but by having township and not church and private burying grounds. Dr. Thomas.—I want to say a little more about this quarantine. If you didn't quarantine in diphtheria and scarlet fever, you would have just as wide spread an epidemic as you would in measles. The public mind has more dread of these two because they are more mortal. I still believe a great deal could be done in the counties if the physician^ who by law constitute the County Board of Health would have readings and discussions of these questions and urge the Superintendents to more work. Your mortuary statistics will be more thoroughly quoted. In our organization the thing had to be done in years and years; it is not a thing which can be done in months. I believe that now the work of this Society and the Board of Health is being appreciated by the people of North Carolina. I would like for the question to be still further agitated. The reading of the Annual Report of the Secretary was then called for, and was as follows : l6 NORTH CAROLINA BOARD OF HEALTH. REPORT OF THE SECRETARY OF THE NORTH CAROLINA BOARD OF HEALTH FOR THE YEAR 189f>-'9T. Richard H. Lewis, M. D., Raleigh, N. C. Since our last annual meeting the Board has accom-plished rather more work than during any period of the same length in its history. A statement of most of this in detail will be found in the Sixth Biennial Report cov-ering the part of 1896 belonging to our society year, and therefore it would be a work of supererogation to do more now than simply recapitulate what was done. Owing to the extent of this work the appropriation for 1896, together with the balance on hand from 1895, was more than exhausted, so that a good deal of the ex-pense had to be met out of the appropriation for the current year. In consequence of that fact w^e have not been able to undertake, since the first of January last, anything outside the usual routine. Practically, there-fore, a full statement of all the work for our past fiscal year will be found in the Biennial Report. With the exception of the convict camps which had to be omitted for want of money to pay the necessary expenses incident thereto, all the State Institutions were visited and inspected by Committees from the Board ap-' pointed by the President for the purpose, viz t The North Carolina Asylum for the Insane, the Institution for the Deaf. Dumb and the Blind at Raleigh, the Penitentiary, the State Capitol, the University, the College of Agri-culture and the Mechanic Arts, the State Normal and Industrial College—twice, once to specifically advise as to the best method of sewage disposal and once to make a general inspection—the Agricultural and SEVENTH BIENNIAL REPORT. 1 7 Mechanical College for the Colored Race, the School for the Deaf and Dumb and the State Hospital, at Morgan-ton, the Eastern Hospital at Goldsboro and the Oxford Orphan Asylum. In addition, upon request, the Board advised the proper authorities as to the best method of sewage disposal for a new building recently erected for the medical department at Davidson College; and the County Commissioners of Johnston County in regard to the removal of the jail to another site. Believing the purity of all drinking water, and espe-cially of the public water supplies, to be of paramount importance to the public health, and realizing that many of the municipal supplies* in our State, owing to the source of supply, were peculiarly liable to contami-nation, the Board at the last annual meeting ordered an examination made of them. This was done, not with the expectation of doing anythiag like thorough work (our limited appropriation forbidding that) but for the moral effect upon the water companies that would be produced by the simple knowledge of the fact that the State, having more regard for the lives and health of its citizens, their consumers, than for the size of their dividends, had an eye upon them. In obedience to this order a bacteriological examination was made of all the municipal supplies in the State. Of the fifteen, four were found to contain intestinal bacilli, and four to be suspicious, and were so reported by the Secretary to the Board at a meeting held in Charlotte on October 15, •96, at the time of the Health Conference there. As the result of this report, the Secretary was instructed to have made immediately another bacteriological and a chemical analysis of all the infected and suspicious waters; and he was further ordered, in those cases where the water was shown to be still bad, to notify the Superintendent of Health, the Mayor and the man- 1 8 NORTH CAROLINA BOARD OF HKALTH. ager of the water works of the fact, and call upon them in the interest of the public health to remedy the trou-ble, and, if he did not receive satisfactory assurance within thirty days that this had been done, to have the analyses published in the local papers for the informa-tion of the people using said waters. While seven or eight sent samples for the bacteriological examination — the Board furnishing the sterilized bottle—only two sent samples for the chemical examination. This second ex-amination revealed the gratifying fact that the intesti-nal bacilli had disappeared in every instance, and the condition of the various waters was much improved. In view of the difficulties of one kind and another en - countered by your Secretary in obtaining samples rightly packed and shipped in the investigations referred to, he would respectfully suggest that in case of another such examination that the samples be collected, packed and shipped by a member of the Board. Although this would add materially to the expense, it would, in his opinion, be money well spent as the works, including watershed, could at the same time be inspected. Besides these examinations of municipal water sup-plies, bacteriological analyses were made of three seri-ously suspected wells, one at the Oxford Orphan Asy-lum, one in Asheville, and one in Burlington, and the water of each was found to be unfit for use. Samples of water from a well in Oxford, one in Rowan County, and one in Winston, containing insects and worms visible to the naked eye were sent to the Secretary for an opinion. He being no entomologist, requested Dr. H. V. Wilson, the able Professor of Biology in the University, to make the identification for him. This he courteously and cheerfully did without charge, and deserves the thanks of the Board. In order to take stock and strike some kind of balance, SEVENTH BIENNIAL REPORT. 1 9 SO to speak, your Secretary addressed a circular letter to several hundred physicians residing in the eastern section of the State, asking their opinion as to what effect in the matter of improving the drinking water and preventing sickness and death had been produced by the pamphlet on Drinking Water in its Relation to Malarial Diseases which, together with other Health pamphlets, had been widely distributed in 1895. Only fifty-six replies were received up to the end of the year and the evidence was, in the nature of the case, far from ideal in quality, but it nevertheless plainly showed that in a great many instances a better domestic water sup-ply had been provided, and that much good had been accomplished in the saving of health and life. In October last Dr. R. H. Whitehead, of the Medical Department of the University, kindly offered through the Board to make for any physician desiring it, free of charge, the serum diagnosis test for typhoid fever and ' ' to make the laboratory useful in any other way so far as my (his) time will permit." His generous offer was accepted with thanks, and notice thereof with directions was given through the Bulletin, a copy of which is mailed monthly to every member of the State Medical Society. Very few, however, we regret to learn, availed themselves of the offer. With the beginning of 1896 a new departure in the collection of vital statistics was made for the purpose of securing more trustworthy reports, by requesting report-ers to sign at the bottom of each monthly report a certi-ficate to the effect that the report included "the whole number of deaths occurring in the corporate limits dur-ing the above month." Since that time twenty-four of the twenty-seven towns making mortuary reports have certified to the accuracy of their reports. A con-sideration of these more reliable statistics has confirmed 20 NORTH CAROLINA BOARD OF HEALTH. thp fact to which attention was called in the Fifth Bien-nial Eeport, that the death rate from tuberculosis was very much higher among the negroes than among the whites—to be exact the proportion in 1896 was 3.33 to 1. The statement made in the same report that the negro seemed to be much less susceptible to diphtheria than the white man, the number of deaths from that disease recorded in the two years 1893- '94 being whites 22, col-ored 0, was also confirmed by the figures of 1896, the deaths from diphtheria during that year being, respec-tively, 13 and 1. As has been the case every two years since the Board was organized, the meeting of the Legislature was an-ticipated with more or less uneasiness. Subsequent events, however, did not justify the feeling, for no hos-tility to the Board and its work materialized. It is true that the law was so amended- as to take the election of the County Superintendent of Health out of the hands of the County Board of Health and give it to the County Commissioners, and at the same time give them abso-lute control of the salary of the Superintendent, but while, looking at the matter from every point of view the change, in our best judgment, was inadvisable, still the reasonableness of the contention that the body pay-ing an official should have the selection of that official and the fixing of his salary, looked at from the point of view of the business man, can not be denied. \Yith this exception the Act Relating to the Board of Health was not interferred with. In the matter of new legis-lation along sanitary fines an attempt was made to have laws enacted for the Prevention of Bhndness, for Com-pulsory Vaccination, and for the Protection of Public Water Supplies, bills for the two latter being prepared by your Secretary, at the request of the Hon. Thos. H. Sutton, one of the Members of the House from Cumber- SEVENTH BIENNIAL REPORT. 2 1 land. The first named was still-born, the 'second was promptly defeated, and the last, while it was reported favorably by the Committee on Public Health, and was endorsed by every one approached on the subject, could not be gotten up, owing to the press of other business in the last month of the session. In this connection we feel that our acknowledgments ai'e due to many en-lightened friends of all parties, and to none more than to Dr. Abner x\lexander, of Tyrrell, who was always keenly alive to the value and importance of our health and medical laws. In conclusion it is due His Excellency, (xoveruor Rus-sell, that we should express our appreciation of his evi-dent desire to keep politics out of the Board, as shown by the truly non-partisan appointments of members to fill the vacancies caused by the expiration of the pres-ent incumbents. We trust that this may ever remain so, whatever the political faith of our Chief Executive, and that the usefulness of the Board may remain un-impaired. MINUTES OF THE ANNUAL MEETING AT CHAELOTTE IN 1898. BuFORD Hotel, Charlotte, N. C, May 3, 1898. Annual meeting of the Board. Present: Drs. O'Ha-gan. Battle and Nicholson, Col. Shaffer and the Secre-tary. In the absence of the President, Dr. O'Hagan was called to the chair. The minutes of the last annual meeting were read and approved. The report of the Engineer of the Board, Col. Shaffer, 22 NORTH CAROLINA BOARD OF HEALTH. on the public water supjDlies of the State, was read and discussed. On motion, the Secretary was instructed, after con-sultation with the Engineer, to devote one issue of the Bulletin, or so much thereof as may be necessary, to the publication of said report, together with the chemical and bacteriological analyses of the samples of the vari-ous water supplies; and to send a copy to the Mayor and Board of Aldermen of the respective towns. On motion, the President and Secretary were appointed delegates to the annual meeting of the National Con-ference of State and Provincial Boards of Health, and Col. Shaffer as delegate to the American Public Health Association. On motion, it was ordered that the public institutions of the State be inspected, and their sanitary condition be reported on by committees of two from the Board, to be appointed by the President. Col. Shaffer, who was appointed a committee of one to audit the account of the Treasurer, reported it cor-rect. On motion, the Board adjourned to meet at the Con-joint Session to-morrow at 12 m. RICH'D H. LEWIS, Secretary. CONJOINT SESSION ^YITH THE MEDICAL SOCI-ETY OF THE STATE OF NORTH CAROLINA AT CHARLOTTE, MAY 4, 1898. The special hour having arrived, the Conjoint Session of the Board of Health was announced, and in the ab-sence of the President, Dr. S. Westray Battle, of the Board, was called to the chair. The Secretary read his report, which, after a full dis-cussion, was ordered printed. SEVENTH BIENNIAL REPORT. 