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There should be some revision of the Pure Food Laws to make them more fully harmonize with the United States Law, especially with reference to slaughter houses and the care and handling of meats.

TUBERCULOSIS.

This scourge of the human race which, for centuries has claimed its victims from all classes of society, is at the present time engaging the attention of the civilized world, with a determination to eradicate it from every country. For this purpose organizations, municipal, state, national, and international have been formed to study into the causes that lead to its development, and seek the means of prevention. The International Congress on Tuberculosis is to meet for the first time in this country. This Congress is to be held in Washington, D. C., beginning the twenty-first of next September. At the suggestion of Your Excellency, and upon the request of the officers of the Congress, this Board has extended to various state, municipal and other organizations an invitation to send delegates to attend its sessions and thus become identified with this great philanthropic movement. The opportunity for our people to meet and hear the causes, and the best known methods of prevention and cure discussed by the distinguished scientists of the world, is one that will not again be available for many, many years. We would make an urgent appeal for a large representation from these organizations.

The munificent gift, by our loved, honored and now lamented Senator, Redfield Proctor, of a sanitorium for the treatment of citizens of our state who may suffer from this plague, has caused Vermont to be recognized as being in the front rank of those who seek to stay this great destroyer. Out of grateful respect to the memory of Senator Proctor, and as a just appreciation of the philanthropic purpose of this gift, we would recommend that an official delegation be appointed by Your Excellency to represent the state at the meetings of this Congress.

The Legislature early recognized the importance of educating the people upon all points in this disease by creating the Tuberculosis Commission, which at the proper time will undoubtedly report to you the result of the efforts made, as required by their appointment. Of an act passed in 1902 the first section reads, "Every physician engaged in the practice. of medicine in the state of Vermont shall, immediately upon the passage of this act, submit to the Secretary of the State Board of Health, the names and addresses of all persons under his treatment for tuberculosis and thereafter each case within one

week after applying for treatment." We regret to report that the number of cases submitted to the Secretary in any one year has never equaled more than one-half of the deaths for the same year from the disease, although blanks for reporting these cases have been widely distributed. Evidently the profession stands in need of education relative to the importance of making these reports as set forth in Section 2. In controlling the spread of any communicable disease the first great essential is to locate the place where the disease exists. It is also necessary to know the history of the individual's environment, and all particulars, as by these means we learn the manner of preventing the recurrence of other cases. In 1885, the year before the establishment of the State Board of Health, the number of deaths from tuberculosis, in this state, was 805. Since then there has been a gradual reduction in this mortality down to the present time, in 1907, when the number was 463. We believe this reduction in mortality has been the direct result of the gradual adoption of improved hygienic conditions in general, better living in families, especially greater care in the use of impure milk and meats, the further protection from the inclement seasons by better homes and clothing, more fresh air, better ventilation of school houses (although in all these respects there is much room for further improvement). These changes have rendered the individual less susceptible to the specific germs. By means of continued efforts along educational lines, and the added force of example and precept from the sanitorium at Pittsford, there is reason to expect a more rapid decline than has already taken place.

EDUCATIONAL WORK.

In 1899, by the authority of an act of the Legislature of 1898, a School for Health Officers was held, and has become an established annual educational factor in the sanitary work of the state. The attendance by local health officers and others has given an opportunity for the dissemination throughout the state of the principles of practical sanitary science. The presence of the President or Secretary of the State Board at the summer schools for teachers and the agricultural institutes of the State Board of Agriculture have given a further occasion for diffusing the principles of hygiene. The Bulletin, published by the Board, is, we believe, much appreciated, and a great aid in an educational way. Ten thousand are mailed every quarter.

THE EYES, EARS AND THROATS.

The examination, as required by law, of the eyes, ears and throats of the school children was made last September. The

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reports of these examinations, which should have been returned at once, have come in slowly. Thirty-eight towns and six incorporated districts have at this time, April 1, failed to report. The towns reporting show that 40,296 pupils have been examined. Of these 13,044, or 32 per cent., were defective. In 1905, 16 towns failed to report. In those reporting for that year, 41,373 children were examined, of whom 14,290, or 34.5 per cent., were found defective. In 1907, 38 towns failed to report. These same towns, in 1905, reported 4,232 pupils examined, with 1,434, or 33.8 per cent., defective. While the parent or guardian of each defective was notified, in 1905, as the law requires, and advised to consult their family physician or an oculist, in order that such defect might, if possible, be removed, in too many instances this advise was not followed.

VITAL STATISTICS.

Vital statistics are the base upon which state and municipal sanitation rest. Upon their accuracy often depends the entailment of property, the identification of individuals for various purposes, for pension, insurance, and so forth.

