• TABLE OF CONTENTS
HIDE
 Front Cover
 Title Page
 Board members, directors, and field...
 Letter of transmittal
 Table of Contents
 State health officer's letter of...
 Bureau of communicable diseases,...
 Bureau of laboratories, report
 Division of public health nursing,...
 Bureau of engineering, report
 Library, report
 Multigraph department, report
 Division of drug inspection,...
 Division of accounting, report
 Division of malaria research,...
 Division of malaria control studies,...
 Control bureau of vital statistics,...
 Statistical tables 1933
 Conclusion






Title: Annual report - State Board of Health, State of Florida
ALL VOLUMES CITATION PAGE IMAGE ZOOMABLE
Full Citation
STANDARD VIEW MARC VIEW
Permanent Link: http://ufdc.ufl.edu/AM00000243/00005
 Material Information
Title: Annual report - State Board of Health, State of Florida
Series Title: Publication - Florida. State Board of Health
Physical Description: v. : ill., ports. ; 23-29 cm.
Language: English
Creator: Florida -- State Board of Health
Florida -- State Board of Health
Publisher: State Board of Health.
Place of Publication: Jacksonville Fla
Frequency: annual
regular
 Subjects
Subject: Public health -- Periodicals -- Florida   ( lcsh )
Genre: government publication (state, provincial, terriorial, dependent)   ( marcgt )
 Notes
Dates or Sequential Designation: Ceased in 1968.
Numbering Peculiarities: Report year for 1893/94 ends Mar. 31; for 189<7>-1968, Dec. 31.
Numbering Peculiarities: Reports for 1923-32 combined in one issue.
General Note: Reports for 1910-<17> issued as its Publication.
 Record Information
Bibliographic ID: AM00000243
Volume ID: VID00005
Source Institution: Florida A&M University (FAMU)
Holding Location: Florida A&M University (FAMU)
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: oclc - 01569394
lccn - 07039608
 Related Items
Succeeded by: Annual report - Division of Health, Department of Health and Rehabilitative Services, State of Florida

Table of Contents
    Front Cover
        Front Cover
    Title Page
        Title Page
    Board members, directors, and field personnel
        Page i
        Page ii
    Letter of transmittal
        Page iii
    Table of Contents
        Page iv
        Page v
        Page vi
        Page vii
        Page viii
    State health officer's letter of transmittal
        Page 1
        Page 2
        Page 3
        Page 4
        Page 5
        Page 6
        Page 7
        Page 8
        Page 9
        Page 10
        Page 11
    Bureau of communicable diseases, report
        Page 12
        Page 13
        Page 14
        Page 15
        Page 16
        Page 17
        Page 18
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
        Page 24
        Page 25
        Page 26
    Bureau of laboratories, report
        Page 27
        Page 28
        Page 29
        Page 30
        Page 31
        Page 32
        Page 33
        Page 34
        Page 35
        Page 36
        Page 37
        Page 38
        Page 39
        Page 40
        Page 41
        Page 42
        Page 43
        Page 44
    Division of public health nursing, report
        Page 45
        Page 46
        Page 47
        Page 48
        Page 49
        Page 50
        Page 51
        Page 52
        Page 53
        Page 54
        Page 55
        Page 56
        Page 57
    Bureau of engineering, report
        Page 58
        Page 59
        Page 60
        Page 61
        Page 62
        Page 63
        Page 64
        Page 65
        Page 66
        Page 67
        Page 68
        Page 69
        Page 70
        Page 71
        Page 72
        Page 73
        Page 74
        Page 75
        Page 76
        Page 77
        Page 78
        Page 79
        Page 80
        Page 81
        Page 82
        Page 83
    Library, report
        Page 84
    Multigraph department, report
        Page 85
        Page 86
        Page 87
        Page 88
        Page 89
        Page 90
        Page 91
        Page 92
        Page 93
    Division of drug inspection, report
        Page 94
        Page 95
        Page 96
    Division of accounting, report
        Page 97
        Page 98
        Page 99
        Page 100
        Page 101
        Page 102
        Page 103
        Page 104
        Page 105
        Page 106
    Division of malaria research, report
        Page 107
        Page 108
        Page 109
    Division of malaria control studies, report
        Page 110
        Page 111
        Page 112
        Page 113
        Page 114
        Page 115
        Page 116
        Page 117
        Page 118
        Page 119
        Page 120
    Control bureau of vital statistics, report
        Page 121
        Page 122
        Page 123
        Page 124
        Page 125
        Page 126
    Statistical tables 1933
        Page 127
        Page 0
        Page 1
        Page 2
        Page 3
        Page 4
        Page 5
        Page 6
        Page 7
        Page 8
        Page 9
        Page 10
        Page 11
        Page 12
        Page 13
        Page 14
        Page 15
        Page 16
        Page 17
        Page 18
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
        Page 24
        Page 25
        Page 26
        Page 27
        Page 28
        Page 29
        Page 30
        Page 31
        Page 32
        Page 33
        Page 34
        Page 35
        Page 36
        Page 37
        Page 38
        Page 39
        Page 40
        Page 41
        Page 42
        Page 43
        Page 44
        Page 45
        Page 46
        Page 47
        Page 48
        Page 49
        Page 50
        Page 51
        Page 52
        Page 53
        Page 54
        Page 55
        Page 56
        Page 57
        Page 58
        Page 59
        Page 60
        Page 61
        Page 62
        Page 63
        Page 64
        Page 65
        Page 66
        Page 67
        Page 68
        Page 69
        Page 70
        Page 71
        Page 72
        Page 73
        Page 74
        Page 75
        Page 76
        Page 77
        Page 78
        Page 79
        Page 80
        Page 81
        Page 82
        Page 83
        Page 84
        Page 85
        Page 86
        Page 87
        Page 88
        Page 89
    Conclusion
        Page 90
Full Text



STAT to 0OALD* Of ti tALTt


fLOLIDA


fttlITY- f If Tt


fok_ T111


S.ANNUAL


Yt AL.


tNDIN


* LtpOLT
G DtCtMbt LR


JAC 'ONVILLt


fLOUIDA


YJATt


bOA D


5 ~"
-,
;-



31,1934


'3'


I~B\ A t ~:


'It


Of fltALTti







JTATt


bOALD
Of


of fitALTtI


fLOLIDA
\'


ANNUAL


foL I ht


LtpOLT


YtAL, TENDING


ADMIN I NATION
JA c H'ONV t


bLANCti


DtCtMbt -)I 1934


OfflICt/
LLt


LAbouA OLItf
TAMPA


t N ACOLA
MIAMI
IA LLAH A./tt



JAC S.r/ONVI LLt
JTA t bo~DA(
S1955 -


Of-


tltA L T+


U




A'
5',
A
i.











S





III


THILTT-f ff TH






- I.-


BOARD MBIBERS, DIRECTORS AND FIELD PERSONNEL


Board Members


N. A. Baltzell, M.D., President
Marianna


Harry Dash Johnson,M.D.
Daytona Beach


R. L. Hughes, M.D.
Bartow


State Health Officer
Also Executive Officer and Secretary of Board
Henry Hanson, M.D.


Bureaus at Jacksonville
Directors
Laboratories ...... ......................................
*Vital Statistics ..... .................................
Communicable Diseases ...............................
Engineering ........ ......... ... ..................... ...
Public Health Nursing .................................
Accounting .... ....................,.....,. ,.,.,..... ...
Librarian .............. ...................... ..... ......



*Registration Inspector ...................... ........
Chief Drug Inspector .................................
Assistant Drug Inspector ...............................


Paul Eaton,M.D.,D.P.H.
Stowart G.Thompson,D.P.H
F.A.Brink, M.D.
Louva G.Lenort,B.S.,C.E.
Ruth E.Mettinger, R.N.
G. Wilson Baltzell
Elizabeth Bohnenborger


Anna C .Emmons
M. H. Doss
Frank S. Castor


Laboratories


Jacksonville .........................................
Miami ................... ...............................
Ponsacola ........ ....................................
Tallahassee ................. .. .. ....................
Tampa .......................................... .... ....


Pearl Griffith, B,E.
E. R. Powell
Johnette McCormick
Estelle Bryan
H.D. Venters, B.S.


Medical Officers


DoFuniak Springs ......***..............................
Inverness ...............................................
Jacksonville .................................. ..........
Jacksonville ...........................................
Tallahassee ............................................
Tampa ...... ...... .... .................... .........
And Tuberculosis Clinician

District Sanitary Officers
Milton........................... ........................
Ocala ................. .... .. .. ......... ...... .....
Orlando ............. ...............................
West Palm Beach ........................................*
On"F2RA"Duty..............* ...... ......................


C. W. McDonald, M.D.
Leland H.Dame, M.D.
Thos. E. Morgan, M.D.
W.A. Claxton,M.D.*
H. A. McClure, M.D.
C.W. Pease, M.D.



T. S. Kennedy, M.D.
C. A. Holloway
Russell Broughman
S. D. Macready
Fred A. Safay






II -


BOARD MEMBERS, DIRECTORS AND FIELD, PERSONNEL (cont.)


Public Hoalth Nursing


Jacksonville ................ ...................
Lake City ..........................................
'Marianna .. ......... ,......................
Tampa ........ ...... ..... .... .................

Malaria Research

Tallahassee ........................................


Malaria Control Studies

Jacksonville ............ ... ......................


Consultant-in Entomology


Joyce Ely, R.N. Asat.Director
Johanna L.Sogaard, R.N.
Lalla Mary Goggans, R.N.
Julia 0. Graves, R.N.


Mark F. Boyd, M.D.,
(Rockefoller Foundation)



T.H.D. -Griffitts, M.D.,
(U.S.Public Health Service)


Orlanrlo ... .. ........ .. ... ................. ...... W. V. King, Ph. D.
(U.S. Bureau Entomology)

Directors Full Time County Health Units

Tallahassee ......................................... L. J. Graves, M. D.
Pensacola .................................... ......... W. A. McPhaul, M.D.

Multigraph Department

Jacksonville .................. .................... E. Fs H. Ganten

Custodian.

Jacksonville .................................Y...... frank M. Whiddon
















December 31, 1934


His Excellency, David Sholtz
Governor of Florida
'Tallahassee, Florida


Sir:

I beg to hand you herewith a report of the

State Board of Health for the period of January 1,

1934 to December 31, 1934, inclusive.


Respectfully submitted,
Florida State Board of Health
By N. A. Baltzell, M.D., President










- IV -


TABLE OF CONTENTS






Page
Personnel ....... ........... .... ... .. .... ............. .. .... I
President's letter of transmittal ...................................... III
Table of contents *................ .................... ........... ... IV
State Health Officer's letter of transmittal ........................... 1
Bureau of Communicable Diseases, report ................. ............ 12
Communicable Disease investigations ............................... 13
Tables
#1 Summary of activities during 1931,1932,1933,1934 ........ 18
#2 Number of pamphlets distributed, 1931-1934 ............... 19
#3 Number of cases of communicable diseases reported to the
State Board of Health, 1931-1934 ..................... 20
County Health Units
Escambia County Health Unit, report .......................... 21
Loon County Health Unit, report ............................ 23
Bureau of Laboratories, report ........ ............................... 27
Tables
#I Examinations made in the laboratories during 1934 ...... 30
#II Total number of examinations made by months during 1934. 31
Central Laboratory, report .......................... .... ....... 32
Tampa Laboratory, report ...... .......................... ......... 35
Pensacola Laboratory, report ...................................... 37
Tallahassee Laboratory, report ................................ 39
Miami Laboratory, report .......................................... 41
Tables
#3 Biologics distributed during 1934 ...................... 44
Division of Public Health Nursing, report .............................. 45
Personnel ...................................... ...... 45
Staff education ................................................... 47
Demonstrations .................................................... 48
Parent education ......................................... 49
May Day ............................ ........... ......... 49
Indian Nursing Service .. ....................... ............... ... 49
Midwifery .................... ............................. 49
Survey of Public Health Nurses .................................... 49
Tabulated report
District Supervisors of Nurses ............................... 51
Visiting Nursing ........ ............... ........... 52
County Nurses ........,.... ... ... ................. .......... 52
Hospital and Clinic Nurses ............................. ..... 56
Literature and Supplies Sent Out ............ ............. 57