23 ANNUAL REPORT OF THE SECRETARY OF THE NORTH CAROLINA BOARD OF HEALTH, 1897-'98. By Richard H. Lewis, M. D., Rai/EI«h, N. C. The past year has of necessity been less active than the years immediately preceding. Our work being largely educational, prosecuted chiefly by the free dis-tribution among the people of health pamphlets on sani-tary subjects, has been—temporarily we hope—sus-pended for want of funds to pay for the printing. To meet this difficulty, as far as possible, it will be remem-bered that the Board ordered at its last annual meeting at Morehead in June last, that the character of the Monthly Bulletin be somewhat changed by omitting certain statistical tables and inserting in lieu thereof reading matter that might be of more interest and profit. Not being able to mail a copy to everybody, it was thought best—as the physicians, especially those liv-ing in the country, largely control public sentiment in all medical and kindred matters—to send it free of charge to every registered physician in the State. Owing to the inability, in spite of earnest efforts, to secure a complete list of the physicians, the execution of this or-der was postponed until the September issue. Since that time the Bulletin has been mailed regularly to every doctor whose name was on the register a year ago. In this connection it would be proper to allude to the complaints generally made by County Superintend-ents of the failure on the part of the physicians to re-port to them, and the plan adopted to overcome this ap-parent indifference. Hoping that the failure to report was more the result of thoughtlessness or forgetfulness rather than actual indifference, and that a monthly re-minder might help matters, I have since the November 24 NORTH CAROLINA BOARD OF HEALTH. issue printed on the last page of the Bulletin the usual blank, with the request to the reader to fill it out and mail it to his County Superintendent by the 3d of the month for use in making up his report to me. While it sometimes happens, owing to press of work with the State printer, that the Bulletin does not reach its destination as early as it should, it doubtless generally does on or before the 3d, but we fear that it has brought no material improvement. INSPECTION OF WATER SUPPLIES. Believing that the mere analysis of the waters of the public supplies of the State ordered by the Board at the Winston meeting two years ago had been of benefit by the intimation it conveyed to the water companies that some one had an eye on them, it was decided at the Morehead meeting to repeat the work, but more thor-oughly. The plan first adopted of having the sample of water taken and shipped by the local health officer hav-ing been found in more than one instance unsatisfactory, and an inspection of the works and watersheds by a re-sponsible and disinterested person being deemed desira-ble. Col. A. W. Shaffer, the Engineer of the Board, was requested to make such inspections, and while doing so to take and ship in a proper manner samples of the various waters to the State Experiment Station for a chemical, and to the bacteriologists of the Board for a biological analysis. Col. Shaffer did this work in bis usual thorough and painstaking manner, and I regret to say, found not a few things deserving of criticism. In the course of his examinations he made it a point to learn water rates. He found that they were from iri to 75 cents per 1,000 gallons to small consumers, with, in some cases, a required minimum consumption amounting to not less than Si per month. This, of course, means prohibition of the use of the public sup- SEVENTH BIENNIAL REPORT. 25 ply to the poor except where pubhc fountains are pro-vided. Although these supplies in our State are not as a rule, first-class, the water in nearly every instance is safer than that of the wells, and it should be within the reach of all. If there is anything more than another except air, to which every man is entitled, it is an abundance of good water. I doubt if the Board could do a better work than to inaugurate and prosecute a crusade for free water—at any rate, water as cheap as possible—for those of our people in the larger towns not blessed with an abundance of this world's goods. YELLOW FEVER. The epidemic of this disease occurring last summer and fall on the Gulf while, fortunately, it did not ex-tend to our borders, was a constant' source of anxiety to the authorities of our city of Wilmington, which was liable to infection. During the prevalence of the epi-demic, the follovv^ing correspondence, which explains it-self, occurred: Raleigh. N. C, September 22, 1897. Dr. R. H. Lewis, Secretary State Board of Health, Raleigh, N. C. Dear Sir: I am directed by the Governor to enclose you this letter from Surgeon-General Williams for j'our consideration and advice in the matter. The Governor would suggest that while this invitation, if extended. might be productive of inducing some men of means to make their homes in Western Carolina, it might also result in bringing into our State large numbers of people without the means of subsistence while here and whose expenses in returning might have to be paid by our people. Very truly yours. J. E. ALEXANDER, Private Secretary. AsHEViLLE. N. C, September 18, 1897. His Excellency, Daniel L. Russell, Governor. Dear Sir: If it meet with your approbation, I should be pleased to telegraph United States Marine Surgeon-General Wj'man offering the 26 NORTH CAROLINA BOARD OF HEALTH. mountain plateau of Western North Carolina as a refuge for tlie refugees from the fever-stricken districts. Very respectfully, your obedient servant, JOHN H. WILLIAMS, Surgeon-Oeneral N. C. S. G. Raleigh, N. C, September 23, 1897. His Excellency, D. L. Russell, Governor of North Carolina. Deak Sir : The letter of Surgeon-General Williams asking your ap-probation of the extension of an invitation to persons in the fever infected districts of the South to take refuge on "the mountain plateau of Western North Carolina," submitted to me for my '• consid-eration and advice in the matter," was received this p. m. Having duly considered the svibject, I would respectfully say. in my opinion it would be unwise to extend the invitation. While I do not think that at this season of the year and at the elevation of our moun-tain plateau there would be any appreciable danger of conveying the disease of yellow fever to the residents, I do believe that it would be practically impossible to detain the refugees upon the plateau suflBoi-ently long to prove that they were not infected, and that, therefore, there would be a distinct risk of some of them going to certain sections of our State that are susceptible to the disease—notably our city of Wilmington—and sowing the seeds of a serious epidemic. One section of the State might have to pay very dearly for the advertisement of another—to say nothing of the economical suggestion you make that a number of helpless people might have to be cared for at our expense. The suggestion of Dr. Williams, looked at from the point of the whole State, is, to my mind, clearly unwise. Very respectfully yours, RICHARD H. LEWIS, Secretary. The principal lesson drawn from the epidemic was the unsatisfactory character of our present quarantine ar-rangements. The friction developed between the United Marine Hospital Service and the State quarantine officials was such as to satisfy nearly every one except some of the said State officials that National supervision and control of our maritime and interstate quarantine is greatly to be desired. This being an extremely important matter and the President of the Board, a resident of our prin-cipal seaport, and for maay years on the Quarantine SEVENTH BIENNIAL REPORT. 27 Board of the same, holding identical views with myself on the subject, I thought it well in two numbers of the Bulletin to advocate those views, viz: National quaran-tine by the Marine Hospital Service. The past winter having been a very mild one—not sufficiently cold per-haps to kill the germs—it is to be feared that the dis-ease may reappear with hot weather. Then, too, the communication with Cuba, that may be brought about by the war, is not reassuring. But, if, as a result of the war, the city of Havana can be put under the con-trol of those who will enforce the proper sanitary regu-lations, its present menacing character as the breeding ground par-excellence of this disease, may be abolished. SMALL-POX. In the December Bulletin attention was called to the prevalence of small-pox in South Carolina and Georgia near our border, and Superintendents of those coun-ties near the infected districts were exhorted to make the most of any scare that might exist among their peo-ple and vaccinate as many of them as possible. The first case occurring in our State w^as reported in Wilmington on February 12th, in the person of a negro coming from South Carolina. In a few days another case, also a negro from South Carolina, occurred. Both recovered. In Charlotte there have been four cases —all negroes—with two deaths, origin of the disease also South Carolina. A young man from Georgia introduced the disease into his family in Clay County. Every member of the family, to the number of ten including himself, had it but none died. On March 2, a case in the person of a negro child from Alabama was reported near Gibsonville, in Alamance. On March 30th I was notified by the Superintendent of Health of a case in Salisbury ; origin, Knoxville, Tenn. On April Ittth the 28 NORTH CAROLINA BOARD OF HEALTH. Health Officer of Asheville notified me of a case there in a negro man ten days from Jacksonville, Fla. As there seems to have been no small-pox in that city, he probably contracted it en route through South Carolina. A few days later another case was reported from Ashe-ville— a negro woman who, in the eruptive stage of the disease, had fled from South Carolina for fear of the pest house, and had been in hiding several days before being discovered. There have been, altogether, 21 cases of small-pox in North Carolina since February 12th—10 white and 11 colored, with two deaths among the latter. With the exception of its extension to members of the immediate family of one case in Charlotte and of the Clay County case, there was no spread of the disease whatever. This speaks well for the faithfulness and efficiency of those having the responsibility of its pre-vention, and is very gratifying. But at the same time we should return thanks to the kind Providence that rules the affairs of men, for in some instances the au-thorities, owing to the determined, not to say violent, resistance of the people—the ignorant classes—were not able, or at any rate failed, to carry out the precaution-ary measures required; as, for example, in Wilmington, where the compulsory vaccination ordered was so vio-lently resisted by the negroes as to cause the abandon-ment of the attempt. In Charlotte, however, the au-thorities were more successful. Acting Mayor Brevard sent a man who refused to be vaccinated to jail, and in consequence, and for other reasons, 17,000 it is estimated, were vaccinated. The unreasoning prejudice of iguo- , ranee is extremely difficult to meet, and sometimes re-quires a resort to methods that are very obnoxious to Americans. So we should make all due allowances for such failures. SEVENTH BIENNIAL REPORT. 