in regard to poliomyelitis were also collected during an epidemic which occurred last winter in West Virginia.

Trachoma.-Six small trachoma hospitals have been in operation during the past year in the States of Kentucky, Virginia, West Virginia, and Tennessee, the work being done in cooperation with State and local authorities. A total of about 7,500 cases were treated during the year, of which nearly 2,000 were admitted to hospitals. About 700 were reported as cured of trachoma. A campaign of education has been carried out, with the hospitals as centers, field clinics having been found to be of special service in this connection. Individual instruction as to the prevention of the disease and as to public health generally is given where possible.

Sanitation of extra-cantonment areas.-Owing to the entrance of the United States into the war, the division's activities during the last part of the fiscal year were devoted chiefly to cooperating with the State and local health authorities in public-health studies having a bearing on the military situation. Other work has been curtailed to make these studies effective. A large part of the personnel previously engaged in studies of rural sanitation, malaria, sanitary organization and administration, and pollution of navigable streams and coastal waters has lately been engaged in making sanitary surveys of areas surrounding Army cantonments. Reports of such surveys are being furnished to the State, local, and military authorities.

Rural sanitation.-During the year more than 31,000 rural homes were inspected in 9 counties in as many States, and more than 13,000 homes were reinspected. At these places sanitary data were collected for analysis and publication, and advice was given as to improvement of sanitary defects noted. In addition, many churches, railroad stations, and schools were surveyed, and 400 lectures were given. Work was carried on in Floyd County, Ga., Greenville County, S. C., Obion County, Tenn., Tuscaloosa County, Ala., Clay County, Mo., Cumberland County, Ill., Hill County, Tex., Okmulgee County, Okla., and Mason County, Ky. Marked progress in sanitary matters was made in each of these counties.

Besides these intensive surveys the following special studies are being conducted: (1) Survey of a group of rural towns in Wyoming; (2) laboratory and field studies in regard to the chemical treatment of excreta, so as to make the matter safe from a sanitary point of view without decreasing its fertilizer value; and (3) a practical study of county health work in Edgecombe County, N. C., an officer of the service acting as full-time county health officer.

At the end of the fiscal year the rural sanitation force was principally engaged in sanitation studies of areas surrounding military cantonments in cooperation with State and local health authorities.

Public health organization and administration.-Surveys of public health organization and administration have been made in the cities of Charlotte, N. C., Kansas City, Mo., Piqua, Ohio, Quincy, Ill., Richmond, Va., South Bend, Ind., and Springfield, Ohio. In the course of the surveys recommendations were made to local authorities and reports of the surveys were either published or submitted to these authorities.

Industrial sanitation.-Industrial sanitation studies in regard to the following matters were engaged in during the past year: Health conditions surrounding the employment of women in Wisconsin, in cooperation with the Wisconsin Industrial Commission; health hazards of the chemical industry and the health of chemical workers; health hazards in connection with the manufacture and distribution of illuminating gas; health hazards of the textile industry, in cooperation with the Pennsylvania State Department of Labor and Industry and the occupational disease clinic of the University of Pennsylvania; visual condition of workers engaged in occupations likely to cause eye strain; hygienic conditions of shop lighting, in cooperation with the Wisconsin Industrial Commission; prevalence of miners' consumption among the miners in the Butte (Mont.) district, in cooperation with the Bureau of Mines; and public-health problems in relation to child labor, in cooperation with the Massachusetts State Board of Labor and Industries.

From these studies conclusions are being drawn of great importance to the health of workers in this country. Mention of only a few can be made here. As a result of the studies of the employment of women in industry in Wisconsin, it was concluded that, in view of the fact that it seems practicable to accomplish by proper management as much work in an 8-hour day as in a 10-hour day under conditions existing in Wisconsin, the shorter working day must be regarded as advantageous both to the woman worker and to the manufacturer.

The study of the textile industry indicated that the processes themselves present but few health hazards, but that many of the shops present problems of poor illumination, poor ventilation, undue exposure to organic dusts, and conditions favoring the spread of communicable diseases.

Because of the involvement of the United States in the war, studies of the sanitation of munition plants and similar establishments have already been undertaken and will be extended in the future.

School and mental hygiene.-Studies of mental status were conducted (1) among school children in Nassau County, N. Y., and New Castle and Sussex Counties, Del.; (2) in four Colorado State institutions; (3) in certain almshouses in Delaware; (4) in the National

Junior Republic; and (5) among the children of the pellagrous communities in Spartanburg County, S. C. In the studies of school children so far conducted, of 38,058 examined, 365, or 0.96 per cent, have been found to be feeble-minded. Studies conducted in cooperation with the Children's Bureau showed that the percentage of feeble-minded in the schools examined was approximately double the percentage of feeble-minded in the general population. Studies of the physical status of school children and of the sanitation of school buildings were also conducted during the year.

Pollution of streams.-Studies of stream pollution, centered in Cincinnati, were continued during the year. The first section of this work, a survey of the Ohio River watershed, has been completed, and field studies have now been extended to include a general survey of the conditions and effects of stream pollution in the Northeastern States, while laboratory studies have been directed toward the further evolution of problems developed in the preliminary work on the Ohio River. During the last month of the year practically the whole force assigned to stream-pollution studies was engaged in sanitary surveys in the environment of National Army cantonments in Southern States.