Page
Bureau of Engineering, report.....................................'... 58
Organization Chart ............................. ......**** 59
Water Supplies .. ........... ............... *........ .... ...... 61
American Wator Works Association .... ....................... 64
Sewerage and Sewage Disposal ................................ 65
Florida Sanitary Pit Privy .................................... 66
School Sanitation .............................. ............. 68
Swimming Pools and Bathing Places ............................. 70
Tourist Camp Sanitation ....... .............................. 71
Mosquito Control ...................................**********.. 72
State Institutions ......................... *.. ............. 72
Other Institutions ............................ &........ ..... 73
Canneries ....................................*..**.********** 74
Oysters ..........................................** ***** 74
Milk Sanitation ........................... ................... 75
Rabies ..........................** .............. **.. ***...... 76
Drainage Wells ........................ ................ ***.*.. 76
"Dog Flies" ............................. .......... 77
Key West Rehabilitation ....................................... 78
Legion Convention in Miami ................ ...........*...*. 79
Disaster Relief ............................................... 79
Emergency Health Projects ..................................... 79
Publications ... ................... .......... ................... 82
Library, report ...............*........................ ................. 84
Multigraph Department, report ...............................** **.. *.** 85
Division ef Drug Inspection, report ..................................... 94
Division of Accounting, report .............................*............ 97
Division of Malaria Research, report ................................ .... 107
Division of Malaria Control Studies, report ............................ 110
Tables
#1 Mnlaria Blood Index, schools 1934 ................... 111
#2 Malaria Blood Index, clinics, school and pro-school
children, July 3-Septomber 7, 1934 ................ 114
#3 Malaria Blood Index, clinics (including pro-school
ago).Thirtcen counties in Florida July 3 -
September 7, 1934 .............*................... 118
Central Bureau of Vital Statistics, report .............................. 121
Contents, description ......................................... 121
Original Records ............................................. 122
Certified Copies ............................................ 123
Field Work ....... ...... ................. ... ..... .......... 123
Notices to New Mothers ........................................ 124
Annual Rogistration-Healing Arts .............................. 124
In the Office ................ .............. ............ 124
Allocation of Records ........................................ 125
Current Releases .......................................... 126
Health Notes ...................... ................... .. 126
Registration Affairs ......... ....................... 126










Page
Central Bureau of Vital Statistics, report (cont.)
Appendix, statistical tables .........................****... 127
Births (Exclusive of Stillbirths) and Birth Rates por
1,000 Population, by Color, Florida, 1929-1933 ........ V-0
Deaths Recorded, Resident and .Death Rates per 1,000
Population, by Color, Florida, 1931-1933 .............. V-0
Infant Mortality-Deaths of Infants Under One Year of Ago
and Rates per 1,000 Live Births, by Color, Florida,
1929-1933 ........................................ *... V-1
Typhoid Deaths Recorded, Resident and Death Rates per
100,000 Population, by Color, Florida, 1931-1933 ...... V-l
Smallpox .......... ....... ..... ..**......**** V-2
Scarlet Fever Deaths Recorded, Resident and Death Rates
per 100,000 Population, by Color, Florida, 1931-1933 .. V-2
Whooping Cough Deaths Recorded, Resident and Death Rates
per 100,000 Population, by Color, Florida, 1931-1933 .. V-2
Diphthoria Deaths Recorded, Resident and Death Rates per
100,000 Population, by Color., Florida, 1931-1933 ...... V-3
Influenza Deaths (all forms) Recorded, Resident and Death
Rates per 100,000 Population, by Color, Florida 1931-1933 V-3
Rabies .................................********...... ..*** V-3
Tuberculosis (all forms) Deaths Recorded, Resident and
Doeth Rates per 100,000 Population, by Color, Florida
1931-1933 ......................... ...........* .....* V-4
Syphilis Deaths Recorded, Resident and Death Rates per
100,000 Population, by Color, Florida, 1931-1933 ...... V-4
Malaria Deaths Recorded, Resident and Death Rates per
100,000 Population, by Color, Florida, 1931-1933 ...... V-5
Cancer (all forms) Deaths Recorded, Resident and Death
Rates per 100,000 Population, by Color,Florida 1931-1933 V-5
Pellagra Deaths Recorded, Resident and Death Rates per
100,004 Population, by Color, Florida, 1931-1933 ...... V-5
Heart Disease (all forms) Doaths Recorded, Resident and
Death Rates per 100,000 Population, by Color, Florida
1931-1933 ...........................******** .......... V-6
Pneumonia (all forms) Deaths Recorded, Resident and Death
Rates per 100,000 Population, by Color, Florida, 1931-
1933 .........................* .. .................... V-6
Diarrhea and Enteritis (all forms) Deaths Recorded, Resi-
dent and Death Rates per 100,000 Population, by Color,
Florida, 1931-1933 ................. ****............... V-7
Nophritis (all forms) Deaths Recorded, Resident and Death
Rates per 100,000 Population, by Color, Florida, 1931-
1933 ................. *. ... ....................****. V-
Maternal Mortality-Deaths from Diseases of Pregnancy,
Childbirth and the Puerperal State and Death Rates per
1,000 Live Births, by Color, Florida, 1929-1933 ....... V-7
Maternal Mortality-Deaths from Diseases of Pregnancy,
Childbirth and the Puerperal State Recorded, Resident
and Death Rates per 1,000 Live Births, by Color,Florida
1933 ........................................********* V-8








-VII-


Page
Central Bureau of Vital Statistics, report (cont.)
Automobile Accidents-Deaths from Automobile Accidents
Recorded, Resident and Death Rates per 100,000 Popula-
tion, by Color, Florirca, 1931-1933 .................... V-8
Illegitimate Births and Stillbirths, by Color, Florida,
1929-1933 ............................................. V-8
Illegitimate Births and Stillbirths Recorded and Resident
by Color, Florida,1933 ............................... V-8
Tables
1 Estimated Population by Color, by Counties, Florida,1933 V-9
2 Estimated Population by Color, by Cities, Florida, 1933. V-10
3.- Births (Exclusive of Stillbirths) Recorded, Resident and
Rates per 1,000 Population, by Color, by Counties,
Florida, 1933 ........................................ V-12
4 Births (Exclusive of Stillbirths) Recorded, Resident and
Birth Rates per 1,COO Population, by Color, by Cities,
Florida, 1933 ......;.,......V........................ V-16
5 Deaths (Exclusive of Stillbirths) Recorded, Resident and
Rates per 1,000 Population, by Color,-by Counties,
Florida, 1933 ....*...... .... ... .................. V-20
6 Deaths'(txclusive of Stillbirths) Recorded, Resident and
Death Rates per 1,,00 Population, by Color, by Cities,
Florida, 193355 ..................................... V-24
7 Infant Mortality-Deaths of Infants under one year of age
Recorded, Resident and Death Rates per 1,000 Live
Births, by Color, by Counties, Florida, 1933 ......... V-28
8 Infant Mortality-Deaths of Infants under one year of age
Recorded, Resident and Death Rates per 1,000 Live
Births, by Color, by Cities, Florida, 1933 ........... V-32
9 Stillbirths and Illegitimate Births Recorded and Resi-
dent, by Color, by Counties, Florida, 1933 .......... V-36
10 Stillbirths and Illegitimate Births Recorded and Resi-
dent, by Color, by Cities, Florida, 1933 ............. V-40
11 Deaths from Diseases of Pregnancy, Childbirth and the
Puerperal State, Recorded, Resident and Rates per
1,000 Live Births, by Color, by Counties,Florida 1933. V-44
12 Deaths from Diseases of Pregnancy, Childbirth and the
Puerperal State, Recorded, Resident and Rates per
1,000 Live Births, by Color, by Cities, Florida 1933.. V-48
13 Marriages Performed, by Counties, Florida, 1933 ........ V-52
Marriages Performed, by Months, Florida, 1933 .......... V-53
14 Divorces and Annulments Granted, by Counties, Florida
1933 ....... ....... ............ ........... .......... V-54
15 Deaths from Typhoid Fever, by Color by Months and by
Counties, Florida, 1933 .................. ............ V-55
16 Deaths from Diphtheria, by Color, by Months and by
Counties, Florida, 1933 ............................ V-56
17 Deaths from Tuberculosis (all forms) by Color, by Months
and by Counties, Florida, 1933 .......... .......... V-57
18 Deaths from Malaria, by Color, by Months anr' by Counties
Florida, 1933 ................s ...................... V-58











Central Bureau of Vital Statistics, report (cont.)
Tables
19 Deaths from Pellagra, by Color, by Months and by Counties,
Florida, 1933 ............ .. .................... ....
20 Deaths from Diseases of Prognancy, Childbirth and the
Puerporal State, by Color, by Months and by Counties,
Florida, 1933 ......... ..... .... .... ...................
21 Deaths from Automobile Accidonts, by Color, by Months and
by Counties, Florida, 1933 ...... .. ..........******
22 Deaths from Cancer (all forms) by Color, by Months and by
Counties, Florida, 1933 4............... *...........
23 Deaths from Typhoid Fovor, by Color, by Ago, and by Sex,
Florila, 1933 ........................................
24 Deaths from Diphtheria, by Color, by Age,and by Sox,
Florida, 1933 ...............................*****.******
25 Deaths from Tuberculosis (all forms) by Color, by Age, and
by Sex, Florida, 1933 ...........*.................*** *.
26 Deaths from Malaria,, by Color, by Age, and by Sex, Florida,
1933 ............ ...... .... **.............*...... ......
27 Deaths from Pellagra, by Color, by Age, and by Sex, Florida
1933 ............ ...................* *........******.***
28 Deaths from Diseases of Pregnancy, Childbirth and the
Puerperal State, by Color, by Age, and by Sex, Florida,
1933 .. ........... ............ 6.. .... *.... .... .. -.* .
29 Deaths from Automobile Accidents, by Color, by Age, and by
Sex, Florida, 1933 ............... ..... .................
30 Deaths from Cancer (all forms) by Color, by Ago, and by
Sex, Florida, 1933 ............... ...... *.**.....***....
31 Deaths Recorded and Resident by Color and by Diseases,
Florida, 1933 ............................. ........
32 Combined Totals for Certain Causes of Death, Recorded and
Resident, Florida, 1933 ..............................***
Conclusion ...................,... .**..****...******* ** ** ***


Page


V-59


V-60

V-61

V-62

V-63

V-64

V-65

V-66

V-67


V-68

V-69


V-89
V-9&









ANNUAL. REPORT
STATE BOARD F0 HEATH
1954

December 31, 1934
Dr. N. A. Baltzell, President
State Board of Health

Sir:

The work of the State Board of Health at the beginning of the year
1934 was confused by the necessity ofa dusting the arelar routine to suit the
program of the C.W.A. and other emergency relief activities.

The first phase of -the relief program affecting the Health Depart-
ment was that concerned with Luing. .-it tfie met-ng of, the State Nurses
Association in St. Petersburg in 1933 the Association received a communication
from the Relief Director, Mr. Marcus C, Yagg, in which advice was .sought to
provide nursing care for re)lef. -lients. put of this grew a nursing organiza-
Stion, undsr the supervisionof the State Board of jaQ4th, such as the Stato
had not dreamed eof. .This, however, will be discussed in the corenats on the
work of Public Health Nursing.

The soeond'reliof activity to engross our attention and for a while
threaten to eclipse the public 4h-h program was the grgat rqoh in the C.W.A.
mosquito :ontrol -and a, projoot -for Q:omniuity sanitaianl. So mwah.hate was
-urged-in providing employmant.that w veoe o able to -maGe idiin~ig r surveys
or plans. to guide the supervtsoISa-and foruan in carrying out thp work, and
aOmd 'work wads started without-approval from the State Board of H th; conse-
quently some very serious mistakes were mado creating worse o iontobns than
those the project was to correct.

In each of the divisions and bureaus of the State Board of Health
much has been aecompl.shod during the year., It is, to the -ordi.$ tf the bureau
-and division Iirectorsv as well as the personnel in gooeral, tb4t a continuous
effective program has been maintained, oven though we haveP 'rkod on the small-
est budget since 1923. When the..L giskature of 1933 reduced the b,4dget to
$179,568.00 we were obliged to~:proTtice severe economies in every section of
the service. Salaries were reduced to the point 6f a bare subsistence leaving
no margin to provido'for the omexaio4es which appear unavoidable.in life.

Why poopl-o wheonork for the state should be expected to live on
poorer salaries than"those- in other occupations has never had ,f.logical explana-
tion. A person working for-an income lower than will provide a reasonably
comfortable living will always worry about the, future for himself and family,
if he has one, a condition which impairs tho officioncy of the worker,. Near
the close of :' thadiseussion there is a statement of per capital investment for
health by cities,, Lountios and states.

SThis volume contains the reports of the following bureaus and
divisions:







-2-


1. Bureau of Communicablo Diseases
2. Bureau of Laboratories
5. Division of Public Health Nursing
4. Bureau of Engineering
5. Library
6. Multigraph
7. Drug Inspection
8. Accounting
9. Malaria Research
10. Malaria Control
11. Entomology
12. Bureau of Vital Statistics


BUREAU OF COMMUNIOABLE DISEASES


The work of the Tuberculosis Clinician, Dr. W. A. Claxton, has been
carried on as a division or branch of the Bureau of Communicable Diseases and
rightly so. It is difficult to concede that tuberculosis should occupy a differ-
ent place in a health department than any other oonmmnicablo 'disease, of comparable
incidence.

The greatest difficulty exoprienood by any Bureau of Communicable
Diseases is in obtaining information on morbidity. Very few doctors report cases,
in their practice, listed in the rules of the State Board of Health as portable.
Is this another example of expecting'the doctor to do something for nothing? .Is
the information of sufficient value to the state to Justify paying a small fee
for the report? If communicable disease is not reported early, while still.in
the communicable stage, it will be futile to attempt effective control to limit
its spread.