29 HEALTH CONFERENCE. The usual Annual Health Conference with the People was held in Goldsboro on October 14tli. An excellent programme was prepared, but owing to the unavoidable absence of several of those who had promised papers, it was not as full as usual. Notwithstanding this and the rivalry of a popular theatrical troupe, the attendance aud interest shown were gratifying, and we were as-sured that it had done good. Our former associate, Dr. Venabie, kindly helped us out most materially with a valuable and interesting illustrated talk on ''Bread." FORMALDEHYDE DISINFECTION. The importance of disinfection, thorough disinfection, in sanitation being so overwhelming, and believing dis-infection by formaldehyde gas to be practically the best method, I devoted the November issue of the Bulletin to that subject. Every physician in the State received a copy in regular course, and I hope the interest of many was quickened; but knov/ing how often we are prevented from doing what we like for want of the nec-essary materials, I thought it well to send a copy to all the druggists in the State whose address could be ob-tained— more than 300—together with a letter request-ing them to keep in stock the necessary apparatus for this method of disinfection, and asking tliem to let the jDublic, and especially physicians, know that they had the apparatus. PURE FOOD AND DRUG CONGRESS. In obedience to orders from the President of the Board, I attended the meeting of the above in Washington, March 2-4. A large number of delegates representing practically every interest involved were present, and 30 NORTH CAROLINA BOARD OF HEALTH. seemed to be much in earnest. The Pure Food bill, which had already been introduced in the House by Mr. Brosius, of Pennsylvania, was amended by the Con-gress. A Committee was appointed to work for it, and, but for tlie war with Spain, some much-needed legisla-tion on this line might have been obtained. COUNTY SUPERINTENDENTS OF HEALTH. It is with much regret that I have to announce the failure of ten counties to elect Superintendents since the power to elect was transferred by the last Legisla-ture from the County Board of Health to the Board of County Commissioners. This is very discouraging. It is a retrogression that it is to be deplored. As the election, under the amended law, takes place annually on the first Monday in May, I mailed to the Boards of Commission-ers referred to the following letter: Raleigh, April 27, 1898. Board of County Commissioners— CrEXTLEMEX : Not having any reports from your County Superintend-ent of Health for some time, I fear that j^ou overlooked his election. I would respectfully call your attention to the fact tliat the law (chap-ter 214, Laws 1893,) is mandatory on the subject. As amended by tlie Legislature of 1897 the Superintendent •'shall be chosen by the boai-d of county commissioners of each county annually, on the first I\Ion-day in May of each year, and the said board of commissioners shall fix the compensation of said county superintendent of health." It is very important to the health interests of the people that tliere should be such an oflicial in each county (it being another name for county physician), and inasmuch as your honorable Board has abso-lute control of the selection of the ofiicer and of his remuneration, I hope you will comply with the law and elect a Superintendent on Mon-day nest. Please have your Secretary send me his name and address, and oblige. Yours truly, RICHARD H. LEWIS, M. D., Secretary. In conclusion, I feel it my dutv once more, to call upon the members of the Society and of the profession of the State in general, to lend us their invaluable aid in advanc- SEVENTH BIENNIAL REPORT. 3 1 ing our work. That work is, and must be for many years to come, chiefly educational. As intimated in the begin-ning of this report, in all medical and sanitary matters there is no influence comparable to that of the family physician. If every physician would make it his busi-ness to insist on his patients carrying out the ordinary sanitary precautions, the result in one year's time would be very great. Gentlemen, we count on your help in this glorious work of preventing disease and saving life. DISCUSSION. Dr. Lewis.—I would be glad to have any expressions of opinion in regard to the management of this health business, or suggestions as to what I might do to ad-vance the cause of sanitation. Our hands are tied largely by the want of money in the State Treasury, which prevents the printing and distribution of the health pamphlets, which has been one most effective mode. Dr. Fletcher.—I do not know that this is the time to do it, but I would like very much to see one thing in force, and that is some sort of compulsory vaccination law in North Carolina. Most of our towns have com-pulsory laws, but it is difficult to get them enforced. If we had a law similar to that in effect in some other States requiring every child before entering school to be successfully vaccinated, I think it would be a step in the right direction, and in a few years we would get everybody vaccinated. I don't know whether it is wise or expedient to burden Dr. Lewis with this. Dr. Lewis.—I would like to say that I prepared a bill on that subject and had it introduced in the last Legis-lature, and that it was treated with absolute contempt. The only lever we would have upon the people would be to prevent the children from going to school if they T,2 NORTH -CAROLINA BOARD OF HEALTH. were not vaccinated, dne practical difficulty on educa-tional lines now is to get the children to go to school at all. Dr. Haigh.—T requested our representative, Judge Sutton, before he left for Raleigh, to introduce such a bill, and he told me that he had gone to the Secretary and asked him to write it. There is one point about this matter that I think we might strike at right now. Why is it that the people are refusing to have their chil-dren vaccinated? Formerly there was no objection to it at all, and the virus we used was human virus and passed from the animal through the human system. The re-sult of that was a modified ^condition. We got a virus that did not produce such violent results as the bovine virus does now. The point I want to make is this: The great fear has been all this year, especially from the violent results of the vaccination, that they will lose their arms and that the children will die. What is the cause of it ? I do not know that I am right, but I do know this to be a fact. In using the virus, I have as far as I could selected those points having no color stain, and where I have done that, I have gotten a fuil vac-cine result, and very little erysipelas and inflammation. I believe that you can go back to the origin of this. There has been such a demand for virus that they have been dipping too many points into one pock, and in that way, instead of getting pure virus, they have got pus mixed with it, the result of inflammation. If some-thing could be done along that line, we would not pro-duce this condition and set up such inflammation. Some of the points I sent back and asked to have them ex-changed for pure ones, where not so many points had been dipped into the same pock. I think it has had a great deal to do with it. I do not think I vaccinated over a hundred people. I could not do anything with SEVKNTH BIENNIAL REPORT. them. I think if the matter could be taken entirely under control of the Board of Health, and have our Secretary get all the virus for the State from some one point where he was perfectly sure that it was good, and then send it out to the counties, w^ would get better results than we do now. I am quite sure as long as the results are as they are now, that the people will object to it. Dr. Le^^s.—In regard to the State Board furnishing the virus, I wish to say that some years ago we had a scare in a supposed case at Wadesboro. I "whooped it up" and tried to scare everybody to death, advertised that I had reliable virus on hand, and invested the Board's money in 100 points. I could work off only about thirty. Dr. Minor.—One point I would like to mention, and that is the tendency to advocate humanized virus. In my experience, the patients have always refused to be vaccinated unless I assured them that I had bovine virus. Dr. Haigh.—I was not advocating the humanized virus. I was saying that there was no objection to that but that it was in a modified form as compared to bo-vine virus. Dr. Burroughs.—A great deal of prejudice lingering in the mind of the public is from using humanized virus. Poisoned arms gave our people a great deal of trouble during the Civil war. I will just say for the benefit of the Society that they have had small-pox in South Carolina in close proximity to Asheville, and we strongly advised the vaccination of the whole town and quarantining against these places be-fore Christmas. I went before the local Board of Health and strongly urged the importance of vaccinating the 34 NORTH CAROLINA BOARD OF HEALTH. whole town, especially the school children, before the opening of the schools, but they didn't. I vaccinated about 3, 800 since the last week in Novem-ber, and I haven't made but one visit to see one person in that whole 3,800. Since we got that case of small-pox, I haven't vaccinated very many, because I already had them vaccinated. Since the scare came, I have vac-cinated about 600. 1 used the National vaccine points, and 90 per cent of them have taken. Dr. Anderson. —In regard to the vaccine lymph in tubes. I wanted to be careful, and I wrote to Dr. Gallo-way, asking what he would advise, and to send me 100 points he could recommend, and he telegraphed to Chicago for these lymph tubes. We found them satis-factory, and recommend their use. Dr. Fletcher.—1 want to say a word just along the line of Dr. Haigh's remarks. It is only recently that the tubes have come out, bat I found that many times the points would not take. Since I began to use the tubes, in 360 cases of primary vaccination with tubes, every one of them took. We had a few bad arms with severe inflammation, and some of them did not get well imme-diately. Some of them vaccinated in January are not well yet. We did not have erysipelas, but the arm was red and swollen to the elbow, and even the muscles be-low the elbow were swollen. It does not appear to be safest in every way, but :it takes more effectually than the points. Dr. O'Hagan.—It is a little singular that the remark-able discovery of Jenner, the value of which has been demonstrated time and time again, should find antago-nists not only among the ignorant, but often among in-telligent people ; yet it is unfortunately so. A mode of overcoming this prejudice is yet to be discovered. You may talk what you please about virus and ivory points, SEVENTH BIENNIAL REPORT. 35 neither does it matter what variety of vaccine you use, you will find some cases where the peculiarity of the in-dividual makes vaccination undesirable. I never saw a fiddler vaccinated in my life, and I have vaccinated many thousands of people. It makes little difference what kind of vaccine you use, or under what favorable circum-stances you proffer to the masses of the people such an invaluable protection as this is, somehow or other, tney will not accept it. I have been in the habit of preach-ing vaccination for the last thirty or forty years. Every year of my life I buy a few vaccine points and inform my patients that I have them there. I don't propose to vaccinate gratuitously. I do not propose to go around peddling these points and try to make the people pay me a dollar to vaccinate them, but I try to show the in-estimable value of vaccination. I do not know anything in the world that will make them be vaccinated except a good small-pox scare. I do not know which way is best. I have vaccinated from arm to arm and have had delightful results, and again I have had very unpleasant ones. The President tells me he has used the lymph tubes in Newbern, and has had unpleasant results, and so here it goes. In 1854 we had a terrible epidemic in our county, and I wrote to Wilmington for vaccine, and in reply received a very ugly little scab, but I vaccinated a grep,t many and never had a single bad result. I have seen the most careful vaccination from the most reliable virus fol-lowed by remarkable consequences. The main question is to get the people to accept the protection. I know nothing in the world that will induce them to do so but a good first-class case of small-pox. Dr. Duffy.—Dr. O'Hagan refers to the liquid virus, with which I had some little experience. I can't say, I am sorry, just where it was put up. I think it was 36 NORTH CAROLINA BOARD OF HEALTH. somewhere in Chicago. You may be famihar with it. You will find it in sealed glass tubes ; a rubber tube comes with them. You break off both ends of the glass • tube and attach the rubber tube to one end, and then by gently blowing through the latter, you get out a drop ot the virus. Be careful to first disinfect the arm with alcohol. At first I took a razor, and without drawing-blood, got off the epidermis and put a little drop of the virus upon one spot. I found that all of it, in almost every case, would strike in. I had very sore arms, and no matter how little I put, it seemed to give very sore arms. After some little experimenting with it as to how to do it, instead of putting it in one spot, I put it in three spots. It seemed to me that three small spots gave me less trouble than one, no matter how little I used. One thing I want particularly to refer to, and that is the manner of dressing the arms. A great deal of the trouble in vaccination in my experience has come from the patient's hurting the arm in some way. It is diffi-cult to avoid. The vaccination shields are not very good, for they slip around and are about as bad to press on the arm as anything else. I have tried bandages, going aroLind under the pit of the arm to get some attach-ment, and all proved unsatisfactory until I took a piece of rubber adhesive plaster, about the size and shape of an ordinary envelope, and having attached tapes to the edges of it, fastened it to the arm opposite the vesicle. Then by placing rolls of absorbent cotton under the tapes next to their points of attachment they were lifted up and they could be tied over the dressing without exert-ing too much pressure. You can untie the tapes and dress the arm as often as may be desired. Dr. Murphy.