REPORT OF DIRECTOR

To the State Board of Health:

GENTLEMEN:-In presenting the work of the Laboratory of Hygiene this year, the same form as heretofore has been adhered to as it is thought that this presents as concisely as possible the work being done in the institution together with the localities being served.

A glance at the summary tables XX and XXI will show that work is being done for every county in the state and that the amount is in general in proportion to the population of the county.

The tables for 1907 comprise the work of thirteen months. Heretofore our laboratory year has extended from December 1st to December 1st. A change having recently been made in the financial year, there seems no longer any good reason for adopting these arbitrary limits and as there are many advantages in having the tables conform to the calendar year, this change has been made. Hereafter the work will be tabulated from January 1st to January 1st.

Examinations of specimens from cases of suspected infection for diagnosis and quarantine regulation have been carried on as in previous years.

An outfit which is permitted by the post office officials to pass through the mails has been adopted for sending cultures from suspected diphtheria cases and sputum from cases of suspected tuberculosis. This change we believe is proving a great convenience to physicians in the country along the rural free delivery routes.

Sanitary analyses of specimens from the various town water supplies have been regularly made as usual and all requests for analysis of private supplies have been complied with. That this work is being more greatly appreciated each year is amply attested by the increasing number of such requests. Every specimen of water reported as running through lead pipe has been tested for lead, and Table XXV gives the results. It is seen that practically no spring waters and very few surface waters can be safely conveyed in this manner.

An impetus has been given to the work under the Pure

Food Law by the appropriation of twenty-five hundred dollars made by the last legislature for this purpose. The services of Dr. L. P. Sprague were secured early in the year and his time has been largely devoted to this line of work. Great progress has been made in the improvement of the milk supplies of the various towns of the state. In this work the co-operation of the local health officers has been of great value. Other food products which do not conform to the provisions of the Pure Food and Drug Law are fast disappearing from the markets or are being labelled in conformity with the requirements of this act. The purchase of canned and bottled goods in original packages has been made mostly in Burlington to save express and travelling expenses. These goods are put up largely by outside firms and samples taken at any place are representative. The results of examinations under the Pure Food and Drug Law have been given publicity through the columns of the bulletin and the local papers so that there can be little excuse on the part of the dealers for violations of the law in selling goods which have been examined and condemned. Only few prosecutions have been made so far, as it has been the policy to be reasonable in carrying the law into effect and to give ample time and warning to dealers. The penalties of the law are for those who knowingly violate its provisions. There is no longer any excuse for ignorance on this subject and violators may expect prosecution. This law needs some revision to make it more efficient.

Another new line of work was added by the legislature of 1906 whereby the services of the pathologist are at the call of the various state's attorneys in the matter of autopsies upon suspected criminal cases. Twenty-one autopsies have so far been performed, resulting in much aid in the prosecution of a few cases and dispelling suspicion in many others.

This medico-legal work which is a unique feature of our laboratory, being done in no other state institution of this sort, is of great value in the administration of justice, as must be appreciated by all who are cognizant of its scope. It makes available at any time the services of a chemical and medical expert without delays or red-tape and with no extra expense to the state. Furthermore it provides absolutely unprejudiced and impartial opinions and gives in the trial of criminal cases a referee on medical and chemical questions. The laboratory officials having no motive to be prejudiced can be relied upon to reach impartial conclusions based upon their researches. This is the ideal status of the medico-legal expert. That this ideal is being attained to a reasonable degree is seen from the

following quotation from the Attorney General who has been in a position to know better than any one else the working of this department of our institution.

"I have, for the last three years approximately, had to do with all the homicide cases in the state of Vermont. Taking into consideration the autopsies, the chemical analyses and pathological work, and assuming that outside experts would otherwise have been employed to meet the requirements of justice and adding to all that the duties imposed upon the chemist and pathologist of the Laboratory as expert witnesses, it is safe to say that the state of Vermont would have expended $6,000 in the last two years for services which have been performed by the officers of the Laboratory. It is not certain that that amount would have been expended because a great deal of this work would not have been done at all. I will say, however, that there has been nothing done but what was necessary, and if it had not been done, there would have been a failure of justice. As a matter of dollars and cents, the state of Vermont has been saved that much in the last two years because it has had the Laboratory of Hygiene and efficient officers to serve us there.

When we were figuring what the Laboratory has cost, I did not include and could not include the immense saving that this institution has been to the state of Vermont in preventing trials. Cases every year arise where these suspicious cases would lead a grand jury to find an indictment. If there is a suspicion in their minds, they are prone to put the man on trial and let the truth be developed in the trial court. With the help of this institution, many a suspicious case is cleared up before it reaches the grand jury. This is of the utmost importance in the economical administration of justice. I can recall instance after instance where the researches at the Laboratory of Hygiene have determined what was the cause of death and saved an individual an indictment and saved the expense of a long trial to the state, and saved the man perhaps from financial ruin and prevented the stigma on his name."

The provision of the fourth class license section passed by legislature of 1906 (revised statutes section 5131) which requires that every firm doing a wholesale liquor business in the state, shall have every brand of liquor they contemplate selling, examined and passed upon at the Laboratory has resulted in a large increase in this work which was previously only done for

license commissioners and at their discretion.

The one dollar fee which has accompanied each sample has only partly defrayed the expense of these analyses and should be increased.

A glance at Tables XXII and XXIII shows that the work of the Laboratory during the last year has increased twenty per cent over that of any previous year. A considerable amount of this increase is, of course, due to the addition of new work previously mentioned, but it will be noticed from Tables XX and XXI that there has been an increase in all of the work and that this has been true of nearly every county. Tables XXII and XXIII are presented to give an idea of the value of the actual work done at the Laboratory of Hygiene and are based on the average prices charged for such work in private laboratories. Of course, these figures are only approximate, but the prices are all conservative. Reference to the quotation from the Attorney General cited above, will show that we have not over estimated the value of the class of work to which he refers. In this table no reference is made to attendance in court as expert witness and no attempt is made to estimate the value of the work in preventing epidemics and safe-guarding the public health. It is, of course, absolutely impossible to estimate the economic value of such service from this stand point, yet this is the aim of it all. One epidemic averted, represents a saving of many times our annual appropriation.

This work which in the last twelve months as computed in Table XXIII amounts to $42,088 has been done at an actual expense to the State of twelve thousand five hundred dollars.

Since the establishment of the Laboratory, the work done by the institution has increased one hundred and sixty-one per cent while the appropriation has only been increased fifty-five and twenty-five hundredths per cent.

This steady increase of work has added greatly to the burden of the present staff until it is now not only greatly overworked but under paid. The experience of each year with its increasing requirements has added greatly to the capacity of the individual worker. The present personnell is an efficient one and should, if possible, be kept intact. The loss of any member would be an impairment which could be ill afforded. Greater efficiency and more exacting work deserves higher compensation. Some salaries should be raised and the staff should be increased. The limit of capacity under the present appropriation has been reached and if the continually increasing amount of work with which the institution is flooded is to be done without long delays, or done at all, more money must be made available.