Fortunately the researches of recent years have brought out effective
aids in the form of immunizing inoculations, and tests by which susceptibility
can be determined, the most outstanding example of which is the toxoid for pro-
tection and the Schick test for determination of susceptibility to diphtheria.
In Florida' there has been for many years a consistent drop in the diphtheria
deaths, total numbers as wel.; as rates, upte thb month of A'gust when there was
an increase of one over the previous year and for each of the following months
there wore more deaths than in the corresponding months of the year before. The
greatest number of deaths has occurred in Duval, Manatee, Taylor and Jackson
Counties. Complying with suggestions from the medical profession we have left
some of the immunization to the general practitioner and have not held as many
diphtheria immunizing clinics as we did'previous to the year 1935. In 1951 the
district health officers did 23,865 toxin antitoxin or toxoid inoculations, in
1932, 21,439 and in 1933 and '34, 10,311 and 10,349 respectively, less than half
of what was done during the preceding years. It is rathor.~significant that the
answer to this should be a decided increase in diphtheria deaths

The medical officers of the Board, have been handicapped by uncertain-
ty as to tenure and by being shifted from one district to another making it diffi-
cult to map out and follow a definite program.










On the other hand typhoid has shown a gratifying decline: Malaria
is again on the increase, showing about a 30% increase: Tuberculosis deaths
were fewer in 1934, as indicated by the provisional figures of the Bureau of
Vital Statistics. One cannot enter into any detailed discussion of other than
the 1933 statistics because the data will not be complete before late in the
summer. One can only discuss trends. A deplorable trend is apparent in auto-
mobild accidents which show more fatalities in 1934.


TWENTY LEADING CAUSES OF DEATH, FLORIDA, 1933


CAUSES


Heart Disease (all forms)
Nephritis (all forms)
Cerebral Hemorrhage
Cancer (all forms)
Tuberculosis (all forms)
Pneumonia (all forms)
Influenza (all forms)
Automobile Accidents
.Syphilis
Malaria
Homicide by Firearms
Diabetes Mellitus
Diarrhea and Enteritis
Appendicitis
Hemiplegia
Pellagra
Other Diseases of the Stomach
Traumatism by Fall
Arteriosclerosis
Accidental Drowning,


S3,053
.1, 24
1,366
1,284
1,039
917
608
.495
450
753
254
246
: .1230
213
213
.193
190
1. 83
154
144


TWEN1TY LEADING CAUSES OF DEATh, FLORIDA,,


lAUES &Tt?


Heart Disease (all forms)
Tuberculosis (all forms)
Nephritis (all forms).
Cerebral Hemorrhage
Pneumonia (all forms)
Cancer (all forms),
,Diarghea and Epteritis
Paralysis without specified cause
Hopic ide..by Firearms
Other Diseases of the .Stomach
Malaria
Automobile Accidents
Measles


',1ll
1,054
1,029
1,024
894
. .700
646
356
268
265
249
243
214


1924


DiALTks


-=___~_ i I i~..mim .


`R"TTE S


. .. .. ~ ~ i


... W =. ....--- -, ,-.. _40


UB i@







- 4 -


Syphilis 190
Influenza (all forms) 160
Typhoid 157
Appendicitis 149
Accidental Drowning 141
Arteriosclerosis 139
Intestinal Obstruction 116


Under the Bureau of Communicable Diseases one will find the reports
of the County Health Units, of which there are only two operating under the
supervision of the State Board of Health, and to some extent in conformity with
the County Health Unit Law. Shortly before the close of the year we were in-
formed that the U. S. Public Health SerVice was again in position to take up the
development of rural health work and would send a representative to cooperate
with the State Board of Health in County Health Unit development.


LABORATORIES


If the increase in work as represented by the total number of
specimens submitted is an index of confidence on the part of the users of the
laboratory the State Board of Health should have no concern for its public
health laboratories. Some of the increase was due to surveys conducted for
the relief administration, some to laboratory work associated with persons in
jobs concerned with food handling, canneries, etc., but a great deal, in fact
most of it comes within the scope of preventive medicine.

The laboratory has continued its important work in connection with
cases inoculated with malaria as a therapeutic measure in neurosyphilis. In
1933 the Director, Dr. Eaton, reported on the role of the reticulocyte in
malaria. During this year he had the good fortune to find the first ease of
Piroplasma canis. For details the reader is respectfully referred to the second
page of Dr. Eaton's report.

Excellent work has also been done in the branch laboratories. It
is a fact that all are under-staffed and much important investigation cannot be
carried on for lack of personnel.. Mr. Venters in Taapa, Mrs,. Powll in Miami,
Miss McCormiok in Pensacola and Miss Bryan in Tallahassee, all..deserve commenda-
tion for the character and amount of work done.


PUBLIC HEALTH NURSING


As far as the nurses on the pay roll of the State Board of Health
are concerned they are, for the present, five in number and from the standpoint
of training or efficiency, or general qualifications for the job, a very select
group. It is clear to a person having experience with public health work that
so small a number can only provide the personnel needed in the general direction
of public health nursing and is not enough even for the supervision of a nursing
program of the state. Actually Miss Mettinger and her staff are devoting their









time to direction of the E.R.A. nursing. In this we have been fortunate in
having had clear thinking, and far-seeing Social Service Directors to deal with,
as well as sound State Relief Administrators, who recognized the need for work
of this kind under professional supervision. The program has been one of genera-
lized nursing with emphasis bn prevention of sickness. Our public health nursing,
considering the lack of experience of most of the nurses in the beginning has
made a very creditable showing. This is reflected' in the lowering of the maternal
mortality for the year 1934. The available provisional figures show a thirty
percent reduction below the mortality for-last year, however, we only have data
complete for 1933 an(l at the close of that year there was a rise in the mortality
rate to 11.1 per thousand live births. For details of the nursing program I
respectfully refer you to the report of the Director of Public Health Nursing.

It is obvious that the State Board of Health should have a minimum
of 15 nurses on the regular staff to enable the Board to furnish advice and
supervision to coordinate all Public Ht:alth Nursing in the state. There are 177
white and 1040 Negro midwives in the state, of these the following are licensed:

White 77
Negro 593

consequently 550 are practicing without a license. It is rather important that
we got legislation Which effectively enables us to stop the unlicensed midwife.

For a number of y.ars we have had Negro nurses in scattered com-
munities, those mnae available by a grant from the Julius Rosenwald Fund. The
greatest need for work of this kind is difficult to specify but one can point out
the -~ork in the Okeochobee region by Rosa L. Brown as outstanding. We owe the
Julius Rosenwald Fund a debt of gratitude f6r the sorvicer .!e ought to have
several Negro Public Health Nurses on the regular staff.


ENGINEERING


The Bureau of Engineering has functioned with creditable efficiency.
In the field the Bureau was-reduced to five district sanitary officers, a number
inadequate to meet the problems of general sanitation under the present organi-
zation of the department. When the state becomes properly organized on a county
health unit basis, fevwr sanitation officers on the central staff will be able
to cover the state as they will then serve more in an advisory capacity and the
local details will be taken care of by the personnel of the unit.

Special effort was made during the year to provide' privies for the
schools. In a survey of 2,179 schools it was found that 279 schools had no
toilet facilities at all', a condition which should be corrected. For further
details see report of the Chief Engineer.







-6-


MILJ


The position of the State Board of Health with reference to the
safeguarding of milk through sanitation of dairies continues unsatisfactory.
The laws passed in 1929 and 1951 placing certain duties in the Department of
Agriculture and indicating a dual responsibility is unfortunate and handicaps
the State Board of Health in dairy sanitation. The law creating the Milk Control
Board has possibilities for benefit to the diary industry if the dairymen stop
misinterpreting the intent of the law. When they realize that the law is for
the purpose of preventing some big firm from temporarily lowering the price
until all competition has been killed and not for the fixing of maximum or
profitable retail prices they can adjust the business and make a living out of
it. When it is realized that the intent of the law is to establish a basic
prico rather than local maximum retail prices the dairy business will improve.
Tho attitude now appears to be to grasp very opportunity to raise prices,
taking away from the poor the ability to buy fresh fluid milk. ; Fortunately
both the condensed and powdered milks contain healthful food ingredients. There
has boon a very marked increase in the salo of condensed and powdered milk
during the year of 1934.


DOG FLIES


Your attention is invited to the Chief Engineer's report on finding
the brooding habits of a variety of Stomoxys which has been a serious nuisance
along the Gulf Coast. An excellent piece of work was done by Dr. W. V. King
and Mr. Lenert in working out the breeding habits of this postiferous fly.


DRAINAGE


Drainage is the procedure of choice in communities having a density
of population which brings the per capital cost within reason. The excellent
results obtained by drainage in the malaria control activities on the Panama
Canal have been misinterpreted and wrongly applied within the continental United
States. Persons without experience have started drainage projects in rural com-
munities whore in the first place the cost of tho original ditch is out of
proportion to the benefits derived and in the second place without provision for
maintenance. A ditch which is not maintained soon becomes in itself a serious
mosquito producing element. Those who speak of general drainage fail to realize
that in order to bring maintenance within a reasonable cost it is necessary to
line the bottoms of the ditch with concrete or cement, which gives opportunity
for unobstructed flow and simplifies the matter of sweeping out obstructions
which accirently get in. There is no argument against ditching within and
atjaeent to cities as far as a mile and a half outside of city limits. Such a
procedure must be followed if it is hoped to avoid a high incidence of malaria.









DENGUE


The state had a shock last summer in the announcement from the City
Health Officer of Miai Phat dengue had been recognize iii tht city. The City
Health Officer, Dr, MacDonell, however, is'to'be congratulated n promptly
recognizing the disease and notifyizn the'State B6dard 'd Health and the U. S.
Public 'Health Sedr#ice 6f the condition. The 'appeardne df dergue was a very'
valuable lesson in that we probably would not have reCognized the '-eteit of
Stogomyia breeding prevailing over the state without the incentive for investi-
gation furnished by the knowledge of the existencg6 %f dn opitdeidoef ddegue.
We undertook'dengue 'control to prevent it spread to adjoining statos. It
seemed at tho close of the year that-we had been sucd6ssfi it this effort. The
problem was discidssed at the meeting. f-the Fl*rida Pl11lic Health Association by
Dr. MacDonell of Miami and Dr. Griffitts of the U -S. 'l~t lid Health Service. We
are not yet safe, as theto is a possibility that we may still haoe a focus in the
south, which may start a now epidemic with the onset of th6e"wafm woatherin the
spring.


EMERGENCY 1EL .3 ADMINISTRATION


In additiohto the nursing service, there wasla cooperative project
of the E.R.A. and the State Board of Health, Of CommunitySeanitition headed up
by Dr. Kennedy, of the Buroau of Sanitary fnginooring, in the capacity of Assist-
ant State Director, and Mr. Safay Assistant State Diroetor in charge of the -
mosquito control activity's. In the section of malaria' and mosquito control.
good work was d6no in th~ fresh water and the salt marsh- r pcstiforous nbqgEuito
drainage, the latter being handled by a representative f the Buroau 'of Entomology.


LIBRARY


Considering the limited funds available the Library has made most
creditable progress during the year. I have bedn fortunate in arranging for
exchanges ftbioh bring us material vory useful both 'to th public health workers
and to the medical profossoIn at large. The Librarian *s r"tport', although brief,
is full of important facts. I tish to roitrtorato th statemoht,' that the library
has contributed greatly to the officiencey of the 'Sdtte Board of Health.


MULTIGRAPH '


The statement submitted shows a surprising volue of rk, nl6_..
very doctdod saving to tho Stt'to Board of Health. Our printing bill would' be''
many times what it Is now if the work shown in the statement of Mr. Gareon had
to be put out on contract. Mr. Ganton is to be complimented for the 'fJctloncy
with which he handles his department..







- 8 -


DRUG INSPECTION


The drug inspectors a usual have done good work. In addition to
inspection of drug stores they have had numerous duties in cooking compliance
with the State Uniform Narcotio Drug Act. The enforcement of this act was placed
with the State Board of Health by an act of the Logislature of 1933. Mr. Doss
and Mr. Castor, however, have done an excellent piece of work. Ono of the worst
evils discovered in the state is marajuana peddling. It is surprising how wide-
spread the evil is and how much the habituo will pay for a single cigarette. It
is reported that they have paid as high as $1.00 for one cigarette. The serious-
ness of the ovil is realized when one recalls the wholesale murder which occurred
in Tampa by a young man crazed fram smoking marijuana. The matter of drug addic-
tion as a whole is an extremely serious one to which the State Board of Health
can well lend its best efforts for control. The peddlers stop at nothing. They
are known to go to the Junior and Senior High Schools for the purpose of crocting
addicts among school children.


ACCOUINING


The report of the auditor speaks for itself, Mr. Baltzell has con-
tinued his highly efficient service and has presented a statement which is self
explanatory. Insofar as our financial situation in general is concerned we have
been seriously handicapped by a limited budget, one about forty to fifty thousand
losesthan the actual income from the village established by the Legislature for
the State Board of Health. We hope that the next Legislature will reimburse the
State Board of Health for the money taken out of our millage to pay tax collectors
and tax assessors.