—I understood the Secretary to ask for advice to help him out. I don't know v/hether the Sec- SEVENTH BIENNIAL REPORT. 37^ retary expects to vaccinate or Dot, but it seems to me that we have wandered off from the subject of advice. So far as I am concerned personally, I feel that we have our health affairs in the best hands in which we could put them, and I endorse fully what the Board of Health has done, and I recommend that they continue the Health Conferences about through the State. I would be glad to have them up in our part of the State this vear. Dr. ,— I appreciate the value of vaccination as a preventive of small -pox, but whereas the results we get from vaccination are better than small-pox, I must confess that the popular prejudice against vaccination is not wholly without justification. In our experience during last summer—I speak for myself and my asso-ciate— we used all the care we knew how to use. Thor-oughly believing in the aseptic treatment of wounds, we would prepare the arm aseptically, both scrul)bing the arm, at the point to be vaccinated, with hot water and then rinsing with alcohol, and with a sterilized knife making a slight abrasion, would dip the point into sterilized water and make the application of the virus. When through, we dressed the arm with a little steril-ized gauze, this dressing to be removed again when the sore began to manifest itself. While we could not al-ways follow up the after treatment of these cases, in quite a good per cent we did follow it. True, we did not lose any lives or any arms, but it must be confessed we did have quite a number of very bad arms. I know in the person of my own little daughter, whose case I watched carefully, she was for three days violently ill. She was carefully educated and trained as to the neces-sity of not scratching the place and thereby infecting it, and in spite of the care which had been taken, she had a high temperature and suffered a great deal of pain. 38 NORTH CAROLINA BOARD OF HEALTH. had constitutional disturbances and extensive eruption and was, in other words, quite sick. In one or two cases we were for a while really in great fear for their lives. Now I say this, that while I believe in vaccina-tion and think it ought to be done and urge it, it seems to me that something ought to be done and some steps taken to secure a virus which is less active, and which will not produce such violent constitutional and local symptoms. When we can do that, I believe the public prejudice will to a great extent rapidly fade away. I am glad to hear what my friend Dr. Haigh said in regard to the selection of points, and I shall bear it in mind. I hope he will solve the difficulty. We thought possibly the trouble was that the virus was not suffi-ciently attenuated, had not passed through a large enough number of animals, but that was purely hypo-thetical with us, but certainly something was the mat-ter. We used the National points. I would not vacci-nate one of my children with an Alexander point, though others may be as bad. Dr. Kent.—When the doctor called out this discussion, I had hoped it would take a different turn. I have list-ened with a great deal of pleasure to the discussion of vaccination for small-pox, and yet I feel, as County Su-perintendent, that it has not been of as much value to me as if it had taken that turn. I am disposed yet to call out a different line of discussion, and endeavor as County Superintendent to derive some benefit from it. We meet around us far more evils that we know than those that we know not of. We know typhoid fever, we kuow measles, we all know consumption. We have them to do battle with almost continually, and if from our discussion here I can be better able to prevent a sin-gle case of typhoid fever in my county during the com-ing season, I believe I would be more benefitted by the SEVENTH BIENNIAL REPORT. 39 knowledge of how to do that, than I would by any knowledge of better vaccine virus, and for that reason, I desire to give the discussion that kind of a turn. Some weeks ago I had a gathering of the physicians in my count}'" for the purpose of discussing what we might do to prevent the prevalence of typhoid fever in my county during the coming season. We discussed various means that we knew of, and resolved that we would appoint ourselves each a committee of one to do what he might in his especial community among his patrons to teach them how to live, and how to clean up the hot-beds of this disease around their houses, and how to obtain pure drinking water. And if any of the members here can make any suggestions to me that will enable me to more practically teach the people what to do to prevent the spread of typhoid fever during the coming season, I will certainly be greatly obliged. Dr. Reynolds.—I do not rise to discuss typhoid fever, but I have a few words to say about vaccination, and with your permission, I will return to that topic of dis-cussion for a few minutes. It seems to me that a man when he is vaccinated has to have some constitutional disturbance, a sore arm, and be made sick, before he is successfully vaccinated. You might put the vaccine on a man's arm and have a little scar and a little irritation, and 1 would not call that man successfully vaccinated. I would not think he would be. I remember having vaccinated one child in Novem-ber, and it failed to take. I vaccinated it again in De-cember, and it failed to take. I got that point from Dr. Burroughs, I vaccinated again in April with lymph, all in different places, and that took, and it set up a fire in all three places. I had three scars on that child's arm. I can state positively that I did not get any lymph in the other scars on that child's arm. I think Dr. 40 NORTH CAROLINA BOARD OF HEALTH. Glenn, who has gone around with me considerably, has witnessed a case similar to this one. Dr. Glenn.—I have seen a case like this where the scars would light up. It seems to be latent virus. I saw it in my own family. My brother was vaccinated more than a mouth ago. It did not take, and about six or eight days ago, I vaccinated him again with a lymph tube. Wheu I left Asheville, that vaccination, which was more than an inch distant, and I am sure I did not touch it, was worse than the last place. I remember another case, that Dr. Reynolds called attention to first. Before this case of my brother's, I remember one vacci-nated in December that lit up like that, and I am sure that it never came in contact with the virus the second time. It seems to be latent virus. There is not enough to cause successful vaccination, but when a little more is added, it makes all the places light up anew. Dr. Lewis.—When I was in Washington, I availed myself of the opportunity to visit the National Vaccine Establishment. I was very much gratified with the con-dition of affairs. Everything is in first-class order, and precautions are all carried out. Dr. Burroughs.—In my business I have not used the tubes, but I am very favorably impressed with the re-ports. It seems to be more certain than the points, though I am satisfied with the points of the National Vaccine Company. I never heard of previous vaccina-tion being set up a second time. These cases the Ashe-ville gentlemen report are entirely new to me. In regard to what Dr. Kent says, my impression is that he will get pure drinking water if he will filter it. If he will destroy all the fecal matter from the typhoid patients, he will greatly lessen the disease in his county. In every case you have, destroy all the excreta, and look after the water supply. Therein is the key to health, therein is protection. That is all of it in a nut shell. SEVKNTH BIENNIAL REPORT. 4I Dr. Minor.—Wc all know that typhoid fever is en-demic to many regions of the countr}^ I think where the most trouble comes in is with the jDOor, uneducated classes. You ought to teach them first, if nothing else, that the well should be done away with. Where the well can not be done away with, you must teach them that it ought to have a sacred meaning, and have no close connection with the water-closet. You must teach them that the water-closet, or privy rather, must be water tight. Most of these privies have in them nothing but leaky tubs which are a constant source of contamination. The water supply, the well, and the privy are some of the things that must be looked after. Impress upon them the necessity of keeping these places clean. Scare them, tell them they are liable to die at any minute if they don't look out. Don't wait until typhoid fever comes into the house, but try to make them take cure. Keep on, and after awhile you will see the barrels water-tight instead of open, and they will set to work and clean up around the wells and their premises generally. Dr. Albert Anderson.—To accomplish these results, we have been talking in Wilson about how to introduce water into our houses. Our medical society formulated plans and advised our Board of Aldermen to adopt them. Dr. W. S. Anderson.—It is simply this: We had the water and sewerage system introduced about two years ago, and up to the present time, only about 200 families use them. The plan was to leave the putting in of the fixtures to private enterprise. The result was that plumbers charged the people so much that they would not take the water. I thought they charged tt)0 much, and I sent and got a catalogue and price list and found my suspicions were true, that they were charging an enormous per cent. So we got our local society to 42 NORTH CAROLINA BOARD OF HEALTH. appoiDt a committee to investigate the sanitary condi-tions of our town, and that committee reported to the society that the water was doing no good at all as a sani-tary measure. We recommended that the town investigate as to the cost of the material, and that the town buy the mate-rial in large quantities in order to secure the cheapest rates, and put it in to the people at cost, and let the people pay cash for the material. They haven't de-cided yet what they will do, but we think they will get with this uew Board that is just coming in, and that we will get the people of the town to do that, and in not a great while hence we will have the public water taken by all the people Then there will be a large number of people who can not take it even at cost. We proposed to the town that they go forward and put it in to these people on credit and take their notes for it. because at the present water rent it would pay for it-self in three years, if the poor fellow never pays it back. The town is not in the monej'^-making business on the people of the town. We think that in that way we can get the full benefit for which the water supply was in-tended originally, and make it so cheap that all the peo-ple of the town will take it. Dr. Lewis.—I think it would be well for the session to pass a resolution endorsing the Caffery Bill. I do not know what the sentiment is, but so far as I am con-cerned, and so far as anyone I have talked with is con-cerned, I think our opinion is that the JSIational control of maritime quarantine had better be placed under the Marine Hospital Service, where the men are selected by c(5mpetitive examination and not for political reasons, instead of under a National Department of Health, where the President appoints a Commissioner of Health with a salary of $6,000, who has the power of appoint- SEVENTH BIENNIAL REPORT. 43 ing an assistant Commissioner. The practical difficulty with this plan in the first place is that politics would surely come into it, and the Commissioner of Health would be selected, not as an expert, but as a man po-litically desirable, who would probably, even if he should prove competent, have to give place to a new and inexperienced successor just about the time he had thoroughly learned the business. The Caffery Bill, which was introduced by Senator Caffery, from Louisiana, and chiefly advocated by Sen-ator Vest, from Missouri, is a bill that enlarges the pow-ers of the Marine Hospital Service, and confides to them this National supervision. Dr. Carr.