Pollution of coastal waters.-Field investigations of the pollution of coastal waters have been continued during the year at Jamaica Bay, N. Y., and in the coastal waters of Connecticut, especially the shellfish areas and bathing beaches in New Haven Harbor and outside the harbors of Bridgeport and South Norwalk. These studies consisted in the examination of large numbers of samples of shellfish and water, float and current studies, and sanitary surveys of adjacent areas. The practicability on a commercial scale of the purification of oysters through the use of hypochlorite of lime or chlorine gas when it is not practicable to remove them to nonpolluted areas for purification was demonstrated in Jamaica Bay and in New Haven Harbor. This fact, the result of scientific studies by the service, is believed to be of far-reaching importance to the shellfish industry. Sewage disposal.-Experiments in regard to residential and small community sewage disposal have been carried out at two experimental plants. These show the extent to which various sewagedisposal processes are applicable to the problem of small communities. It is believed that a sewage-disposal device applicable to almost all conditions and capable of operating with a minimum of attention and expense has been developed. Sterilization of steamboat wastes has also been studied.

Industrial wastes.-Studies of tannery, strawboard, creamery, and canning wastes have been continued. A special research has been

carried out upon the difficult problem of determining and expressing the biological oxygen demand of industrial wastes.

Viruses, serums, etc.-In connection with the enforcement of the law governing the sale of biological products, frequent inspections of establishments have been made, and an increased number of samples of products examined. A special appropriation made by Congress for this purpose has permitted the service to exercise greater control over the manufacture of this important class of preparations.

Hygienic Laboratory.-Technical studies of importance to public health and supplementary to the field studies have been conducted during the year at the Hygienic Laboratory. They have related to hookworm, pellagra, plague, poliomyelitis, pyorrhea alveolaris, Rocky Mountain spotted fever, trichinosis, typhus fever, physiological significance of vitamines in nutrition, dietary studies in pellagrous and nonpellagrous families, isolation of two hitherto unknown milk constituents, choice of disinfectants and their use, disinfecting possibilities of various commercial products, toxicity of pine-oil disinfectant, disinfection of human excreta, theory of disinfection, fly poisons, apparatus for making multiple inoculations of culture media, oxygen diffusion in relation to self-purification of streams, the fauna of sludge, physical factors involved in heat interchange between the atmosphere and the human body, detection of small quantities of poisoning gases in the atmosphere, standardization of typhoid vaccine and certain serums, preservatives used in certain serums, medicinal value of domestic digitalis, toxicity of commercial preparations of emetine, cocaine, and cocaine substitutes, standardization of cannabis indica, action of drugs on the ureter, action of distilled water on the isolated uterus preparation, toxicity of salvarsan and analogous compounds. Some of these studies have already been of assistance in carrying on the field investigations.

Cooperation with other branches of the Government has been continuous, and other routine work of a chemical and bacteriological nature has been conducted as in the past. Apart from those examined for research purposes, 3,425 specimens of all kinds have been examined.

In connection with the licensing of biological-product manufacturers, 5,506 products have been examined. The laboratory has sent to State health authorities and other beneficiaries 1,680 complete treatments for rabies. Over 300 persons were given antityphoid prophylactic at the laboratory and 98,989 c. c. of the vaccine, sufficient for 33,000 persons, were distributed.

Leprosy investigation station.-As in the past, research problems in regard to leprosy have been conducted at the leprosy investigation station, Honolulu, Hawaii.

Publications.-Scientific bulletins reporting the laboratory and field investigations have been published, and a number of popular bulletins printed for use in the field.

Educational lectures.-On request of sanitary and civic associations, hundreds of educational lectures have been delivered in practically all sections of the country.

Division of Foreign and Insular Quarantine and Immigration.

During the fiscal year the administration of national quarantine stations by officers of the Public Health Service and the enforcement of the United States quarantine laws and regulations were conducted in the same general line as in former years. The National Government operates 61 quarantine stations on the mainland of the United States, and in the insular possessions officers of the Public Health Service administer 26 stations. At 36 ports the quarantine station includes reservation, buildings, or floating equipment. At 51 stations there are only inspection facilities.

In addition to the officers at the quarantine stations there are 15 officers attached to American consulates in foreign ports for the purpose of supervising precautionary measures that are applicable to vessels sailing to American ports. These officers also perform examination of intending immigrants and thereby often prevent the loss of time and money, both to the prospective passenger and to the steamship company, in many instances where the person has a physical or mental defect that operates to his mandatory exclusion from this country.

Additional quarantine administrative function was imposed upon the service through the acquisition of the Virgin Islands. A. service officer was assigned to duty in those newly acquired possessions as chief quarantine officer of the islands.

At several points along the Mexican border, on account of the increased prevalence of typhus and smallpox in Mexico, national quarantine facilities were materially enlarged, and at the present time the equipment at all ports where required is adequate and satisfactory for the purpose. During the year service officers inspected 16,076 vessels, not including vessels entering ports of the Philippine Islands, and 1,005,132 passengers and crews, exclusive of overland travelers. For the destruction of rats, mosquitoes, and disease-carrying vermin in general there were fumigated 4,039 vessels.

The prevalence of epidemic diseases in various countries having extensive trade relations with the United States constituted a serious menace to the health of this country. An unusually severe epidemic of typhus fever prevailed in Mexico, occurring in a widespread area and having a high mortality rate. The measures carried out for the