MALARIA RESEARCH


The Malaria Research Division,under Dr.. Boyd's able direction, has
continued to add valuable information to our knowledge on malaria, I refer you
to his statement which consists largely of advice for future malaria control in
this state. Dr. Boyd has boon ably assisted by Dr. S. F. Kitchen, who has been
in charge of the Station while Dr. Boyd has been away. The Rockefeller Foundation
has established an Insoctory at the Rockefollor Institute in New York where it
is carrying on supplementary studies under different climatic conditions. Dr.
Boyd's work has continued largely along the use of malaria inoculations of nouro-
syphilitics observing both the therapeutic results and the clinical course of the
different varieties of malaria. In this connection we have had a number of cases
inoculated from Jacksonville who have come back here for hospitalization and
observation. Those have boon followed by Dr. Eaton who has taken daily blood
smears and who has kept detailed records of the disease noting any new points of
value






- 9 -


MARIA CONTROL STUDIES


The Malaria Control Division, under the direction of Dr. T. H. D.
Griffitts of the U. S, Public Hoalth Service, has continued its study of incidence
of malaria in the stato. He is not yet ready to mako any definit'6 statement re-
garding the correlation of morbidity and mortality reports. Dr. Oriffitts'
report covers some 22,000 oxaminations in 2S counties. His tables furnish very
interesting study for those who wish tb follow this work. Dr. Griffitts also
comments on procedures for malaria control. Thero is a fertile field for
study and it is hoped that the budgets of the U. S. Public Health Service and
the state will permit more extensive work. It is hoped that medical personnel
will be assigned to Dr. Griffitts, ultfie~ti t to take advantage of the outstand-
ing problems and opportunities, to work out an effective attack on malaria and
give both the public health workers and the medical profession. something which
can be relied on as a guide. At the prese9pt time thoro is no agreement in the
prpoodure for treatment of the sick, or..in the methods for Anopholine control.
It is often heard that there are cases rosiatant to quinino. At the present
writing I have no recollection of such cases on the wards of oithor Ancon or
Colon Hospitals during the two years of my service on the Canal Zone. In the
question of ditching for malaria or Anopheles control there is need for a clear
understanding of where drainage should be attempted and the type of physiographic
conditions whiah should not be included in drainage projects, Witi adequate
personnel Dr. Griffitts with his extensive exporiinco, a great doal of which was
acquired during his years of association with Dr. Henry R. Carter, the foremost
malariologist of the U. S. Public Health Service, could and would work out for us
a solution of some of the unsolved problems of malaria treatment and control.
With the abundant material coming from Dr. Boyd's research, supplemented by
entomological research by Dr. W. V. lKgingand his co-workors, there is an oppor-
tunity in Florida which is not equalled in any other state. The work should have
the most liberal onoeurgowmnt from the. stato, and the State Board of Health
staff -should take advantage of the opportunity to fit itself in this line of work.


COUNTY HEALTH UNITS


The most effective manner of realizing Malaria Control or any.other
improvement in the public health is to promote county health unit development
under the supervision of the State Board of Health. For this:purpose young
physicians must be trained to serve as health officers. In fact all the personnel
for the units should be carefully selected and given a training at some recognized
school of hygiene and public health. No health officer should serve in his home
county and the same applies to sanitation officers and nurses.

The Central Office staff should serve in a supervisory and advisory
capacity to the county units. For sometime to come thore will be many qcunties
which for one reason or another will not have their full time unit. Such must
be taken care of by the staff from the Central Office.








- 10 -


For various reasons only a few counties will avail themselves of the
opportunity to get a health unit and there will be a large part of the state in
rhich the State Board of Health will be obliged to continue looking after omer-
gencios, and to do so effectively requires export personnel, trained in public
health schools supplemented by practical experience under qualified health
officers. The counties taking advantage of the offer by the State and the U. S.
Public Bealth Service will receive $5000.00 or more from the outside to help
defray the cost of the unit.





The Division of Entomology, under Dr. W. V. King, has continued
its.high grade studies of the distribution of insects injurious to man. Dr.
King has had his mosquito work interrupted by the appearance of the screw worm
(Chrysormia macellaria) which has presented a very serious problem fbr stock
raisers in this state. It is also a pest which monaces the health of human
beings when sleeping in the open, especially if he has a nasal discharge which
has an odor attracting flies. There have been instances whreo these flies have
deposited their eggs in the nostrils of people asleep and where subsequently
doctors have removed as many as 150 of the maggots from the nasal passage of
such persons. The danger is that the larvoa may enter the antrum or sinus and
cause the death of the person infected.


VITJL STATISTICS


It seems proper in the discussion of the activities of the various
arms of the health department that one should save the Bureau of Vital Statistics
to the last, a branch of the service whioh has been designated the bookkeeping
of life and death. Accurate records are necessary. Tho Health Officer of a
state, who is the executive directing the work of all in the organization, makes
constant use of vital statistics data. Inasmuch as complete morbidity cannot be
obtained, one has to plan the control activities on the basis of deaths reported
of proventablo sickness. There are too nany ranificatiens in the Bureau of
Vital Statistics to attempt a full discussion in a report which, because of
economic necessity, must be brief.

The tables on population and rates are full of important facts.
These serve as a guide in a review of what-has been accomplished as well as in
planning the work for the ensuing year. Rather than attempt a further dis-
cussion I refer you to the narrative and tables of the Director of the Bureau.
We have in Florida one of the outstanding Bureaus of Vital Statistics in the
country. Health Officers should learn to make use of the material gathered
in planning the control program.




- 11 -


HEALTH OFFICER


Before closing I wish to report briefly on the affiliated activities
of the office of the State Health Officer. Owing to the prominence of the office
and technical knowledge and experienceiimplied, there are many calls for parti-
cipation in conferences of sociologic or welfare groups. There are many scien-
tific societies whose work has important bearing on the public health. The most
intimate is the relationship with the U. S. Public Health Service and among the
National organizations one has to participate in the meetings of the iAnerican
Public Health Association, the American Medical Association, the Southern Medical
Association, or the Public Health.Section of the Medical Associations, the
Southern Branch of the American Public Health Association, the National Malaria
Contmittoo and the Amorican Society of Tropical Medicine. During the year I
lectured to tho Reserve Officers Association on several occasions, also to classes
in sociology at Gainosville.

On February 5th and 6th the National Research Counoil met in Washing-
ton' for consideration of problems in Tropical Medicine. A1ll leading universities
having Departments of Tropical Medicine were invited to send representatives at
the expense of the Leonard Wood Memorial Institute I felt complimented to be
included and proud that Florida was the only state represented by the State Health
Officer. An Acadeti of Tropical Medibine was organized in which I had 'the honor
of being included as a charter member. 'It was at this meeting I had the privilege
of a coaforonce with Dr, Richard P. Strong which led to his coming to Florida to
address the Florida Public Health Association in December. His address dealt-
with various phases of tro'iceal diseases, and more particularly with"'Onihooerca.

In closing I wish again to refer to the per capital cost of the State
Board of Health to the people of the state. The estimated population is approxi-
mately 1,500,000. The Legislature of 1933 voted to re-establish the half mill tax
as a continuing levy for the operation and maintenance of the State Board of Health
but put a limitation of $179,600.00 the sum to be allowed as an annual expenditure.
On a per capital basis the State Board of Health is costing each*citizen, young or
old, 11.9 cents per year. Some cornunities having their own health department
spend additional amounts, e.g., Tampa, Miami, Jacksonville, Tallahassee, Pensa-
cola and a number of towns having part time health officers. In a public health
program it is generally considered that adequate health protection is not avail-
able for less than 50 cents per capital and in many communities $1.00 is considered
a proper outlay. In this state., nost of which must be served by the State Board
of Health, the por capital cost is low. We hope this will be adequately taken
care of in the development of the County Health Unit Program.

The State Hoalth Officer has served during the year as affiliate mem-
ber of the Public Health Cormittee of the State Planning Board. At a recent
meeting the committeee incorporated in its report a recommendation of a new build-
ing adequate in size and equipment to house the activities of the State Board of
Health. Such building would greatly add to ,the efficiency of the State Board of
Health.
Finally the State Health Officer wishes to express his appreciation
for the cooperation from.the staff, the President and Members of the State Board
of Health and the Governor.

Respectfully,
(Signed) Henry Hanson, M.D.
State Health Officer.






12 -



BURFAU OF 0C ICABLEDS DISpSES.

Personnel

F. A. Brink, M. D., Director
Myrtle MoLendon, Secretary
W AClaxton, M. D., Tuberculosis Clinician,

District Medical Officers

Thos. E. Morgan, M. District NQ. 1
Columbia, Baker, Nassau, Duval, Union, Bradford, Clay, St. Johns, Alachua,.,
Gilchrist, Putnam, Levy, Marion, Flagler.

C. W. McDonald, M. D. District No. 2
Volusia, Lake, Seminole, Orange, Oaceola, Brevard., Okeechobee, St. Lucie,
Indian River, Martin, Palm Beach. Browar4, Dade.

C. W._BeaNs, M. D. District No. 3
Pinellas, Hillsboro, Polk, Manatee, Hardee, DeSoto, Sarasota, Highlands,
Charlotte, Glades, Lee, Hendry, Collier, Monroe.

H. A. McClure, M. D District No. 4
Franklin, Liberty, Gadsdena Leon*, Wakulla, Jefferson, Madison, Taylor,
Hamilton, Lafayette, Dixie, Suwannee.

E. R. Marshburn, M. District No. 5
Eseambia*, Santa Rosa, Okeechobee, Walton, Holmes, Washington, Jackson,
Calhoun, Gulf.

L. H. Dame, M. D. (Special District) District No. 6
Citrus, Sumter, Hernando, Pasco.

Served by County Health Unit.
************

Dr. Morgan was on leave without pay from April slt to July 27th. During a part
of this time, beginning June let, Dr, W. H Y Smith performed the duties of the
medical officer in District No. 1. From July 27th to September i5th' when he re-
signed to accept a position with the Alabama Health Department, he did special
work in mosquito and dengue control,

"Di. Pease was on leave without pay from August llth to September 7th.

Dr. )arshburn's health became so poor in February that he was unable to work
after the 18th and on March 24th he died.

Dr. McDonald was transferred to District No. 5 in Maroh. Since this time Dr.
Claxton has spent a portion of his time in District No, 2 loo1iag.,after the com-
municable disease investigations and holding immunization clinics. The Director
has also made several trips into this district for special investigations.







- 13 -


The tuberculosis program was continued by Dr. Claxton in cooperation with the
Florida Tuberculosis & Health Association and assisted by the State Board of
Health, FERA and local public health nurses.

The number of tuberculin tests was limited because of the lack of the means to
follow up with X-ray examination. The Mantoux skin .test is advised for school
and other children who have been exposed. The reactors should have an X-ray
of the chest, physical examination, medical supervision and suitable preven-
tive care.

The consultation service rendered to a number of physicians and their patients
was well received and helpful. In the diagnosis of doubtful cases and checking
the progress of others lay its chief value. The interest of the profession and
the public in early diagnosis, proper care and hospitalization and in prevention
was stimulated. A number of physicians took advantage of the opportunity to
improve their diagnostic technique. A number of patients from the north who had
come to Florida on the advice of their physicians were seen and found to be mak-
ing satisfactory progress.

During the year 61 clinics were held, 790 persons were given chest examinations
and 137 were found with tuberculosis. About one-half of these wore suitable for
sanitarium treatment. Many were struggling along to keep their disease under
control and could be helped or cured in a sanitarium. There were many patients
with cough and sputum who had never had a laboratory test and whose tuberculosis
could be thus diagnosed. The use of the laboratory is strongly advised for such
whose condition for any reason cannot be determined by physical examination.

Assistance and encouragement was given county officials to provide hospital
beds for patients. Volusia county extended its facilities and Escambia county,
at the close of the year, was rebuilding on the old State Board of Health de-
tention hospital property which had been leased. A twenty-bed hospital is
being erected.

Construction of a State Hospital Unit, as authorized by the 1927 legislature,
was promoted and some encouragement was seen in the appointment by the Governor
of a State Sanitarium Board.

From August 22nd tb September 26th, Dr. Claxton was busy in Key West assisting
the FERA in planning for medical and dental care and in the equipment of a
twelve-bed hospital.

From December 17th to the end of the year, Dr. Claxton was on sick leave.


COMMQNICABLE DISEASE INVESTIGATIONS

In the management of c~hmunicable disease cases the cooperation of the attending
physicians has been good, as usual. There are many cases of infectious disease
that cannot be seen by any health official. In most instances the precautionary
measures are directed in a satisfactory manner by the family doctor, However,
more than 900 communicable disease cases were investigated by the members of the
staff. Usually the patients are seen with the attending physician or after he
had been consulted.







- 14 -


In the discussion of specific diseases reference will be made to their inci-
dence and to investigations of special interest.

TYPHOID: The number of cases reported was fewer even than in 1933 and the
number of deaths provisionally reported w4aalso much lower than for the pre-
vious year. Eight cases in scattered sections of the state were referable to
a hotel and these were thought to be due to the use of raw oysters from un-
approved and contaminated waters. Throd other oases were reported as probably
due to oysters from condemned beds.

At Madison and Eustis there were small outbreaks of typhoid in the colored
sections evidently related to open privies, careless disposal of discharges,
flies and crowded living conditions.

bIPHTHERIA: Although the number of children given alum precipitated toxoid by
the District Medical Officers was slightly higher than in previous years, more
than the usual number of these were under school age and many doses were given
by practicing physicians assisted by FERA nurses, still the number of diph-
theria cases and deaths was notably higher than in 1933. The cause of this
increase is not easy to determine. Such an increase without evident reason is
not uncommon. Among the probable causes may be mentioned delay in calling a
doctor, increased exposure, delay in procuring and administering antitoxin.
All these causes might result from poverty.