—I think if the Secretary would offer a reso-lution the Society would adopt it. We wish to carry out his wishes, for we know he is right. Dr. Minor.—I realize fully that Dr. Lewis under-stands it, but I do not. l have seen lately in the press, and in the medical press, too, such conflicting opinions that it would seem to nie until a full statement of both bills could be presented to us, we might be acting im-properly in proceeding to recommend what we do not fully understand. I can not vote on a thing till I know more about it. Dr. Long.—I do not think any of us can go wrong when we know that one bill proposes to put the control under competent scientific men. I think we must have some National legislation in regard to this. If we can get it and keep it under scientific control and get Uncle Sam's help, too, I am in favor of it, but if it is to be changed every four years, I am not, and we can not go * wrong if we take a stand against it. Dr. Lewis.—I would like to call attention to the fact that this bill is introduced by Senator Caffery, of Louis-iana. The quarantine of New Orleans is superior to any 44 NORTH CAROLINA BOARD OF HEALTH. in America or anywhere, and notwithstanding that fact and that the Senator from Louisiana is a Democrat and a States' Kights man, he has introduced this bill. The most ardent advocate of the bill is Senator Vest, who yields to none in his jealous watch over the reserved rights of the States. The following resolution was then adopted without a dissenting voice : Resolved. That the North Carolina Board of Health and the Medical Society of the State of North Carolina in conjoint session assembled endorse the Caffery Bill, enlarging the powers of the United States Marine Hospital Service, and respectfully request our Senators and Representatives to support the same. The session was then adjourned. THE PUBLIC WATER SUPPLIES OF THE STATE. At the annual meeting of the Board at Morehead in June, 1897, "it was ordered that the municipal water supplies of the State be examined chemically and bac-teriologically during the current year : and that the En gineer of the Board be requested at his convenience to collect, pack and ship samples for the same, and at the same time to make an inspection and report on the vari-ous water works and watersheds.'* Colonel Shaffer having carried out the above instructions, submitted his report to the recent meeting of the Board in Charlotte — the first since the completion of the work—and the Sec-retary was ordered to publish it in the Bulletin. ' It may be remembered by some of our readers that this. work of systematically investigating all the public water supphes of the State was first undertaken in ] 896, and was limited to simply an analysis of the water. SEVENTH BIENNIAL REPORT. 45 While that examination was very incomplete, owing to the extremely small appropriation by the State, it un-doubtedly had a good effect on the water companies. We are all more particular if we know we are watclied. Realizing this, the Board felt that some of its little money could not be put to a better use, and so the ac-tion indicated above was taken. The reader will understand, of course, that we do not suppose that an annual inspection and analysis will make puie water, but it Vvill make far parer water by causing the water companies themselves to take a more active interest in the matter. Neither would any num-ber of analyses insure pure water, for the reason that it must be already infected before the pathogenic bacteria can he found. Frequent inspections of the watershed, however, and thorough filtration would be much more effective. It is far safer and easier to prevent disease germs from getting into the water than to get them out after they have taken possession. And inasmuch as a number of our supplies are taken from small streams whose restricted watersheds are inhabited, the danger of infection is much greater than vrhere the origin of the supply is different. After a careful consideration of the matter, we have come to the conclusion that the best thing water companies obtaining their supply from such watersheds can do to insure the purity of their water, is to employ some reliable man whose sole duty it shall be to thoroughly patrol the watershed, going over it and visiting every residence thereon at least twice a week, and promptly reporting every case of fever or diarrhoeal disease, that it may be immediateJy investi-gated and such precautions taken as may be necessary. We are glad to say that this suggestion, made in a con-versation with one of the owners, has already been adopted by the Charlotte Water Company. If this thor- 46 NORTH CAROLINA BOARD OF HEALTH. ough and continuous inspection should be supplemented by approved filtration, we believe that the danger of in-fection would be reduced to a practical minimum. It is apparent, we think, that it would be clearly to the in-terest of the water companies, for- the occurence of typhoid fever traceable to their water would reduce their receipts far more than carrying out the above sugges-tion for a number of years. Besides, the effect of such careful protection of the water against infection would give confidence to the people, and would be immediately and continuously beneficial to their business. The reader of the report will doubtless be struck with the high price charged for water, especially to small consumers, which, of course, includes all the poorer classes. In several instances a minimum consumption amounting to S12 per annum is required, which is prac-tically prohibitory to the poor. While no doubt some of the companies find it a hard matter to "make buckle and tongue meet," this should not be. We have no control over the price charged, but we feel it our duty to say that high-priced water is not in the interest of public health. Pure water in abundance, at a price within the reach of all, is one of the most power-ful agencies for promoting the health of any commu-nity. It is for this reason that we believe so strongly in municipal ownership. We can not expect those who have invested their money in such enterprises for the purpose of securing dividends to look at the matter from the eleemosynary point of view—they have a right both in law and equity to make such charges as will insure them a reasonable return on their investment. But when the water works are owned by the people as a whole, the object of the management will not be divi-dends but health, comfort, beauty, and safety from fire. The general tendency is toward municipal ownership, SEVENTH BIENNIAL REPORT. 47 and we trust that it will spread in North Carolina. It pays. Wilson owns its own works and sells water at ten cents per 1,000 gallons at a profit. It should be noted in connection with the chemical analyses that where the albuminoid ammonia is too high, that it is nearly always due to vegetable matter in the stream in the form of leaves, etc., and that it is not dangerous in itself. In regard to the bacteriological tests, it should be said that while they are not as elabo-rate and complete as they might be, they are made by good men, and are carried far enough to show whether or not there is reason to suspect the water of being in-fected. In conclusion, we wish to put ourselves on record as favoring the use of public water supplies as against the water of wells, provided the companies will conscien-tiously use every reasonable effort to insure the purity of their supplies. The water of the public supply may sometimes be dangerous, but that from wells in closely-built cities and towns with surface privies, and more especially cess-pools, is much more apt to be so. The chemical analyses were all made for us without charge b^ the North Carolina Agricultural Experiment Station, and we desire to make our acknowledgments to Acting-Director Withers for his valuable aid in this respect. The comments on all chemical analyses are made by the chemist. REPORT OF COL. A. W. SHAFFER, ENGINEER OF THE BOARD. GOLDSBORO. GOLDSBORO, August 3, 1897. One saini>Je taken from intake on Little River at the power house, and one from the tap in front of Hotel Kennon, on Railroad street, 4 48 NORTH CAROLINA BOARD OF HEALTH. both for bacteriological analysis, taken, packed and delivered to Dr. Anderson, of Wilson, in his presence. Samples for chemical analysis have been since procured by yourself. This visit to Goldsboro has been fully reported heretofore. The following is the report referred to: "I reached the city about noon, and was glad to find awaiting me the President, Dr. George G. Thomas, and the Biologist, Dr. Ander-son, Drs. Spicer and Hill conferring with us cordially. "We visited the water works on Little River in company with the mayor, and found the works small, but filter working well, and sup" ply tinted with the juniper and cypress through which it passes, but clear, and free from green scum, bad odor or taste, which had been reported to exist there. We took samples from the intake and re turned to the city ; took another from the tap in front of Dr. Hill's drug store, in the hotel building, and Dr. Anderson packed both in ice and carried them with him that night to Wilson. "Through the courtesy of the mayor we were enabled to ride over the town and view its watershed and drainage. We found no sew ers, but we never saw a town so well adapted by nature for efficient sewering at a moderate expense—say Waring's system. There is ample grade and fall in every direction, with no rock or hard sub soil to penetrate, and would discharge into Neuse River within a mile of the corj^orate limits, two to three miles below the intake on Little River. "The water bearing stratum of Goldsboro lies barely ten feet be-low the surface, and in wet seasons the water in the wells rises to within four to slx feet of the surface. The waste water of the town empties into shallow surface ditches, and is liable to percolate through the sandy crust to the wells, from which a large majority of the citizens of Goldsboro obtain their water for all purposes. "I think that so far as the health of the town is concerned, there is greater danger than with no water works, because of the lack of sewerage to carry off the waste. "Briefly stated, Goldsboro is situated upon a plateau of open, sandy loam, elevated about twenty feet above, and distant about one mile from Little River on the northwest, and Neuse River on the south. The water bearing stratum under the town averages eight to twelve feet below the surface, and there are localities in which the well water can be reached from the surface with a long, handled gourd. Having no sewers, the city is drained by shallow surface ditches, alternately wet and dry from atmospheric causes; always more or less charged with the waste and sewage of buildings, and the use of the street and lawn taps connecting with the river supply, the shallow wells being the common receptacle and reservoir of all. "If typhoid germs breed and multiply under these conditions, SEVENTH BIENNIAL REPORT. 49 then Goldsboro is an ideal propagating ground, though the waters at the intake be as pure and hmpid as those of Pison, Gihon or Hid-dekel, that sprang from the garden of Grod. "Works belong to private parties, who sell water to small con-sumers at 40 cents per 1,000 meter gallons." N. B.—Since the above report was made the people of Goldsboro have voted bonds for sewering the city. CHEMICAL ANALYSIS. Sample from Intake. Total solid matter in solution 3.3 gr. per U.S. gal. Hardness .-- 1.4 deg. Clarke's sc. Equiv. to cal.car , 0.33 gr. per U. S. gal. Chlorine... 0.33 gr. per U.S. gal. Free ammonia 0. 106 parts per mil. Album, ammonia 0. 170 parts per mil. The chemical analysis indicates that this is not a good water for drinking purposes. Sample from Faucet in City. Total solid matter in solution 3.3 gr. per U.S. gal. Hardness 1.4 deg. Clarke's sc. Equiv. to cal.car 3.3 gr. per U. S. gal. Chlorine 0.33 gr. per U. S.gal. Free ammonia 0. 043 parts per mil. Album, ammonia 0. 233 parts per mil. The chemical analysis indicates that this is not a good water for di'inking purposes. BACTERIOLOGICAL EXAMIIfATION BY DR. ANDERSON. One sample, until fcered, was collected from the intake at the river. This showed 300 bacteria to the C. C. of benign form. The other sample, faltered, was collected from a faucet on Railroad street, and this contained only 53 bacteria to the C. C. The last sample repre sents the water used by the city, which is good. WILSON. Wilson, November 8, 1897. Two samples taken from tap in drug store adjoining Dr. Anderson on Main street—one delivered personally to Dr. Anderson and the other sent to Experiment Station at Raleigh. 