BIENNIAL REPORT

CARSON CITY, NEVADA, January 2, 1910.

HON. TASKER L. ODDIE, Governor of Nevada.

SIR: I submit herewith the biennial report of the State Board of Health for the years 1909 and 1910:

Under our present health laws the board is sadly handicapped in its efforts to obtain morbidity reports from the physicians, or, in fact, vital statistics of any kind.

The Secretary of the State Board appealed, through circular letters, to the chairmen of the several County Boards of Health for such information as they could give along those lines. All of them responded promptly except those of Lander and Lincoln Counties. From the latter not one item was obtainable, nor anything from the chairman in Lander County; however, Dr. Geo. F. Pope of Battle Mountain kindly complied and forwarded a comparatively correct list of deaths that have occurred in that county during 1909 and 1910.

Thanks are due to the State Board of Embalmers for valuable information given the secretary. Through that association a complete list of deaths has been supplied from all the counties in which they have a representative, except from Lander and Lincoln.

It is to be regretted that no matter how important the subject, the good that might entail, or for information sought by sister States or the National Government, physicians will not, as a rule, supply it unless compelled to do so by legislative enactment.

The following article from the Michigan Monthly Bulletin gives the reason and necessity for such reports, words so trite and pungent as to appeal, it would seem, to the heart and conscience of every practicing physician:

THE PHYSICIAN AND VITAL STATISTICS

Doctors, like lawyers and teachers, are safeguarded in the practice of their profession. This is because the maintenance of health, like the maintenance of justice and of education, is in large measure a duty of the government and in following his profession the physician is at the same time promoting a primary end of the State.

In return for the unusual protection thrown by the law around the profession of medicine, every physician is expected and, indeed, lawfully required to report certain sorts of events which come to his knowledge, that is, to report promptly every death, every birth and every case of contagious disease occurring in his practice. Now and then a physician objects to this requirement because no fee

is paid for its performance and he thinks that the State has no right to make demands upon his time and professional knowledge without paying him. The objection seems forcible, but it is not. The true payment that the State makes for these services is the protection it throws around the medical profession. Thus one of our highest medical and statistical authorities, Dr. John Shaw Billings, has said: "The certification of the causes of death by physicians is the essential foundation of legislation with regard to the qualifications which the State has a right to demand from practitioners of medicine," and a standard legal treatise on public health declares: "It is within the power of the State to compel the performance of these duties (that is, reporting deaths and births) without compensation, in the interest of the general welfare"

It is only now and then that an individual physician questions the right of the State to this information. But many who do not challenge the right of the State are careless and dilatory in the performance of the duty. This heedlessness is an obstacle to effective work on the part of the State Department of Health far more difficult to overcome than a direct refusal to report on the part of a few. It is to such physicians especially that this article is addressed in the hope of showing the necessity and the benefit of these records.

CONTAGIOUS AND INFECTIOUS DISEASES

Epidemics of communicable diseases have prevailed to a greater or less extent in various parts of the State. To obtain as much light as possible upon the subject, the secretary, on October 25, 1910, addressed the following letter to the chairmen of the several County Boards of Health:

CARSON CITY, October 25, 1910.

MY DEAR DOCTOR: Will you kindly give me at your earliest convenience a statement of any epidemic or epidemic diseases that have prevailed in your county during the years 1909 and 1910?

The law does not enable the State Board of Health to obtain any vital statistics, and for that reason I am appealing to the several county physicians to aid me along those lines. Your report will be incorporated with mine to the Governor, at the convening of the coming Legislature.

If you have not time to give me an extensive report, please favor me with a brief statement of the most important events in the premises.

Sincerely yours,

S. L. LEE,

Secretary State Board of Health.

To this communication the following responses were received:
RENO, October 29, 1910.

S. L. LEE, M.D., Secretary State Board of Health, Carson City, Nevada.
MY DEAR DOCTOR: In regard to your letter of the 25th concerning vital sta-
tistics in our county, I will say that I am in about the same position as you are,
and the only way that I will be able to make any report at all to you will be to
write to all the doctors in the county, asking them for information concerning
any epidemic disease they may have treated during the last two years, and go to
the records of the City Board of Health.

Some two years ago I wrote all the physicians in the county, asking them to report to me any such cases as came under their observation. This they did for a month or two, and then forgot it.

As I remember now, there was a small epidemic of typhoid fever in Wads

worth last year.

The number of cases I cannot give you now. We had about six cases of smallpox here this year, about six cases of scarlet fever, and a few cases of typhoid fever.

As it

I will make an effort to give you a detailed report as soon as possible. will require considerable work, it may take me a week or two. If this is satisfactory, please let me know.

With very kindest regards, I am yours very truly, S. K. MORRISON,

City Physician.

DAYTON, October 29, 1910.

DR. S. L. LEE, Secretary State Board of Health, Carson City, Nevada.
DEAR SIR: Your letter of recent date received, and contents noted.
The following epidemic diseases were treated by me during the year 1910:
Male, white, age about 42, varioloid, Silver City, Nevada, January 8-22;

recovery.

Female, white, age about 34, variola confluent, Silver City, Nevada, January 28-February 19; recovery.

Female, white, age about 28, scarlet fever, Silver City, Nevada, October 12-30; convalescent.

Infant, white, age about 28 months, diphtheria, Dayton, Nevada, July 27August 11; recovery.

Fraternally yours,

BEAUMONT BROWN, Chairman Lyon County Board of Health.

GOLDFIELD, October 3, 1910.

S. L. LEE, M.D., Secretary State Board of Health, Carson City, Nevada.
DEAR SIR: Yours of the 26th instant to hand. In reply will state that during
July, 1910, five cases anterior poliamyelitis; during August three case of same.
There were three deaths, but only one (I think) reported (Esmeralda County).
We now have epidemic of pertussis, three hundred cases in Goldfield and
Tonopah; no deaths.

No other contagious disease.

Respectfully,

D. A. TURNER, Chairman Esmeralda County Board of Health.

FALLON, November 9, 1909.

DR. S. L. LEE, Secretary State Board of Health, Carson City, Nevada.

DEAR SIR: At a meeting of the Board of County Commissioners at which meeting Drs. G. L. Dempsey and G. M. Gardner were present, having been called as a County Board of Health, it was ordered that the State Board of Health be notified that there were about fifteen cases of scarlet fever in the Carson Sink; that each of said cases is under quarantine regulations, and that the schools in Wightman District No. 3 and Smart District No. 10 have been closed, to which districts the cases are so far confined.

Yours respectfully,

G. L. DEMPSEY, M.D., Chairman Churchill County Board of Health.

ELKO, November 11, 1910.

DR. S. L. LEE, Secretary State Board of Health, Carson City, Nevada.

DEAR DOCTOR LEE: In response to your kind letter of October 25th, we would state that the following epidemic diseases have been present in Elko County during the years of 1909 and 1910:

Scarlet fever, about twenty cases.