SMALLPGX: There was no case of smallpox in which the diagnosis was substanti-
ated until just at the close of the year, a colored fugitive, returning to
DeFuniak Springs from parts unknown, developed an attack that was confirmed by
the District Medical Officer. As in previous years, a number of suspected
cases were reported but they were finally diagnosed as chickenpox, syphilis or
some skin disease.

DENGUE itFEVR: Dengue was reported by Dr. G. N. MacDonell, City Health Officer
of Miami, late in July. On the 28th, in company with Dr. T.H.D. Grtffitts of
the U. S. Public Health Service, an investigation was made by the Bureau Dir-
ector, In company with Dr. MacDonell a number of patients were seen and
abundant breeding of Aedes aegypti observed in the colored section. The
energies of the Bureau were immediately directed toward control measures.
Bulletins were sent to physicians, health officers and public health nurses de-
scribing the disease, urging prompt reporting of cases and describing the breed-
ing habits and measures for the control of the dengue carrying mosquito, Aedes
aegypti. Numerous inspections were made. In nearly every town visited larva,
pupa and adults were collected, demonstrated and displayed. Conferences with
officials and citizens were hold, information and advice was furnished through
the papers.

Numerous cases of dengue were reported in Ft. Lauderdale, Jacksonville, Orlando
and Tampa. Scattered cases were reported from other sections, principally in
South Florida. The epidemic reached its height in August and then subsided
steadily.

DENGUE CASES REPORTED, 1934

July 199 September 459 November 51
August 899 October 390 December 7






- 15 -


In cities and towns where dengue cases were reported the control measures were
very effective. The unusual cold snap in December seems to have completed the
success of the campaign.

INFANTILE PARALYSIS: Only sixteen cases of infantile paralysis were reported.
Five of these occurred at Green Cove Springs during the first half of June and
in but one of these was there definite paralysis.

MEASLES: There was a widespread epidemic of measles which began in January,
reached its peak in April and subsided by the end of June, though some cases
were reported throughout the year. A total of 8,115 cases were reported. This
is but a fraction of all that actually occurred.

MALARIA: The malaria control activities of this bureau consist largely of
education which is brought about by the distribution of bulletins, talks in the
schools by personal interview.

Cooperating in the malaria control studies many blood specimens were collected
for laboratory examination to determine the prevalence of malaria in certain
counties.

LEPROSY: The Director, with Dr. F. A. Johansen of the National Leprosarium,
made a trip to investigate certain patients reported to have leprosyA Two of
the patients were found to have skin diseases, not leprosy. Two cases were
seen with the disease in an active stage but probably non-communicable and two
other patients were taken to Carville by Dr. Johansen.

HOOKWORM: Hookworm treatments have been given by the District Medical Officers
to quite a number of patients with the approval of local physicians. We adhere
to the policy, however, that treatment is a function of the practicing physician.

AMOEBIC DYSENTERY: During 1934 twenty-four cases of amoebic dysentery were re-
ported. Seventeen of these occurred at the Florida State Hospital. Upon in-
vestigation it was found that seven were white female patients, four were white
male patients, four were colored patients, two male and two female, and two
were employees. The study was made with the cooperation of Mr. Lenert. The
evidence indicated that the infection was spread by contact with "untidy pati-
ents". The crowded condition of the institution is believed to be a factor. No
evidence was found suggesting contamination of food or the water supply.

In a number of counties the Home Demonstration Agents-have been assisted in the
annual health contest by the District Medical Officers. The Director examined
the contestants at the State Contest in Tallahassee.

In the control of preventable diseases the cooperation of the FERA nurses has
been very helpful in the following ways:

(1) Collection of hookworm specimens, arranging for treatment and promoting
sanitation as a preventive measure. (2) Encouraging parents and guardians to
take pre-school children to practicing physicians or clinics for alum pre-
cipitated toxoid treatment to prevent diphtheria, for smallpox vaccination and
for typhoid immunization. (3) Teaching and demonstrating the technique of








- 16 -


communicable disease isolation. (4) Finding tuberculosis suspects and con-
tacts and getting them to the clinics or local doctors for examination.

Supervision of the County Health Units by the Bureau Director has been con-
tinued. Reports from the two unit directors will follow.

Only one major bureau activity was curtailed during the year, viz, examination
of school children. This is due in part to the increase of other work and in
part to the activities of the FERA nurses who have mado a great many "inspec-
tions" of school children.

All the staff members and county health officers attended the meeting of the
Florida Medical Association and the Florida Public Health Association. All
reported that they felt these meetings very helpful to them in their work.

Inspection of Child Caring Institutions for certification to the Board of Pub-
lic Welfare,was continued and twenty-four of these places were visited. The
aim, as usual, has been to raise the standard of housing, diet, medical care
and personal hygiene for the children. Many of these places have been improved
following our suggestions. Others are so poorly financed and operated so badly
that the approval of the State Board of Health has been withheld.

The motion picture educational service has been furnished only on special in-
vitation to schools and C. C. 0. Camps. This work was curtailed because of
the limited resources for salary, travel expenses and much needed films. The
ones how in use are worn and brittle.

The immunization work done by the District Medical Officers was equal in vol-
ume to that of previous years. The demand for vaccines to be used by local
physicians was greater than usual and the budget item for the purchase of
biologics was nearly all expended during the first half of the fiscal year.

For the free treatment of indigent syphilitics, 1-,050 doses of neoarsphenamine
were distributed to physicians.

Dried brewers yeast was furnished for the treatment of pellagra. 1,225 two-
pound packages were purchased and sent out.

It is obviously impossible for the District Medical Officors to give adequate
service in every county and community. The districts are entirely too large.
The time that can be spent in any locality is so short and the visits so in-
frequent that the full benefits of the educational, communicable disease con-
trol and health promotion program cannot be realized. There is a dire need for
funds to be used in placing in the field additional physicians with adequate
training and good personality. A further reduction in the number of cases and
deaths from preventable diseases can be definitely assured with additional
health officers.

The development of full time local city and county health service, financed and
directed in accordance with the health unit law enacted June 4, 1931, would
afford excellent local health service and relieve the field medical officers
from duty in areas so protected, They could then serve the remainder of their
districts more adequately.







17 -




It is our constant aim to preserve a wholesome relationship between physicians
and their clientele to promote the interests of both by encouraging people
to seek the family doctor for advice on all matters pertaining to health and
the prevention as well.as the cure- of sickness.

Much can be learned regarding the nature and volume of work done by the staff
by a study of the following tables.







- 18 -


Table No. 1


Summary of Activities during 1931, 1932, 1933, 1934

1931 1932 1933 1934

Interviews & Conferences 6397 7746 5279 5917

Public Addresses 691 821 698 914

Newspaper Articles 198 169 117 89

Schools Visited 2140 2809 1924 2291

Clinics Attended 1809 2698 1611 2390

Persons Examined 6703 10769 6198 3743

C. D. Investigated 1017 1136 589 908

Cases Isolated or Excluded 659 572 253 514

Houses Placarded 293 73 31 75

Smallpox Vaccinations 11276 17325 10804 16973

Typhoid Inoculations 55409 94160 62468 62282

Schick Tests 19889 21000 13792 21370

T.A. and/or Toxoid 23865 21439 10311 10349

Throat Swabs 4598 2605 417 1604

Other Specimens 2789 2948 550 487

Tuberculin Tests 2798 10769 4697 595

Malaria Shears 57 3146 683 8324

Hookworm Treatments 1144 2100 4329 1730







- 19 -


Table No. 2

Number of pamphlets distributed by the Bureau of Communicable Diseases
1931-1932-1933-1934

1931 1932 1933 1934

Manpower 758 248 737 334
Outdoing the Ostrich 399 124
Sex Education in the Home 210 287 747 313
Keeping Fit 390 393 523 381
The Girl's Part 388 389 100
Healthy Happy Womanhood 283 381 720 1146
Sex Education in the Schools 234 305 416 287
Wonderful Story of Life for Boys 21 28
Wonderful Story of Life for Girls 21 28
Syphilis Information 165 440 65
Gonorrhea Information 165 80 65
Social Hygiene Outline 650 150

Tuberculosis 3850 1895 1120 2918
Typhoid 1879 341 25
Malaria 4921 2440 10132 5383
Hookworm 11263 8675 13977 11058
Pellagra 389 455 800 312
Whooping Cough 285 120 51
Diphtheria 3739 2585 2673 762
Sore Eyes 1149 250 106 212
Smallpox 2874 1730 639 317
What To Do When 4384 4235 1615 3377
Influenza 440 155 245 210
Fly 500 337 384
Rabies 50 10
Mosquito Control 100 677 712
Privy 186 417
Communicable Disease Placards 245 300






- 20 -


Table No. 3

Number of cases of certain communicable diseases reported to the State Bpard
of Health during 1931-1932-1933-1934.


1931 1932 1933 1934

Typhoid 183 266 183 129

Typhus 31 42 54 35

Malaria 339 518 1011 1106

Smallpox 27 S3 1 3

Measles 3779 217 1048 8115

Scarlet Fever 266 235 203 190

Diphtheria 501 735 452 491

Influenza 1543 335 1267 65

Poliamyelitis 17 8 7 16

Encephalitis 1 1 2 5

Tuberculosis 511 591 661 605

Syphilis 3965 4063 4833 5198

Gonorrhea 714 713 616 702

Pellagra 64 60 73 151

Undulant 3 2 6 8

Tularemia 2 2 1 1








- 21 -


COUNTY HEALTH UNITS

U. S. Public Health Service
Rockefeller Foundation
State Board of Health
Cooperating


ESCAMBIA COUNTY HEALTH UNIT
W. A. McPhaul, M. D., Director

In presenting this, our annual report for 1934, it is gratifying to note that
there was.not a death from typhoid fever. Only seven cases were reported,
three of these being doubtful diagnosis.

The control of typhoid fever in Escambia county resulted, we believe, from the
elimination of "bootleg" oysters taken from polluted waters; the safeguarding
of the milk supply; the elimination of the filthy, disease producing open sur-
face privy. Many inoculations were given. The elimination of the "bootleg"
oyster was brought about by the adoption and enforcement of a suitable ordi-
nance prohibiting their removal from polluted waters or the peddling of oysters
from any source whatsoever.

To protect the milk supply, the standard milk ordinance recommended by the
U. S. Public Health Service was adopted and constant supervision was exercised
to prevent any milk of unsafe quality being offered for sale. Whole hearted
cooperation from most of the dairymen was secured.

Our hardest problem Was to eliminate the surface toilet. This work has been
very much hindered on account of the depression. They are not yet entirely
eliminated but the campaign will continue until the last one has been destroyed.
A suitable ordinance was enacted to help in this undertaking. We tried to im-
press the owners with the necessity of eliminating these privies. Our ordi-
nance could compel the owners to comply with its provision but unless he knew
why they should be eliminated, we felt that our work was only partially done.
We tried to teach the reason why he was compelled to make them sanitary.

Health Conferences

Prenatal conferences have been held weekly, many expectant mothers have been
examined and kept under constant supervision until after the baby came. Num-
bers of babies were born healthy that would have been born dead but for the
follow up work and medical care during the prenatal period.

A venereal clinic was conducted once a week for the examination and treatment
of indigent venereal patients. Curative and prophylactic methods were used.
Several prenatal cases were treated in this clinic.

The midwives of the county were brought together several times during the year
and were given instructions at these meetings in the "art of midwifery", the
care of the mother before, during and after confinement being duly stressed.
The care of the new born infant was greatly emphasized, cleanliness being the
watchword of instruction through these various conferences.







- 22 -


A BRIEF SUMMARY OF WORK DONE BY OUR THREE PUBLIC HEALTH NURSES

The field of public health nursing is a varied one. For instance, 533 school
visits were made and a total of 18,553 school children were examined as to
cleanliness, skin infections, abnormal conditions of the eyes, ears, nose and
throat, communicable diseases and any other noticeable defects. Of the chil-
dren examined, 360 were excluded from school due to some infectious or con-
tagious condition, and 1,199 follow up visits were made to homes for consulta-
tions with parents. The nurses aided in securing 11 pairs of glasses for
children with defective vision, and 55 tonsil and adenoid operations were done.
Many other corrections were made by families financially able to pay.

Eight children suffering with physical handicaps were examined by Dr. Fort in
his clinic for crippled children in November. One child received treatment
and hospitalization in Jacksonville under the direct care of Dr. Fort. The
condition is very much improved due to the operation performed. X-ray pic-
tures of three clients were secured.

Hookworm infection presents a real problem. 2,326 specimens were collected
for examination and 1,117 treatments were given by the nurses under the super-
vision of a doctor.

The nurses assist the city doctor in the prenatal and venereal clinics 226
prenatal visits were made in the homes.

A total of 991 visits were made to the homes of sick patients and surgical
dressings were done on 97 cases. 265 visits were made to tubercular patients
in order that they might receive proper nursing and medical care, and to in-
struct them in proper sanitary precautions that they might protect not only
themselves but their families and the members of their communities.

Frequent talks were made to different Parent-Teacher Associations; quarantine
signs were placed and removed; cultures of throats were taken at the request
of attending physicians; immunizations against diphtheria, smallpox and
typhoid fever were given and assisted with; demonstrations of the proper care
of the sick and of the new born and mother were made; 42 patients who had no
means of transportation were taken to a physician's office. One home hygiene
class with an enrollment of 20 young girls was conducted over a period of six
weeks. Assisted the Kiwanis Club in compiling a list of the under-privileged
children in school who needed milk.