50 NORTH CAROLINA BOARD OF HEALTH. Visited power-house, intake and watershed with Dr. Anderson These are about a mile from town. The works have no filter and the town no sewerage. The intake is about one hundred yards from the works, on the run of Toisnot Swamp, with a flow of water over the dam 10 inches deep and 12 feet wide, clear, but full of floating: leaves, and tinted slightly by decaying vegetation. The canal drain mg the swamp is about one thousand feet in length, and the area of the swamp about one and a half square miles, with ever recurring living springs along its margin—a very slight run crossing the road a mile above the intake. If an open, dry ditch could be maintained around the margin of the swam^), the banks of the canal and the run of the swamp cleared—say twelve feet wide on each side—and the run of the swamp opened and kept clear from dead leaves, fall-ing branches, trunks of rotten trees and water grasses that obstruct the flow, they would have as near an ideal reservoir as swamp lands ever afford. The works are owned and operated by the town ; sell water to small consumers at ten (10) cents per 1,000 meter gallons, and reali2e a profit upon the cost of'plant and its operation. CHEMICAL ANALYSIS. Total solid matter in solution 3. 33 gr. per U. S. gal. Hardne.ss 1.7 deg. Clarke's sc. Equiv to cal.car ._. 0.58 gr. per U. S. gal Chlorine 0. 33 gr. per U. S. gal. Free ammonia 0. 0449 parts per mil. Album, ammonia 0. 2155 parts per mil. The high percentage of albuminoid ammonia indicates vegetable contamination. BACTERIOLOGICAL EXAMINATION BY DR. ANDERSON. The bacteriological examination of sample of water collected from the Wilson public water supply, November 10, 1897, showed 150 bac-teria to the C. C. All tests used in making the examination showed the water good. NEWBERN. Nbwbern, November 10, 1897. Took two samples water from the running public hydrant at the corner of Main street, near the Hotel Chattawka; one sent to Dr. Anderson at Wilson, the other to Experiment Station at Raleigh. Water derived from six bored, or artesian wells; no watershed or SEVENTH BIENNIAL REPORT. 5 1 filter. Works owned and operated by private corporation, and water sold to .small consumers at 50 cents per 1,000 meter gallons, with a minimum of 100 gallons per day. CHEMICAL ANALYSIS. "> Total solid matter in solution 10. 25 gr. per U. S. gal. Hardness 10.01 deg. Clarke's sc. Equiv.to cal.car 7.58 gr. per U.S. gal. Chlorine 0.5 gr. per U. S.gal. Free ammonia - 0. 0100 parts per mil. Album, ammonia .. 0.020 parts per mil. There is no indication of organic contamination. BACTERIOLOGICAL EXAMIXATIOA' BY DR. AXDERsOK^. The sample of vvater received from the Newbern public water sup-ply, November 10, 1897, showed only 83 bacteria to the C. C. in mak-ing a bacteriological examination. All tests used show this water to be very good. WILMINGTON. WiLMiJfGTON, November 11, 1897. Took two samples water from tap in Mr. Munds's drug store on Main street ; packed, addressed and deposited them in exj^ress oflBce, and withdrew them after conference with and upon advice of the President of the Board to be retaken upon the completion of the artesian well now boring upon the site of the power house, or other production of acceptable water. Owing to the liability of infection by the city sewage in the ebb and flow of the tide, it is earnestly recommended that the intake be removed above tide water, in the event of the failure of the artesian well now boring. The works are owned and operated by private parties, and the water is sold to small consumers at 20 cents per 1,000 meter gallons. FAYETTEVILLE. Fayetteville, November 12, 1897. Two samples of water taken from the running public hydrant at the corner of Hotel Lafayette on Main street. One to Dr. W. T. Pate, at Gibson Station, and the other to the Experiment Station at Raleigh. 52 NORTH CAROLINA BOARD OF HEALTH. This water is derived from the great spring on Haymount Hill, and used for drinking purposes chiefly. Other water is taken from the run of Cross Creek, used for general purposes, and for drinking where Haymount water- can not be obtained. No sample taken from Cross Creek water. The works are owned and operated by private parties, and the water sold to small consumers at 25 cents per 1,000 meter gallons, but not less than §1 per month. CHEMICAL ANALYSIS. Total solid matter in solution 2.83 gr. per U. S. gal. Hardness 1.8 deg. Clarke's sc. Equiv.to cal.car. 0.67 gr.per U.S.gaL Chlorine.--- 0.5 gr.per U.S. gal. Free ammonia 0. J361 parts per mil. Album, ammonia 0. 0375 parts per mil. The chemical examination shows no indication of organic con-tamination. BACTERIOLOGICAL EXAMINATION BY DR. PATE. The quantitative analysis gave 180 bacteria per cubic centimeter. The qualitative tests showed no suspicious organisms. Sample good. ASHEVILLE. ASHEVILLE, November 19, 1897. Two samples taken from tap in Asheville hotel. One to Dr. Albert Anderson at Wilson ; the other to the Experiment Station, Raleigh. Through courtesy of Dr. Fletcher, visited the filter within the city, the stand-pipe and reservoir on Beaucatcher Mountain, and the power house and intake five miles out on the left bank of Swan-nanoa River. This is the best plant in the State. Four large filters are enclosed in brick walls ; the reservoir is an abandoned rock quarry, cleaned out and cemented, safe against the intense cold that destroyed the stand-pipe a few years ago, and the power house, dam and forebay are of solid rock masonry. The water is conducted to the city through two lines of pipes, one 10 and the other 16 inches in diameter, over two mountain spurs into the stand-pipe and the reservoir. This most expensive of the municipal water works of the State is the property of the city of Asheville, selling its water to small con sumers at 15 cents per 1,000 meter gallons, and supplying the street sprinkling, the sewer flushing, the public hydrants and the public fountains free. SEVENTH BIENNIAL REPORT. 53 The only settlement on this watershed is at Black Mountain, 16 miles away, and very small. CHEMICAL ANALYSIS. Total solid matter in solution 3. 16 gr. per U. S. gal. Hardness •- ". - - 1.4 deg. Clarke's sc. Equiv.to cal.car 0.33 gr. per U.S. gal. Chlorine 0.16 gr.per tj. S.gal. Free ammonia 0. 013 parts per mil. Album, ammonia 0. 0335 parts per mil. A very pure water. BACTERIOLOGICAL EXAMINATION BY DR. ANDERSON. The sample from the Asheville public water supply was received November 30, 1897. In the bacteriological analysis of this water no harmful bacteria were found. CHARLOTTE. Charlotte, November 33, 1897. Took two samples water from the running tap at Van Ness's gro-cery on North Tryon Street. One to Dr. W. T. Pate, Gfibson Sta-tion, the other to Experiment Station, Raleigh. By courtesy of Dr. Brevard, joint owner with Mr. Eli Springs, I visited the power- houses, reservoirs and part of the watershed. The latter consists largely of cultivated land. Not a favorable watershed for first-class water without thorough filtration. There are how ever, four filters in use. The supply is derived from two streams. Both average about one and a half miles from the principal square in town at the intersection of Trade and Tryon streets. Both are conducted to a settling basin near the power-house, from, which the water is conveyed to the filters. This plant is owned and operated by private parties, and water is sold to small consumers at 50 cents per 1,000 meter gallons. There exists an inchoate contract for the sale of the plant to the city. Note.—The management proposes to reduce the rent to private consumers. CHEMICAL ANALYSIS. Total solid matter in solution 5.91 gr.per U.S. gal. Hardness 3.8 deg. Clarke's sc. Equiv. to cal. car 8.33 gr.per U.S. gal. Chlorine 0.416 gr.per U.S. gal. Free ammonia - - 0. 36 parts per mil. Album, ammonia 0. 1877 parts per mil. 54 NORTH CAROLINA BOARD OF HEALTH. The chemical analysis indicates vegetable organic contamination. BACTERIOLOGICAL EXAMINATION BY DR. PATE. The quantitative examination gave 435 bacteria to the C. C. This sample forms gas in both glucose and lactose bouillon, but 1 did not succeed in isolating the fermenting bacteria. SECOND BACTERIOLOGICAL EXAMINATION MADE FOR WATER COMPANY BY DR. PATE. I have the honor to report as follows on sample of water sent me from the public water supply of Charlotte June 3, 1898: Sample shipped without ice. Is is clear ; no sediment. Contains only 130 bacteria to the C. C. of water. No fermentation in lactose or glucose bouillon, e\en after several days' growth. This analvsis indicates a safe drinking water. CONCORD. Concord, November 83. 1897. Two samples of water taken from tap at Marsh's drug store in presence of Mayor Crowell—one to Dr. W. T. Pate at Gibson Sta tion, the other to Experiment Station at Raleigh Visited power-houses (two—both inside city) with Mayor Crowell. The city is built upon the crest of a long ridge, and the supply of one station is taken from the Reed Grold Mine shaft on one water-shed, and the other from surface springs on the opposite side, both very exactly on the watershed of the town. At the first I found a pond of perhaps an eighth of an acre, about a hundred feet above the shaft, the overflow passing the station within ten or twelve feet. On the other watershed, directly opposite, was the other power-house, beside a walled and covered spring. The power-house contained a small Worthington pumping engine, furnishing power to run the pump and the electric light plant of the town. The Concord plant is owned and operated by a private party ; has a stand-pipe, but no reservoir or filter, and the water is sold to small consumers at 50 cents per 1,000 meter gallons. chemical ANALYSIS. Total soUd matter in solution 9. 66 gr. per U. S. gal. Hardness 6.1 deg. Clarke's sc. Equiv. to cal. car 4. 35 gr. per U. S. gal. Chlorine 1.16 gr. per U. S. gal. Free ammonia 0. 0449 parts per mil. Album, ammonia 0. 05 parts per mil. SEVENTH BIENNIAL REPORT. 55 The chemical analysis dees not show any indications of organic contamination. BACTERIOLOGICAL EXAMINATION BY DR. PATE. The quantitative examination gave 350 bacteria to the C. C. This water ferments both glucose and lactose at 4'3 degrees in 36 hours. Quantity of bacteria low—quality suspicious. CONCORD. SECOND INSPECTION. Concord, May 5, 1898. I have the honor to report that pursuant to the direction of the Board, made at Charlotte conference on the 4th inst., I visited Con cord, N. C, and took new samples of the municipal water, one for the North Carolina Experiment Station, at Raleigh; the other for Dr. W. T. Pate, Biologist, Gibson, N. C, forwarding same to each on the 5th inst. I also visited and carefully inspected the pump houses and water-sheds of the two stations, from which the water is obtained, in com-pany with Mayor Crowell and the owner, Mr. Fetzer. I found the ground about the walled sirring had be^n raised about the spring and graded off so as to make a watershed of about fifty (50) feet all around it, and the surface was clear and free from grass and weeds, but not inclosed. Some additional machinery, of an im-proved pattern—mostly electrical—had been placed in the power-house, but no closet or stables had been removed from the water-shed. Mayor stated, however, that an ordinance removing them, to go into effect June 1, had been passed. At the station on the opposite side of the ridge on which the town stands, known as the Reed Gold Mine Shaft Station, I found the pump and connecting pipes repaired and the pond freshly drawn off. Another dam had been con.structed across the run of the spring about ttvo hundred and fifty (250) feet above the shaft—covering an area of about three thousand feet—the overflow of which was car ried by a side-hill ditch to a wooden box receptacle about fifty (50) feet from the power-house, to be utilized for street sprinkling, the sprinklers taking it direct from the box. The watershed of this station is exactly as I found it in November last—barring the change of the pond. No closets or stables have been removed. All of the stables, and most of the closets discharge upon the surface, but others discharge in unwalled and uneemented pits and "old wells," the latter of which are presumed to connect 56 NORTH CAROLINA BOARD OF HEALTH. directly with the water-bearing strata within a radius" of three hun-dred yards of the pumping stations. Mayor Crowell is deeply interested in a plentiful supply of pure water and a limited sewerage within the financial capacity of the town. He afforded me every possible facility for inspection and .stated that the town council had lately adopted an ordinance for the removal of the closets and stables from the watershed, and as-sured me that if not rescinded at a subsequent meeting, he would see that the pits and vaults, after cleaning, should be well limed before filling, but the measure had met strong opposition, and there was danger of a reconsideration and rescinding of the ordinance before it goes into effect on June 1, 1898. I saw and conversed with some of the members of the town council, and gathered from their remarks that while all wanted pure water and plenty of it, they were disinclined to credit the contamination theory, and feared a "job," by which oppressive taxes would be inflicted without corre-sponding benefits. The wells on the dividing ridge are about forty feet in depth. How they will cleanse and purify those used for closet vaults, or whether they will fill them up without cleaning, or continue their use as heretofore, is yet an unsolved problem. I regret to have to state that the situation at Concord is not greatly improved from the situation of my November report, and I doubt whether it will be greatly improved until the water supply is taken from a source above and beyond the town limits. The Mayor assured me that such a source existed about two miles out, with ample sup-ply for many years of rapid annual increase. CHEMICAL ANALYSIS. Total solid matter in solution 9. 