The laws of the state provide for their being properly, fully, accurately and promptly reported. The physician or head of the family, the clergyman, the town clerk and the Secretary of the State Board of Health are required to perform, each, a special duty. If the report of a marriage, birth or death is not promptly reported, with all the required details plainly written by the clergyman or doctor, then delay begins and a fine of those individuals may result. The town clerk must make a plain, legible, accurate transcript, and forward it within a given time to the Secretary of the State Board of Health, who must compile, classify and embody them in a general report within a given time. There has been an improvement, both in accuracy and promptness of these returns, during the past year. We regret to say that, in too many instances, we are obliged to ask for plainer writing and more careful accuracy in the filling in of blanks, and greater promptness in making the returns.

DIVORCES.

The number of divorces is increasing to such an extent as to threaten the stability of the state. The home is the foundation upon which rests the fabric of our government. The marriage relation entered into by a man and woman should be of the most sacred character, as they certainly are the creators of the home. This home, maintained by industry, frugality and peace, results not only in happiness to the home-makers, but here the future citizen is born and reared, his character moulded,

the moral and mental elements developed which, in due time, give to the state and the nation their power and position in the world. In 1886 the number of divorces to the number of marriages was one in 20.03; in 1897 it was one divorce in every 12.5; in 1907 one in 8.52. At this rate in the increase of divorces it will be but a short time before the divorces will equal the marriages. It is certain that, as a people, we should pause and consider what causes are at work to produce these startling results. We believe that many influences are at work to bring these about. First, the lax discipline in families; children and youth are not taught to render obedience to parents, hence do not respect them, nor heed the advice regarding their conduct. Being devoid of respect for paternal advice they seek freedom from the presence of those who offer it. Without any consideration or appreciation of what marriage and home making mean, or the sacred character of the vows supposed to be solemnly taken, they hastily assume this new relation, with as little sense of the responsibility they assume as they do in purchasing a pair of shoes, which, if they do not suit them, they can exchange at any time for another pair which they fancy will prove more acceptable. Therefore, instead of conforming to the new environment in which they find themselves, with united effort trying to assimilate their desires, adapting themselves to the new relations, they determine not to submit to the restraints necessary to overcome the petty differences and straightway seek release in the courts from the sacred obligations they had assumed to bear and forbear, to love and cherish, until death do them part. The home that was to be is deserted and another divorce goes to swell the number which disgrace the social life under the best government in the world. The remedies must be sought in placing, early in life, greater restraints upon the impulses tending to disregard the rights of others. The legal causes for which divorce should be granted should be reduced. The church should make more emphatic its teaching of the sacred character of marriage. The state, the church, the school should all unite in an effort to discourage hasty, ill-considered marriages. To this end we could well afford to return to the custom of requiring that no marriage should be solemnized until the intention of the parties to such marriage had for some weeks been announced in a public manner prescribed by law. Serious consideration should be given to the question whether divorced people should be allowed to marry again, especially when the divorce is obtained for others than the biblical causes, especially whether the church should allow its ministers to officiate at marriages of persons divorced except for the one cause.

AN ANALYSIS OF THE CAUSES OF DEATH IN 1907.

We find that of the 6,131 deaths from all causes one-half of them resulted from seven causes which were, in the order of their mortality, as follows: Pneumonia, 682; organic heart disease, 581; tuberculosis, 463; apoplexy, 446; Bright's disease of kidney, 353; cancer, 337; senile debility, or old age, 226. The deaths from whooping cough were one less than from the three diseases of typhoid fever, measles and scarlet fever, five more than from measles, scarlet fever and diphtheria. Yet physicians and the heads of families fail to report whooping cough to the health officers and give little, if any aid in the prevention of its spread. The gradual increase in the mortality from organic heart disease and apoplexy emphasizes the necessity of a return to a less strenuous life. The deaths from all forms of tuberculosis have been about the same for the last five years. If incipient cases were brought under treatment during this stage not only the death rate would be reduced, but the number of cases would decrease. With the opening of the Vermont Sanitorium for the care and treatment of these cases there ought to be a marked saving of suffering and of lives. One cause of the delay in the recognition of the cases in this stage is that but few of them come under the observation of the physician. It is so insidious in its development that the patient and family attribute the apparent indisposition to a variety of causes and do not consult any medical authority until the disease is well into the second, or even the third stage. Even then it frequently occurs that both patient and friends have serious doubts of the diagnosis and postpone active and efficient measures for dilatory or experimental ones, and the golden opportunity to avert the diseased processes passes, and all there is left is to smooth the remaining months of life as much as kind and affectionate care can do. We would, if possible, impress upon all that whenever there is observed the slightest departure from the accustomed vigor of health, to remember the old adage, A stitch in time saves nine."

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We note the increase in years of life, the average age now being 4834 years. During this year four persons have lived

to be 100 or over:

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