FERA Nurses

I desire to call special attention to the nursing service rendered by our FERA
nursing staff under the supervision of the Unit. They go into the most humble
home and minister to the sick and afflicted in the very best manner possible.
No family who needs the service of these nurses is neglected. During these
visits in giving bedside care they teach prevention, home hygiene and home nur-
sing.








- 23 -


The Escambia Tuberculosis Sanatorium now under construction is located about
two miles northwest of the City of Pensacola. It will provide accommodations
for about twenty-two patients, will be modern in every respect and will be
operated in connection with the Escambia County Health Unit until suitable
legislation is enacted providing for the operation. A full staff of trained
tuberculosis nurses will operate this institution under the direction of a com-
petent physician. This institution will be the means of reducing the incidence
of tuberculosis in this county.

CONCLUSION

It is difficult to evaluate accurately the benefits which accrue from the ser-
vices of an organization of this sort. You can point with pride to the decline
in the death rate from typhoid fever and other communicable diseases, or a
lower death rate as a whole. But perhaps the greatest accomplishment is that
of the awakening of a health consciousness among the people of the county. This
was done through health education among the masses, actual demonstrations in
the public schools, children were weighed and measured, nutritional classes
organized. Contacts were made with parents of children who needed correction
of defects; hookworm treatments were given, diseased tonsils were removed,
glasses were fitted in selected cases, personal hygiene was strongly emphasized.

It is gratifying to know that in spite of difficulties and misunderstandings at
the beginning, we now have the whole hearted support of the general public.
They want and will demand adequate health protection.




LEON COUNTY HEALTH UNIT
L. J. Graves, M. D., Director

Most of the immunization was done during February, March and April. Clinics
were held at practically every school in the county, both white and colored.
The adults were urged to come to those clinics for the typhoid inoculation and
to bring the preschool children for the toxoid. We had fairly good response
this year; 2,507 complete typhoid inoculations; 1,475 preventative treatments
against diphtheria and 318 smallpox vaccinations were given; also 1,132 Schick
tests made.

During the summer months we made special efforts to get as many preschool chil-
dren immunized against diphtheria as possible.

The dairymen are required to take the typhoid inoculation before they are given
health certificates.

SCHOOL WORK

The physical examinations of school children were begun as soon as the schools
opened in the fall, and were practically finished by the end of the year. These
examinations are made only in the white schools.








- 24 -


Last January we met with the dentists and a plan was worked out whereby each
dentist gave one hour each week to dental work for school children whose par-
ents were unable to pay. The Kiwanis Club bought filling material for the
dentists, also 100 tooth brushes.

The Kiwanis and Lion Clubs and some individuals paid for glasses for indigent
children with defective vision. These children were sent to eye specialists
who made the examinations gratis, and furnished the glasses at cost. The
Kiwanis Club also sponsored tonsil clinics, paying the hospital fee, the phy-
sicians giving their services.

Since most of the defects found among school children include defective teeth,
defective vision or diseased tonsils it will be seen from the above that the
indigent children have received an unusual amount of attention; and we wish to
acknowledge the excellent cooperation of the Civic Clubs, Dentists, Physicians
and others for the services they have rendered.

Those children whose parents are able to pay have responded in getting the cor-
rections made. As a result comparatively few children are found now in the
schools with these defects uncorrected. Among the 2,257 white school children
examined we have 236 listed with defective teeth, temporary teeth not included.
63 had defective vision and several of these have been sent to specialists
since our examination and have been fitted with glasses. There were only 34
with 3-X tonsils.

Near the end of the last school year Health Certificates were given to each
student that had met certain requirements. This necessitated the rechecking of
a large number of students by me to ascertain if they had had defects corrected
after they were examined. At each white school in the county a Health Day
Program was arranged at the time the Health Certificates were awarded. At most
of the schools short talks on health were made. The County Superintendent of
Education attended most of these meetings and made a talk. He frequently com-
mented on the improved physical appearance of the children and told how much
better the attendance was now as compared to a few years ago. The teachers
manifested much interest in the health program and cooperated in every way
possible.

In our examinations those children suspected of having hookworm disease were
given containers for specimens. The parents are in most instances anxious to
have their children treated when necessary; but it is hard to persuade many of
them to build sanitary toilets as a means of permanent relief.

The colored physicians examined a number of the colored school children and held
tonsil clinics, operating for the small fee of five dollars

VENERiEAL WORK

During the year 1,292 specimens of blood were taken for Kahn tests. The colored
people found positive were either sent for treatment to private physicians or
to the clinic at the A. & M. College Hospital. White indigent patients were
treated by the physicians with neoarsphenamine furnished by the State Board of
Health. Many blood tests were made on cooks, nurses and maids in private homes
at the request of the employers.







- 25 -


In the early spring several community meetings were held in the county for the
purpose of discussing the malaria problem, Dr. F. A. Brink, of the State Board
of Health, Dr. T. H. D. Griffitts of the U.,S. Public Health Service, and others
made the talks at these meetings.

CITY SANITARY INSPECTOR

The City Inspector has supervision over the House Inspectors and the crew with
the truck that is used for oiling and dusting. The dusting this year was ex-
tended to all anopheles breeding places within the three mile area. Drainage
ditches in the city have been kept open. Additional inspectors were added dur-
ing the summer to combat the threatened dengue epidemic.

During the year 148 permits for new sewer connections were issued 123 houses
within the sewer area remain to be connected. About 100 new pit toilets were
installed during the year in the city, leaving 125 more houses with open toilets
in the outlying sections.

481 inspections were made of dairies, and milk samples were taken periodically
throughout the year. Most of the dairies were operated in a satisfactory manner.

There has been a steady improvement in the meat markets; 261 inspections were
made. Regular inspections were made of all places handling oysters to see that
they complied with the City Regulations pnd that they handled oysters from
approved beds.

Approximately two miles of new city water mains were laid and chlorinated be-
fore placed in use.

The new Imhoff tank gave trouble for awhile odor and flies. Quite a little
time was devoted to getting these nuisances corrected. No complaints have
come to the Health Office now in several months.

COUNTY SAVITARY INSPECTOR

The County Sanitary Inspector devoted his time largely to rural sanitation.
During the year he installed 153 pit toilets, being more than one every two
working days. 16 septic tanks were installed and 22 rural homes screened.

He directed the maintenance work on several miles of ditches that were dug in
1933. County Prisoners provided the labor.

A complete survey of the sanitary conditions and water supplies of the rural
schools was made.

During the summer and fall all communities were visited and the people were urged
to destroy all breeding places for Aedes aegypti mosquitoes

COUNTY NURSE

The County Nurse assisted with examinations of all the school children. She
weighs, measures and tests vision and hearing. 1,245 inspections were made by
her for skin trouble, and to ascertain those who needed further medical or den-
tal care in order to receive their Health Certificate.







- 26 -


Thirteen nutritional classes were held wi-h a total attendance of 1,070.

The County Nurse assisted with all office work on Saturday mornings, also with
the Kiwanis Club Tonsil Clinics, dental clinics and orthopedic clinics.

The Civic Health Council sponsored a milk fund for the needy children in the
city schools, 110 pints of milk were supplied. The money was donated by the
various Civic and other organizations, Churches and individuals. The Council
also furnished 35 layettes.

Home visits to prenatals, infants and school children were made.

COUNTY COLORED NURSE

The colored nurse continued her class in home nursing and infant care, meeting
once a week. The midwives meet once a month for their class. She assisted for
three weeks in the Midwife Institutes held at St. Augustine and Tallahassee.

The nurse assisted the colored physicians in the examination of the school chil-
dren. In April she was transferred to tho FERA and this necessitated the making
of calls to morbidity cases in addition to her other work. There were eight or
ten active cases of tuberculosis that were visited regularly by her.

She has carried on a well rounded public health program making home visits in
the interest of prenatal cases, infant care, hookworm, pellagra, immunization,
school follow up work, etc.

Six mother's clubs were organized in the fall and others are contemplated in
the near future.

FERA WHITE NURSES

Most of their time has been required in making calls to morbidity cases.







-27-


January 1, 1935.

Dr. Henry Hanson
State Health Officer,
State Board of Health
Jacksonville, Florida.

Sir:

I have the honor to submit herewith a tabular report of the work
done by the Laboratories of the Board of Health during the calendar year 1934.

Table I sets forth the gross amount of work done during the year
as well as the way in which it was partitioned among the various branches.

Table II showing the distribution of the work by months, indicates
peaks in March and October as in the previous year.

The gross figures indicate large increases in the numbers of
specimens examined for Intestinal Parasites, Malaria, Typhoid Fever and allied
conditions, Rabies, and Syphilis; and lesser increases in the case of Throat
conditions, Tuberculosis, and Gonorrhea. The gross number of procedures for
1934 was 341,486 as against 244,042 for 1933.

INTESTINAL PARASITES

The whole number of specimens examined for Intestinal Parasites in
1934 was 80,173. Since the total for 1933 was 48,254, it will be seen that
the increase was 64%. Much of this increase was due to the activities of the
Emergency Relief Administration. The proportion of specimens found to
contain parasites was 27%, a figure not significantly different from that
found in previous years.

THROAT AIND MIUTH CONDITIONS

There was a slight increase in the number of specimens examined
for Diphtheria and for Vincent's disease. In the case of the latter, there
was a slight drop in the proportion found positive.

MALARIA

The number of specimens examined for Malaria was more than double
that of the previous year with 10o positive as against 121% last year.
This increase is largely due to the assignment of Doctor T.H.D.Griffitts to
Florida by the United States Public Health Service. Our indebtedness to
Doctor Griffitts is by no means limited to this increase in volume of work.







-28-


SPECIAL 1WORK

The following is reprinted from the Journal of Parasitology, Volume
20, page 132, September 1934.

"PIIBPLASMA CAlIS Li FLORIDA"

"Through the courtesy of Dr. T. J. Mahaffy, of Jacksonville,
I have recently had the opportunity of studying the blood of a
dog which harbored Dirofilaria immitis. In addition to the
microfilariae, I found intra- and extra-corpuscular organisms
that were strange to me. These have been identified by Dr, Bruce
Mayne, of the United States Public Health Service, as Piroplasma
canis, a tick-borne Haemosporidian said to cause malignant
jaundice in dogs. This observation is of interest in view of the
remarkable increase in the prevalence of dog-ticks in Florida.
The literature available to me does not contain any previous record
of P. canis from this region.

Two points are of especial interest. (1) The piroplasma
disappeared from the blood, as did the microfilariae, after the
intravenous injection of a proprietary organic antimony preparation.
(2) The piroplasms showed an especial predilection for reticulocytes,
comparable to that which I have recently shown to characterize the
human malaria parasites, Plasmodium vivax and P. falciparum".

Paul Eaton
State Board of Health
Jacksonville, Florida

According to the Bureau of Animal Industry this is the first re-
ported finding of this parasite in the United States. The dog had never
been outside of the State of Florida.

TYPHUS COiTr)L "ORK

The Typhus Control work carried on co-operatively by the Emergency
Relief Administration and the United States Public Health Service did not
reveal the existence of any rodent carriers of Typhus Fever (Brill's disease)
but it did reveal the presence of 93 cases of rat leprosy among some ten or
twelve thousand rats trapped during the year.

TYEPDID FEVER

A considerable increase in the number of specimens examined for the
purpose of aiding physicians in establishing the presence or absence of
Typhoid Fever was accompanied by a fall in the proportion of positive
specimens. How much of this is due to technical short-coming (the use of
inappropriate test cultures, etc) is not clear, but an investigation of this
question is under way.

TUBERCULOSIS

An increase in the number of specimens submitted for this exam-
ination brought little change in the proportion of positives.







-49-


GONORMiEA

Very little change is to be noted either in the number of
specimens submitted or the proportion of positives.
SYPHILIS

The increase in the number of specimens submitted for the Kahn test
(35%) was largely due to the activities of the Emergency Relief Administration,
much of it, I regret to say, useless. The proportion found positive (17%) is
slightly less than last year owing to the submission of samples from many who
needed no such examination (food handlers, cannery workers, etc).
RABIES

The improvement noted last year did not carry over into 1934. The
number of animals found to have been rabid, increased from 20 in 1933 to 48 in
1934.

BIOIDGICAIS

Table III shows the distribution of Biologicals.


During a part of the year the Clerical Staff has been very
acceptably augmented through the Emergency Relief Administration otherwise we
would not have been able to carry on.
Respectfully submitted,

(Signed) Paul Eaton
Director of Laboratories








-30-


CENTRAL:
Jacks


TABLE I


EXAMINATIONS MADE IN THE LABORATORIES DURING THE YEAR 1934


LABORATORY EXAMINATIONS

DIAGNOSTIC MILK AND WATER TOTAL


sonville, Fla. 190,440 3544 193,984


BRANOIES:
Tampa, Florida.


Pensacola, Fla.


Miami, Florida.


Tallahassee, Fla.