58 gr. per U. S. gal. Hardness 3.6 deg. Clarke's sc. Equiv.to cal.car 3.16 gr. per U.S. gal. Chlorine .0.79 gr. per U.S. gal. Free ammonia 0. 0073 parts per mil. Album, ammonia 0.0175 parts per mil. A very pure water. BACTKRIOLOGICAIi EXAMINATIOjN' BY DR. PATE. Sample of water collected May 5, 1898, by A. W. Shaffer, S. E., from tap at Johnson's drug store. Concord N. C. This sample contains only 92 bacteria to the C. C. of water. No fermentation in lactose or glucose bouillon in 48 hours. This indicates fair drinking water, and is by far the best sample that we have had from this supply. SEVENTH BIENNIAL REPORT. 57 • SALISBURY. Salisbury, November 24, 1897. Took two samples water from flowing hydrant of E. K. James, on Inniss street. One to Dr. Albert Anderson, at Wilson; the other to Experiment Station, Raleigh. Water derived from Cane Creek, rising about six miles above town and flowing along the base of Dunn's Mountain, from which a large part of its water comes. Watershed, cleared land on one side and mountain growth on the other. No residential obstructions. Power house and intake tw^o miles out; stand-pipe in town; no sewerage; pump run by Worthington engine; no filter; aU in good condition. E. B. Neave, Superintendent. Plant owned and operated by private parties, and water sold to small consumers at 30 cents per 1,000 meter gallons. CHEMICAL ANALYSIS. Total solid matter in solution 9.16 gr. per U. S. gal. Hardness 3.8 deg. Clarke's sc. Equiv.to cal. car 3.33 gr.per U. S.gal. Chlorine 1.66 gr. per U. S. gal. Free ammonia 0. 0566 parts per mil. Album, ammonia 0. 0725 parts per mil. The chemical analysis does not give any indications of organic contamination. BACTERIOLOGICAL EXAMINATION BY DR. ANDERSON. In the bacteriological analysis of sample of water sent from Salis-bury, received on the 26th of November, there were revealed some bacteria of a suspicious nature. There were 180 bacteria to the C. C. GREENSBORO. Greensboro, November 25, 1897. Took two samples water from running tap at Holton's drug store, in Hotel McAdoo Building, on Main street. One sent to Dr. Albert Anderson, at Wilson ; the other to the Experiment Station, Raleigh. Thanksgiving Day; everybody gone abirding; did not go to plant or watershed. Couldn't find anybody who knew anything about it. Plant owned and operated by private parties, and water sold to the small consumers at 40 cents per 1,000 meter gallons. 58 NORTH CAROLINA BOARD OF HEALTH. CHEMICAL ANALYSIS. Total solid matter in solution 5.66 gr. per U. S. gal. Hardness 3. 4 deg. Clarke's sc. Equiv. to cal. car 2.0 gr. per U. S. gal. Chlorine 0. 25 gr. per U. S. gal. Free ammonia - 0.0126 parts per mil. Album, ammonia 0. 0737 parts per mil. The chemical analysis does not give any indication of organic eon taminalion. BACTERIOLOGICAL EXAMINATION BY DR. ANDERSON. On November 26 I received sample of water from the Grreensboro public water supply. The bacteriological analysis showed 150 bac-teria to the C. C. This water is good. WINSTON. Winston, November 26, 1897. Took two samples from public hydrant in City Hall. One sent to Dr. W. T. Pate, Gibson Station ; the other to Experiment Station- Raleigh. Supply derived from two springs. No watershed ; no filter and no sewerage. Plant owned and operated by private parties and water sold to small consumers at 40 cents per 1,000 meter gallons. Rained all day. No ice accessible. CHEMICAL ANALYSIS. Total solid matter in solution 4. 08 gr. per U. S. gal. Hardness . 2. 1 deg. Clarke's sc. Equiv. to cal. car. 0.91 gr. per U.S. gal. Chlorine 0.766 gr. per U.S. gal. Free ammonia 0. 0233 parts per mil. Album, ammonia 0. 0435 parts per mil. The chemical analysis gives no indication of contamination. BACTERIOLOGICAL EXAMINATION BY DR. PATE. Shipped without ice. The quantitative examination gave 880 bac-teria to the C. C. The Qualitative examination reveals no suspicious bacteria. SEVENTH BIENNIAL REPORT. 59 SALEM. Salem, November 26, 1897. Took two samples water frcm tap at Dr. Shaffner's drug store, on Main street. One for Dr. W. T. Pate, at Gibson ; the other to Ex periment Station, Raleigh. Water supply derived from springs in southwest part of town. No watershed, no filters and no sewerage. Plant owned and operated by private parties, and water sold to the small consumers at 50 cents per 1,000 meter gallons. Rained all day, No ice accessible for bacteriological specimen. CHEMICAL ANALYSIS. Total solid matter in solution. 5. 08 gr. per U. S. gal. Hardness - . - 1.9 deg. Clarke's so. Equiv. to cal. car. 0. 78 gr. per U. S. gal. Chlorine 1.25 gr. per U.S. gal. Free ammonia 0. 24 parts per mil. Album, ammonia 0. 1935 parts per mil. The chemical analysis indicates that this water is very dangerous. There seems to be contamination from sewage. BACTERIOLOGICAL EXAMINATION BY DR. PATE. The quantitative examination gave 1,360 bacteria per C. C. This sample was sent by express without ice. ^ The qualitative examination gave no indication of the presence of suspicious organism. As soon as the attention of the management of the Salem Water Comjjany was called to the report of the State Chemist on their water they expressed their inability to explain the apparent condi-tion of the water, and at once asked that four new analyses, repre-senting the four sources of supply, be made. This was done, but all four samples turned out chemically excellent water. The apparent contamination of the first sample has never been explained. The following are the supplementary analyses: Total solid 'matter in solution 2. 92 gr. per U. S. gal. Hardness 2. 5 deg. Clarke's sc. Equiv. to cal. car 1.25 gr. per U. S. gal. Chlorine 0.46 gr. per U. S. gal. Free ammonia _ . 0. 051 parts per mil. Album, ammonia 0. 050 parts per mil. This sample shows no indication of organic contamination. 6o NORTH CAROLINA BOARD OF HEALTH. Total solid matter in solution 3. 35 gr. per U. S. gal. Hardness 3.3 deg. Clarke's sc. Equiv.to cal.car 1.92 gr. per U. S. gal. Chlorine.... 0.67 gr. per U. S. gal. Free ammonia 0. 0316 parts per mil. Album, ammonia 0. 0500 parts per mil. This sample shows no indication of organic contamination. Total solid matter in solution 3.17 gr. per U.S. gal. Hardness 3.3 deg. Clarke's sc. Equiv. to cal. car 1.O8 gr. per U. S. gal. Chlorine 0.25 gr. per U. S. gal. Free ammonia 0.0500 parts per mil. Album. ammonia 0. 0487 parts per mil. This sample shows no indication of organic contamination. Total solid matter in solution 1.17 gr. per U. S. o-al. Hardness.. 1.8 deg. Clarke's^sc. Equiv. to cal. car 0.67 gr. per U.S. gal. Chlorine.-.. 0.308 gr. per U. S. gal. Free ammonia 0.044 parts per mil. Album, ammonia 0. 0813 parts per mil. This sample shows no evidence of organic contamination. DURHAM. Durham, December 3, 1897. Took two samples water from flowing pubhc hydrant, corner Cochrane and Main streets. One to Dr. Albe-t Anderson, Wilson ; the other to Experiment Station, Raleigh. Water supply taken from a stream nine miles out, at its junction with Eno River. Reservoir five miles out. Filter and sewerage here. Did not visit watershed, as it would consume another day. Works owned and operated by private parties, who sell water to small consumers at 25 cents per 1,000 meter galions, or |3 per quar-ter, with privilege of 12,000 gallons. CHEMICAL ANALYSIS. Total solid matter in solution 3.67 gr. per U. S. gal. Hardness 1.9 deg. Clarke's sc. Equiv.to cal.car. 0.75 gr. per U.S. gal. Chlorine 0.375 gr. per U.S. gal. Free ammonia 0. 173 parts per mil. Album, ammonia 0.0505 parts per mil. SEVENTH BIENNIAL REPORT. 6l I While the chemical analysis will not condemn this water, it places it under suspicion of being contaminated with organic matter. BACTERIOlrOGICAL EXAMIXATIOX BY DR. ANDERSOIs^. There were 316 bacteria to the C. C. found in sample of water from Durham public water supply, received and put in culture De-cember 3, 1897. The water is fairly good. HENDERSON. ' JEiEj^DBRSOJf, December 3, 1897. Took two samples water from running public hydrant on public square. One sent to Dr. W. T. Pate, Gribson Station; the other to Experiment Station, Raleigh. Water taken from wells; no watershed, no filter, and no sewerage. Plant owned and operated by private parties, and water sold to small consumers at 40 cents per 1,000 gallons meter measure. CHEMICAL ANALYSIS. Total solid matter in solution 3. 25 gr. per U.S. gal. Hardness 1.5 deg. Clarke's so. Equiv.to cal.car 0.42 gr. per U. S. gal. Chlorine _ . . 0. 25 gr. per U. S. gal. Free ammonia 0. 067 parts per mil. Album, ammonia 0. 02037 parts per mil. BACTERIOLOGICAIi EXAMINATION'^ BY DR. PATE. The quantitative examination gave 184 bacteria per C. C. The qualitative tests indicate safe drinking water. RALEIGH. Raleigh, December 7, 1897. Two samples water taken from running public hydrant in front of Metropolitan Hall on Fayetteville street. One to Dr. Albert Anderson, at Wilson; the other delivered in person to Experiment Station, Raleigh. Water supply taken from Walnut Creek, one mile south of city. Intake a mile above, and a fourth of a mile above Rhamkatte road. Stream rises at Gary, eight miles west of city. Watershed visited, inspected and fully reported on heretofore. Condemned Yates dam still dominates the waters. The company filter their water, and the city is sewered. 62 NORTH CAROLINA BOARD OF HEALTH. Plant owned and operated by private parties who sell water to the small consumers at 40 cents per 1,000 meter gallons, conditioned that it amount to $12 per annum, or 30,000 gallons per annum. DETAILED REPORT ON WATERSHED. "I have the honor to report upon the watershed of the Raleigh AVater Company, visited and inspected in company with Dr. .James McKee, Superintendent of Health of the city; W. M. Russ, Mayor; and Alexander M. McPheeters on the part of the comiaany, on the 24th inst. Commencing at Cary, we found two open, unboxed privies on the bank of the main ditch, and a pig pen on another, the contents of the latter flowing directly into the main ditch at a distance of about two hundred feet. "The main ditch contained a very slight run of water, the product of a heavy shower the previous night. There is no living tributary at Cary, the ditch carrying no water except surface water during, and a few hours after, a storm—twenty four hours after which it is as "dry" as the town ordinance. The first evidence of a living stream appears about a mile below the town. "We found all the streams running muddy water from the rains of the previous night, until we reached the Hugh Campbell Spring Branch, a bold, crystal stream flowing from two fine springs on the place. "The watershed from Cary to Raleigh is largely covered and pro-tected by a natural growth of forest and hedge, briars, cane and shrub, and we found little to criticise until we reached the "Little Yates Mill," of L. D. Castleberry, on the Avent Ferry road in Swift Creek Township. The dam of this mill backs water over five to six acres, filled with mud and decomposed vegetation, with a rank growth of grass, reeds, shrubs and weeds. As the water is very shallow and the mud very deep the site can be of no considerable value for mill purposes, and afforded no evidence of late use. Such a deposit in the main run of the water supply must of necessity con-taminate the water that flows from that point, creating a nuisance that ought to be abated if possible. "I am informed by Dr. McKee that this dam was reported detri-mental to the health of the people of Raleigh and declared to be a nuisance in December, 1895. 