TOTAL


65,817


13,859


41,528


10,162


521,606


4860


2169


8415


892


70,677


16,028


49,743


11,054


541,486


19,880


I









-31-


TABLE II

TOTAL NUMBER OF EXAMINATIONS MADE BY MONTHS DURING THE YEAR 1934


JACKSONVILLE


January

February

March

April

May

June

July

August

September

October

November

recemter


12685

14092

23244

18407

13838

12106

13786

16874

16896

23231

16897

11928


TAMPA PENSACOLA

6515 930

5018 1191

5856 1302

5784 1253

5812 1441

4183 1928

4976 1467

5636 1546

5529 1040

7385 1596

7970 1575

6013 759


MIAMI

5758

4927

4183

3868

3748

3314

3339

2742

2919

5769

4437

4719


TALLAHASSEE

961

696

820

947

970

910

1016

1341

773

1226

860

534


70677 16028 49743


TOTAL


26849

25944

35405

30259

25809

22441

24584

28139

27157

39207

31739

23953


TOTAL 195984


11054 341-486






-32- 1934
CENTRAL LABORATORY
Jatksonville, Florida.
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Total
ANIMAL PARASITES
HOOKWORM: Pos. 940 11.27 4946 3401 1098 757 817 1176 1013 1559 1411 829 19074
Neg. 2039 25,, 6314 3557 2157 1196 1234 1801 1609 3613 3463 1870 31439
Unsat. 49 42 131 73 38 7 6 6 30 62 83 42 569
ASCARIS 43 61 137 67 74 44 50 40 9 25 19 20 589
0QYUIIS 2 4 18 16 16 12 9 7 4 15 15 6 124
STRONGYLOIDES 3 19 21 32 21 9 22 14 10 16 14 5 186
TAPEWORM 8 14 31 20 8 7 12 13 7 6 18 4 148
TRICEIURIS 4 2 8 3 13 10 9 2 1 1 53
THROAT CULLTUR"ES
DIPTHLER'I4 -Pos3 24 17 11 14 6 19 11 14 23 15 45 25 2 24
Neg 756 1080 580 572 464 459 833 665 939 1522 2020 1107 10995
Unsat 9 2 11
VINCENT AIJ- NA


Fos. 4
Neg. 70
STREPTOCOCCUS
po0. a
Neg, 11
MALARIA:


18 24
62 104


4 5
3


135
665

55
60


4
3 4


Pos. 84 178 266 80 66 96 121 271 325 424 132 61 2104
Neg. 1140 2245 3139 1909 1177 1236 1720 2968 3182 2413 860 591 22580
Unsat. 1 1 2
AGGLUTINATION TESTS
TYPHOID: Pos. 9 2 3 2 6 1 3 1 6 33
Neg. 654 453 717 866 910 1101 1175 1399 1366 1516 907 644 11708
Partial 3 1 1 1 4 2 2 2 16
Unsat. 3 3


PARA TYPHOID A:
Neg. 64
PARA TYPHOID B:
Pos.
Neg. 64
'EIL FELIX: Pos. 2
Neg. 62
BRUCELLA ABORTUS
Pos.
Neg. 40
Unsat..


44 72 83 83 73 116 142 114 145 100


44 72 83
3
44 72 80


2
34 60


73 116 142 114 144 100
3 4 3 5 2
73 113 138 111 140 98


3
54 49


3
48 91 110


92 1128

1
92 1127
27
92 1101


9
42 49 742


Grand
Total









52182



11230


800


24686


11760

1128


1128

1128





1934
CENTRALL IABORATORY-cont.
Jacksonville, Florida
Jan Feb Mar Apr May June July Aug Sept Cct Nov Dec


Total Total


BRTCELA ABOTUS
( Contirnued)
Unsat
TULAREMIA: Neg. 13
SPOTTED FEVER:
Neg.
TYPHOID CULTURES
Blood: Pos. 2
Neg. 1
Urine & Stool:
Pos. 2
Neg. 12
TUBERCULOSIS
Microscopic:


2 1
8 11 15 15 10 21 31 22 30


2 6


15 25


1 3 1


9 21 20 16 18 36 26 35 58 14 23


Pos. 42 23 36 58 47
Neg. 205 199 270 294 309
Unsat. 5 1 1 2. 1
Animal Iroculations 6 5 7 2 5
OPHTHALMIA: Pos. 2 1 1 3
Neg. 2 8 12 7 8
GONORhHEA: Pos. 161 147 170 150 174
Nrg. 571 577 637 634 688
Unsat. 5 1 1 2 3


SJYPRHI~S
Kahn:



RABIES
rog:


Cat :

Cow:


Pos. 879 672 712 902 773
Neg. 3977 3568 4022 4559 4511
Partial 171 250 161 197 207
Unsat. 2P4 160 199 206 249


Pos.
Neg.
Unpat,
Pos,
Neg.
pos.
Neg.


6
6 2


8 1 4 3 1

1


50 35 36 41 25
236 282 256 197 326
2 1 1
10 6 6 5 7
4 1
10 18 12 12 14
146 149 186 160 145
652 667 662 772 825
7 4 8 9 5

788 880 858 678 905
4109 4185 4749 4974 7911
204 227 2a90 219 370
309 461 359 323 427


6 4
8 11 11
I 3
1 1
3 2 3
1


37 42
243 199

5 14

11 6
155 156
629 607
3 2

536 608
5058 3850
284 258
208 195


2 1


3
216


754
216


288


472
3016
14
78
12
120
1899
7921
44

9191
55473
2838
8320


290




3502
78

132


9864




70822









1934
CENTRAL LABORATORY-cont.
Jacksonville, Florida Grand
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Total Total


RABIES (Cont.)
Hog: Pos.
Neg.
Horse: Neg.
Human: Neg.
Mink: Neg.
Mule: Neg.
Rabbit: Neg.
Rat: Neg.
Skunk: Neg.
Squirrel: Neg.
RAT LEPROSY:
?os.
Neg.

MIIK:
ICE CREAM:
MISCELLANEOUS:


S1
1 2


3 10
4


273 337 260 331 384
1 1 2 2 1
29 39 24 24 21


208 204 357 362 299 252 226
3 14 7 8 6 6
19 34 21 21 21 17 29


3493
51
299


12685 14092 25244 18407 13838 12106 13786 16874 16896 23231 16897 11928 193984 193984


-34-


171


126


3493
51
299


TOTAL:






-35-
Jan Feb Mar Apr May
ANIMAL PARASITES
HOKIORM: pos. 290 273 378 395 323
Neg. 1162 1169 1536 1127 1306
Unsat. 1 1
ASCARIS 112 140 56 49 62
OXYURIS 6 9 8 10 5
STRONGYLOIDES 1
TAPE ORMi 5 2 3
TRICHIURIS 91 116 49 41 88
THROAT CULTURES
DIPHFTHERIA:.os 62 53 22 15 15
Neg 552 328 230 351 168
Unsat 1 1 4
VIfCENT AIGINA
Pos. 11 22 31 20 22
Neg. 29 42 69 51 54
STREPTOCOCCUS


Pos.
Neg.


7 2


7 3


MALARIA: Pos- 26 13 19 14 38
Neg. 187 168 198 222 304
Unsat.
AGGLUTINATION TESTS
TYPHOID: Pos. 4 1 1 1
Neg. 176 147 176 204 260
Partial 9 6 13 9 28
PARA TYPHOID A


Neg.
Partial
PARA TYPHOID B
Neg.
Partial
WEIL FEIX-:Pos
Neg
Partial
Unsat.


1 5 10


1934
TAMPA LABORATORY
June July Aug

176 258 487
422 552 970
3
37 33 78
1 3 7


1
28 39


31 28 52
208 184 370
5 1


Scpt Oct Nov Iec

241 514 440 450
715 1725 1793 1078
1I
38 63 146 69
1 7 21 20
1 2 2C
1 3 8 10
24 43 178 184

51 74 90 57
221 361 848 438
2 2


Grand
Total Total


4225
13555
6
883
98
25
35
903

550
4259
16


236
551


5 1

49 6C 82
396 347 356
1

2 6 4
252 248 250
15 15 15

9 2 9


2 5 8 8 2 9


1
4 5- 3


2 1
3
3 6


4 8 5 5
I
71 72 66 32
338 334 249 188


2 1
266 138
3 7


45
1
542
3287
1

27
2266
146


7 2 3 1


2 3 1 47
4
5 1 23
7 8 4 73
2 1 2 6
i


19730



4825


3830



2439







-36-


BRUCELLA. ABORTUS
PoS.
Neg.
TULAR MIA:Neg.
TYPHOID CULTURES
Blood: Pos.
Neg.
Unsat.
Urine & Stool:
PoS.
Neg.
Unsat.
TUBERCULOSIS:
Microscopic:
Pos.
Neg.
Unsat.
OPHTHATI/A: Pos.


Neg. 10
GONORRHEA: Pos. 54
Neg. 192
Unsat.


SYPHILIS
Kahn:



RABIES
Dog:


Pos.
Neg.
Partial
Unsat.

Pos.
Neg.
Unsat.


Cat: Neg.
WATER:
MILK:
ICE CREAM:
MISCELLANEOUS:


244
2322
192
94


1934
TAMPA LABORATORY-cont.
Jan Feb Mar Apr May June July Aug


2. 5
I


29 22 7 5 7


.6 11 31
16 103 .127
2 4


21 6
60 64
129 219
3


182
1479
156
50


18 24
65 93
251 259
1


175 176
1828 1860
152 187
49 101


197
1685
176
76


3 1 1 1 2


78
402
31
12


44
241
36
10


70 32
320 342
28 35
12 13


57
312
35
11


Sept Oct Nov Dec Total


6 3 5 1
1


8 19 14 17
S


8 12
86 100

2 1
20 19
79 52
199 230
1 1

164 205
1269 1782
127 120
59 92


2 6


53 49
342 370
30 53
9 6


40
136
1
3
10
59
229
5

199
1510
157
76


19 10 8 165
5


19 40
87 150
1 1

12 17
90 70
253 249
3

183 244
2059 2475
131 205
144 124


3


16 25
138 132
1
2 6
10 8
61 69
195 192
1


186
2644
198
96


2


50 64 47 46
290 358 278 308
32 37 35 32
6 3 7 15


131
2067
179
148


30
262
31
14


5812 4183 4976 5636 5529 7385 7970


6013 70677


Grand
Total


172




1641

189


3428




28335


292
1339
10
14
175
816
2597
15

2266
22980
1980
1109


I
620
3825
415
118


26
620
3825
415
118


TOTAL 6515 5018 5856 5784





1954
SPENk3ACOLA LABORATORY


Jan Feb Mar Apr May Yune July


ANIMAL PARASITES
HOOKWORM:Pos.
Neg.
Unsat.
ASCARIS
CKYURIS
STRTOGYILO IDES
TAPE'ORPd:
TRICHIURIS
THROAT CULT--RES
DIPHITiELIiA:
Pos.
Neg.
Unsat.
VTTCENT E LTCi k I,
?os.
Neg.
ST0EOCOCCUSTJ
Pos.
Neg.
MAJARIA: Poas
Neg.
Unesat.
AGGLUTINATIOTn TESTS
TYPHOID: Pos.
Peg.
Partial
Unsct.
PARA TYPHOID A:
Pos.
Neg.
Part ial
PARA TYPH010 B:
Neg~
Partial
WIL FELIX:
Neg.
Partial


217 223 358 270
267 345 332 226
6
5 9 6 2
1 3 1


3 7
I


a12 16
12 16


1
20 29 51


1
14 20 25
1


1: 1


1


151
184
4
4


120
196
2
1


Aug Sept


51 136
226 148


1
18 2 5
2


Oct Nov Dec Total


154
240
1
3
2


12 5 10


4
28


5
17


1
9
100


41 56
4
1


1953
2553
17
53
11
1
75
5


28
266
9

104
193

2
17
79
678
5

4
503
8
1


3
77 66 57 60 47


-37-


303


1 1
4 27 59 74 65 52 59 50 29 421
1 1


4 25
2


1 2 1 3 23 56
-~1


74 65 51 60 50 26
3


55 58
2


50 29 415
5


Grand
Total









4668







-38-

BRUCELLA ABORTUS
Neg.
TYPHOID CULTURES
Stool & Urine:


1934
PENSACOLA LABORATORY-cont.
Jan Feb Mar Apr May June July Aug Sept eat Nov Dec Total

S7 2


Neg. 6
TUBERCULOSIS:Pos. 8
Neg. 11
Unsat.
OPRTHJIliIA: Pos.
Neg.
GONORRMEk: Pos. 11
Ieg. 39
Unsat. 1


SYPHILIS
Kaahn:


WATER:
MILK:
ICE CREL.:
MISCEILAN


Pos. 74 51 42 76 59
Neg. 177 170 222 276 336
Partial 7 9 4 16 23
Unsat. 9 4 3 10 22
5 32 36
9 197 109 66 329
2 1 2
EOUS: 20 3 60 1


92 67 77
370 291 362
23 24 24
40 30 20

570 190 180

1 3 1

1928 1467 1546


113 155 123 50
132 372 497 199
10 7 9 5
17 20 30 21
2 24 14 8
120 91 69 102


49
315


2
7
183
588
6

979
3404
161
226
121
2032
16
93


Grand
Total

2


366

9


777




4770
121
2032
16
93


TOTAL 930 1191 1302 1253 1441


1040 1596 1575 759 16028 16028






-39-


1934
TALLAHASSEE LABORATORY
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Total


ANIMAL PARASITES
HOOKNORM:Pos.
Neg.
Unsat.
ASCARIS
OXYURIS
TAPE'TORM
TRICHIURIS
THROAT CULTURES
DIPHTHERIA:
Pos.
Neg.
VINCENT AITMINA
Pos.
Neg.
STREPTOCOCCUS
Pos.
Neg.
MALARIA: Pos.
Neg.
Unsat.
AGGIDTUINATION TESTS
TYPHOID: Pos.
Neg.
PARA TYPHOID A
Neg.
PARA TYPHIOID B
Neg.
WEIL FELIX:
Neg.
BRUCELLA AMORTUS
Neg.
TYPHOID CULTURES
Blood: Neg.
Stool & Urine:
Pos.
Neg.