1 have since found such report and declaration, bearing date December 21, 1895, and signed by him oflB-eially as Superintendent of Health of the city of Raleigh, and the signature of Dr. P. E. Hines. preceded by the following: 'I endorse the above recommendation.^ "The intake of the company is situated upon the Grimes farm above the bridge on the Rhamkatte road, about a mile southwest of the corporate limits of the city. The surplus water flows over a SEVENTH BIENNIAL REPORT. 63 natural ledge of gneissoid granite brought to a dead level so as to carry off all floating foreign matter at every point, always provided it first escape the wide mouth of the intake, set in the current and facing up stream, like a saurian bobbing for flies. A proper adjust-ment of this intake would greatly relieve the filter at the pump-house and remove an ever-present source of adverse criticism." CHEMICAL ANALYSIS. Total solid matter in solution 4.58 gr. per U. S. gal. Hardness 2.1 deg. Clarke's sc. Equiv. to cal.car 0.92 gr. per U.S. gal. Chlorine... 0.30 gr. per U.S. gal. Free ammonia - . . 0. 031 parts per mil. Album, ammonia 0. 0787 parts per mil. The chemical analysis shows no indication of contamination from organic matter. BACTERIOLOGICAL EXAMINATION BY DR. ANDERSON. 1 found 240 bacteria to the C. C. in sample from the Raleigh pub-lic \^ ater supply, some of which were of a suspicious nature. The order of the State Board of Health is executed. All which is respectfully submitted, A. W. SHAFFER, S. E. As showing the spirit in which the efforts of the Board to secure purer water for the people were met by the municipal authorities, we take pleasure in printing the following from the Mayors of Charlotte and Concord, respectively. We are also glad to say that the w^ater companies seemed disposed to do what they could to insure pure water to their patrons. But we should add in this con-nection that there is apt to be a difference of opinion as to "what they could"' might mean, and that conse-quently, as pure water is a vital matter, the precautions, etc., to be taken by operators of public water supplies, should be defined with reasonable exactness by law. In view of this we prepared and had introduced in the last General Assembly the appended bill. It met with favor 5 64 NORTH CAROLINA BOARD OF HEALTH. from the Committee on Public Health, and all others to whose attention it was called, but owing to the mul-titude of other bills of more interest to the Members, it could never be gotten before the House. Charlotte, N. C, February 10, 1898. Dr. Rich'd H. Lewis, Raleigh, N. C. Dear Sir:—Your letter in regard to the condition of our city water received and noted. Your instructions are being carried out, and I also will have the watershed patrolled. Dr. Brevard, who is President of the Water Company, will be in Raleigh on the 22d of this month, and will call on you in regard to this matter. Any ad-vice you can give him in regard to.the jjermanent improvements of this plant we will be glad to carry out. Yours very tr\ily, E. B. SPRINGS, Mayor. Concord, N. C, February 12, 1898. Br. Richard H. Lewis, Raleigh, iV. C. Dear Doctor:—Your favor of 3d instant received, inclosing the chemical and bacteriological analyses of our city drinking water, and I thank you for Ihe suggestions made about the necessity of keeping the watersheds as clear as practicable. I assure you I am exerting myself to keep the watershed free from filth. But when you remember that the watersheds of our two water supplies are dotted thickly over with residences, etc., you will see how hard it is to keep it clean and free from filth {)ol]ution. There is one thing I desire your opinion on—that is "dry wells," so called, into which sewerage from water-closets empty. It is reported that there are three or four on the watersheds here. I am preparing an ordinance to abolish them, and shall ask the Board of Aldermen at our next meeting to pass it. I desire, therefore, that you give me your opin-ion on these "dry-wells" or cess- pools, so I can have it before the Board who, by the advice you may give, can vote intelligently on the i3roposed ordinanee. I will thank you for your opinion about this matter as early as practicable. I am convinced that these wells or pools should not be tolerated, and if you agree with me I feel sure our Board will pass the ordinance. Mr. Fetzer, the Manager of the Waterworks Company, is having the spring—one of the^^sources of water supply—drained and im-proved. SEVENTH BIENNIAL REPORT. 65 The report of your Engineer—about literally landing in human excrement—Mr. Fetzer thinks might be misunderstood. He says some thoughtless person had made this deposit—only one—near the well, and that was all of it. I will thank you for suggestions at any time, and pledge you my prompt efforts in carrying them out. Yours very truly, J. S. CROWELL, Mayor of Concord. Answer, February 14, 1898: Cess-pools absolutely condemned. Change of water supply suggested. Begged to do all in his power to get his people vacci-nated. This very important matter will be brought again to the attention of our law-makers in the hope that it may meet w^ith favorable action at their hands : AN" ACT TO PROTECT PUBLIC WATER SUPPLIES. The General Assembly of North Carolina do enact : Section 1. In the interest of the x>uhlic health, every person or company selling water to the public °for drinking and household purposes, shall take every reasonable precaution to protect from contamination and assure the healthfulness of such water ; and any provisions in any charters heretofore granted to such persons or coiii|janies in conflict with the proxisions of this act are hereby re-pealed. Sec. 2. Those water companies deriving their supply from lakes or ponds, or from small streams not more than fifteen miles in length, shall have made a sanitary inspection of the entire watershed, not less under any circumstances than once in every three calendar months, and a sanitary inspection of any particular locality on said watershed at least once in each calendar month, whenever, m the opinion of the Board of Health of the city or town to which the water is supplied, or when there is no such local Board of Health, in the opinion of the County Superintendent of Health, or in the opinion of the State Board of Health, there is reason to apprehend the infection of the water by that particular locality'. Said com-panies shall have made a sanitary inspection of any particular local-ity on said watershed at least once in each week, whenever, in the opinion of the Board of Health of the city or town to which the water is supplied, or when there is no such local Board of Health, in the opinion of the County Superintendent of Health, or in the 66 NORTH CAROLINA BOARD OF HEALTH. opinion of the State Board of Health, there is special reason to ap prehend the infection of the water from that particular locality by the germs of typhoid fever or cholera. The inspection of the entire watershed as herein provided for shall include a particular examination of the premises of every in-habited house on the watershed, and in passing from house to house a general inspection for dead bodies of animals or accumula tions of filth. It is not intended that the term "entire watershed" shall include uninhabited fields and wooded tracts that are free from suspicion. The inspection shall be made by an employee of, and at the ex. pense of said water company, in accordance with reasonable instruc-tions as to method to be furnished by the secretary of the State Board of Health. The said sanitary inspector shall give in person to the head of each household on said watershed, or in his absence to some mem ber of said household, the necessary directions for the proper sani tary care of his premises. It shall further be the duty of said in spector to deliver to each family residing on the watershed such lit-erature on pertinent sanitary subjects as may be supplied him bj' the municipal health oflQeer, or by the Secretary of the State Board of Health. Sec. 3. In case of those companies obtaining their supply of water from rivers or large creeks, having a minimum daily flow of ten mil lion gallons, the provisions of section 3 shall be applied to the fifteen miles of watershed draining into the said river or creek next above the intake of the water works. Sec. 4. Failure on the part of any water company to comply with the requirements of sections 2 and 3 shall be punished by a deduc-tion from any charges for water against the city or town supplied of twenty five dollars for each and every such failure: Provided, That in no one year shall the sum of such forfeitures exceed five hundred dollars. Where the water works are owned and operated by the city or town, failure on the part of the municipal official having in charge the management of the water works to comply as above, shall be a misdemeanor, and punishable by a fine of not less than ten nor more than twenty-five dollars, or by imprisonment for not less than ten nor more than thirty days: Provided, The said official do not prove to the satisfaction of the court that in spite of reasonable effort and diligence on his part he was prevented, directly or indirectly, by his superiors from doing his duty in this respect, in which ease said su-perior officer or officers shall be deemed guilty of a misdemeanor, and punishable by a fine of not less than fifty nor more than two hundred dollars, or by imprisonment for not less than one nor more than six months. SEVENTH BIENNIAL REPORT. 67 Sec. 5. Every city or town having a public water supply shall, at its own expense, have made at least once in every three months by one of its own officials a sanitary inspection of the entire watershed of its water supply, and it shall be the duty of the said official mak-ing such inspection to report to the Mayor any violation of this act. Sec. 6. Every person residing or owning property on the water shed of a lake, pond or .stream from which a public supply is ob-tained, shall carry out such reasonable instructions as may be fur-nished him in the manner set forth in section 2, or directly by the municipal health officer or by the State Board of Health. Failure to do so shall be deemed a misdemeanoi', and shall be punishable by a fine of not less than two dollars and costs, nor more than twenty- five dollars and costs, or by ir:prisonment for not less than ten nor more than thirty days. Sec. 7. The charters of all cities and towns having public water supplies are hereby amended so as to give said cities and towns the same police powers on the watersheds of said public water supi^lies as they now possess within their corj^orate limits: Provided, These police powers shall apply only to violations of this act. Sec. 8. The Mayor of each city or town ha^^ng a public water sup ply shall have jurisdiction of all violations of this act, and the same shall be reported by the inspector of the city or town and of the water company to and tried by him, except where the water works are owned and operated by the city or town, in which case the mat-ter shall be tried by some other justice of the peace or by the supe-rior court, according as the penalty imposed fixes the jurisdiction, upon complaint of the municipal health officer, the Ccunty Superin-tendent of Health, the Secretary of the State Board of Health, or any resident of said city or town. See. 9. Every water company, whether owned by private individ-uals or corporations, or by the municipality, shall have made, not less frequently than once in every three monhs, at its own expense, both a chemical and a bacteriological examination of a sample of its water drawn from a faucet used for drinking purposes, packed and shipped in accordance with the instructions to be furnished by the Secretary of the State Board of Health, and shall transmit a copy of the same to the Mayor, the municipal health officer and the Sec retary of the State Board of Health. Sec. 10. As a check and a guarantee of the faithful performance cf the requirements laid down in the preceding sections of this act, the State Board of Health shall make or have made by its author-ized agents such inspections of the watersheds an4 such chemical and bacteriological examinations of the public water supplies of the State as may be deemed necessary to insure their purity. Should such inspections or examinations show conditions danger- 68 NORTH CAROLINA BOARD OF HEALTH. ous to the public health, the Secretary of the said State Board of Health shall notify the Mayor, |
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