154
88


Grand
Total


5 55 42
03 35 165
S3
3 3 2


1227


18 37 36 22


14 15
124 121


5
9



32
169



14


1
9 32 17


2
12 16


247


168


48
120


2
45
184


1
18


46 36 63
220 241 254


1
18 32 46 33 20


2 1

2 1


1 1 2


52 102 55
189 253 191


1
29 35

3 2

3 2


4
507
2264
2


18
328


5


2773


346


4 5 4


8 1








-40-


1934
TALLAHASSEE LABORATORY-cont.


TUBERCULOSIS
Microscopic:Pos. 2
Neg. 17
Unsat.
GONORRHEA: Pos. 14
Neg. 60


SYPHILIS
Kahn:



WATER:
MILK:
MCE CREAI:
MISCELLA~EC


Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Total


3
17 6 15


Pos. 107 74 103 117 92 106 99 125 71 95 71 39
Neg. 181 190 199 211 337 259 254 427 216 350 198 148
Partial 7 4 2 7 6 5 2 6 1 2 2
Unsat. 2 13 8 8 6 4 16 14 11 12 8 3


115


)US:


27
198
I
228
617

1099
2970
44
105


57 81 75 77 66 72 57 48 68 92 68 876


3 8 4 3 4 3 1 6


961 696 820 947 970 910 1016 1341 773 1226 860 534 11054


Grand
Total



226

845




4218
9
876
7
41

11054


TOTAL







-41-


Jan Febt rir


ANIIAL PARASITES
HOOYSEORld:PC s -
Neg.
Unsat.
OXYUBRIS
STRONGYLGOIDE
TAPEWORhi
TRICHIURIS
THE OAT CUTIPURES
DIPHTHERIA:
Pos.
Neg.
Unsat.
VIIrCENT ANGINA
pos.
Neg.
Unsat.
STREPTOCOCCUS
Pos.
Neg.
Unsat.
VIJLARIA: PCs.
Neg.
Unsat.
AGGLUTIATION TESTS
TYTHOID: Pos.
Neg.
Partial
Unsat.
PAJLA TYPHOID A
Neg.
Partial
Unsat.
PARA TYPHOID B
Pos.
Neg.
Partial
Unsat.


Apr Wiy


6 3 6 1
160 180 237 245
9 5 4 7


12 13
681 1136
16 39


2 P,
477 387
21 15


1
29 22 44


3
24 43
3


34 24 49 70
1


34 24 48
1


54 63
2

3 2
51 81
6


1 1


6C 83 67 45
3 1
1 1


1
83 66
3
I


5
187
2


19&4
MILMAI LABORATORY Grard
June July Aug Sept Oct Nov Dec Total Total


13 2
200 178
6


2 10 10 5
108 195 218 157
2 8 5 1


6 4e.
289 1856
1 48


19 27
687 549
17 17


1 1
1 1
1


45 51 42
4


1
55 51
2
2


65
2241
53
1
1
3
2


156
6549
185

199
678
163

5
14
2
!


25 527
12


17
578
27
4


55 54 40 36 617
5
2 4

1
55 54 40 35 613
1 4
2 4


2366





6890




1040




21


54C





626




626





62c-







1934
MIAMI LABORATORY-cont.
Jan Feb Mar Apr May June July Aug


Grand
Sept Oct Yov Dec Total Total


WEIL FELIX:
Pos.
Neg.
Partial
Unsat.
TYPHOID CULTURES
Urine & Stool:
Pos.
Neg.
Unsat.
TUBERCULOSIS
Microscopic:
Pos.
Neg.
Unsat.
OPTTI~FrJLTI: Neg.
Unsat.
GONORRHEA: Pos.
Neg.
Unsat.


SYTILIS
Kahn:


Pos.
Neg.
Partial
Unsat.


Mueller: Pos.

Partial
RABIES
Human: Neeg.
Dog: Pos.

Unsat.
Cat: Ne,.
LEPROSY: Pos.

WATER:


1
34 24 49 71 58
1


1 1


52 123
5 3


8 15
4


2 2 2 4
1
32 23 29 24 22 24 41 29
147 146 134 111 101 129 135 138
6 2 2 3 3 2 2

230 159 141 115 132 92 113 114
2969 1961 1742 1350 1422 1127 1326 1020
153 113 87 78 60 82 41 48
66 86 61 40 50 56 43 26


3 1 2 2
1


2 1 2


I

3 2 4
228 180 220 186 262 214 258 210


3
55 54 40 36 617
2
2 4


11
33 450
53


41 43 65 45
2
4 2 1
1 1
19 27 35 47
117 135 182 208
3 2 10 6

141 224 235 230
1180 1714 1835 2296
59 80 90 104
50 62 50 59


1
1

3
210 218 202 140


74
591
4
17
3
352
1683
41


626




494





669

20


2076


1926
19942
995
649 23512
1
15
1 17

1
1
13
2


1
12
2528


13
2528


-42-













MILK:
ICE CREDIT:
MISCEL&ITEOUS:


TOTAL:


1934
MIAMI L&BORATORY-cont.
Grand
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Total Total
600 542 420 538 604 552 535 447 231 557 266 416 5708 5708
13 14 41 13 12 12 12 11 12 13 13 13 179 179
89 67 91 101 98 106 97 93 91 134 95 85 1147 1147

5758 4947 4183 3868 3748 3314 3339 2742 2919 5769 4437 4719 49743 49743








-44-


JANUARY

FEBRUARY

MARCH

APRIL

MAY

JUNE

JULY

AUGUST

SEPTEMBER

OCTOBER

NOVEMBER

DECEMBER


DIPHTHERIA
iNTITOXIN
10000 5000
units units

130 41

43 24

74 17

29

35 20

39 8

46 10

73 35

124 28

93 24

117 44

89 29


TABLE III
BIOLOGICS DISTRIBUTED DURING
1934


TOXIN
SCHICK TOXOID ANTITOXIN


5680

4710

3650

5360

2770

690

1960

400

5130

5110

7470

1060


3030

4452

2430

3055

2395

1140

1834

1376

3069

2238

2895

1513


759

420

249



609


TETANUS
TYPHOID VACCINE ANTIRABIC ANTITOXIN
VACCINE VIRUS VIRUS 1500
units


3840

2319

3504

4316

5710

2045

2744

2748

4637

2658

4176

890


2711

2028

1880

2771

1600

510

1650

1120

2612

1790

2450

1593


43990 29427 2037 39587


TOTAL 892 280


22715 298 87





-45-


DIVISION OFPUB3LIC ILALTE NURSING



Personnel


Miss Ruth E. Yettinger, Director
Miss Joyce Ely, Assistant Director &
Supervisor of iMid*ives
Miss Jule 0. Graves, Field Nurse
Miss Lalla jary Goggans, Field Nurse
Miss Johanna L. Sogaard, Field Nurse
Miss Annie Gabriel, Field Nurse
Miss Helen Van Osdell, Secretary
Miss Anne ling, Olark

Florida ERA Supervisors of Nurses:
Mrs. Annie Carlisle
irs. Myrtle Conquist
Mrs. Nancy Flannagan
Miss Mary L. Harrison
Mrs. Lydia Holischeiter
Miss Margaret Hoxsey
Mlrsi Mary Wright Matthews
Miss Cynthia May Mabbette
Mrs. Inez M. Nelson
Mrs. Vivian Ross
Liss Anna Grace Whipple


February 1,
January 1,


January
January
January
January
January
January


February 1
August 1
June 1
February 1
February 1
February 1
February 1
February 1
February 1
February 1
February 1


1934 December 31, 1934
December 31


December
December
December
June .1
December
December


December
December
December
December
December
December
December
December
December
December
December


During 1954 most of the Director's time was confined to the Florida
Emergency Relief Administration nursing program, which was placed under the
supervision of the State Board of Health February 1. This project provided
for 15 supervisors and 275 county nurses. Only 11 supervisors were employed
under the Florida RA and the four State Board of Health field nurses were
detailed as supervisors, The state was divided into districts and super-
visors wtere placed at central points to assist the nurses with the program.
A generalized public health nursing program was planned, which included
visiting nursing, physical inspection of children in families receiving
relief or in need though not on relief and referring for medical examination
children with evident need for corrections or treatment. The nurses were
instructed when possible to conduct classes in Home Hygiene and Care of the
Sick, which includes simple procedures for home nursing, community and home
sanitation, care of the infant and preschool child, and control of
communicable diseases.

3ecausu the maternal death rate in Florida was extremely high,
special stress was laid on tho prenatal, infant and preschool program.
Through prenatal classes and individual visits, the patients ware instructed
in prenatal care, preparation for dolivwry, and care aftur delivery. This
instruction, of course, was given under the supervision of a physician.
Since this program was instituted there has been a 33% decline in the maternal
death rate.







To build for the permanency of the nursing program after the
Florida Emergency Relief funds are withdrawn, public hE.alth nursing
committees of lay people have been organized in sixty of the counties.
These committees have assisted the nurses in securing equipment for Home
Hygiene classes and supplies which are nooded in their programs. The
committees meet once a month, at which time the nurse gives her monthly
report. In two counties appropriations have been mode by the commissioners
to continue the work.

Immediately after the assignment of the nurses to a county, the
Iviodical Society was given a copy of standing orders as to the care and
minor treatment of patients, with the request that the standing orders be
r.jviowed and if approved, signed by the president of the society and
returned to the. nurse. Those orders s.rve as a guide to the nurse on the
first visit if a physician is not in attendance. Repeated visits to the
patient are not made unless a physician is called. If a patient is.in
need of a doctor, the Social Service Director is notified and she requests
the services of a physician. Upon the assignraent of a physician, the nurse
immoaiately Gats in touch with him to receive definite instructions as to
the nursing care desired.

Where Nursery Schools are operated for the care of the children of
mothers on Florida a- ;-ork projects, the nurses make regular visits for
the health supervision of the child.'rn--Wiioh, measure, and inspect and
follow the children into the homes to give advice and help arrange for the
correction of defects and assist the mothers w"ith their feeding problems.
Standing orders for the teachers' guidance are secured from the local
physician. The nurse interprets and instructs the tjachurs in the
execution of thesu orders.

Other duties of the Florida -Ai nurses include vw?,kly visits to the
mattress factories for health supervision of the vor~an employed, excluding
from duty any that have evidence of skin disease or other ailments. The
employees are permitted to return to work on the authority of the physician
to whom they have beun referred.

Duo to the demands made upon the State Board of H~alth for specimen
containers and laboratory service, it has bojn necessary to encourage cities
and counties to purchase hookworm containers. 97,699 specimens were aub-
mitted in a period of ten months.

One or more nurses have boon assigned to every county in the state,
and several have been assigned to regular duty in hospitals caring for
relief patients. The total number on duty at the end of the year was 269
graduate registered nurses. Through the Nursing Service we wore able to
provide nurses for the summer camps sponsored by the Extension Dopartment
of the Department of Agriculture under the direction of Miss Flavia Gleason.
Most of these camps were held in north-,.est Florida.

As the nursing service progresse-, the noed of more training was
realized. Therefore, before assigning a nurse to a county, she was placed
for a period of three weeks on the visiting nurse staff in Jacksonville or
in Tampa where she received lectures in public health nursing. She is also
given experience in homn visiting, rural school nursing, clinic service, and
has the opportunity of observing classes in Home Hy6ieno and Care of the Sick.
Eany of the nurses who woer assigned to duty without this training have asked
for it. On November 1, the training period was lengthened to six weeks.








-aV-


Staff Education

When the Florida ERA Nursing Project was placed under the State Board
of Health, an institute was held in Jacksonvillo for the supervisors. The
details of the Nursing Project were discussed from the following angles:

1. Methods, of introducing the project into a county.
2. Aims of the project.
3. Methods of supervision.
4. Uniformity of routines -- The TOPHN Manual for Public Health Nurses to
be used as a guide for all nursing procedures.
5. Records.
6. Relation to the State Board of Health.

Folders providing source material on the6 following subjects were fur-
nished to each supervisor.


Prenatal Care
Infant and Preschool Care
School Nursing
Comnunicable Disease Nursing
Mi diifory
dural Sanitation


Supervision in Public Health Nursing
Nutrition
Vital Statistics
Demonstrations
records
Bibliographies.


State Board of'Health. staff members addressed the supervisors on the
following subjects:


The State Nursing Program . . .
Attitude of the Nurse Toward the Social 'Worker
Conmunicable Disease Control . .
The Function of the Laboratory ..
I laria and Yellow ievr . . .
Ths Progran of the Buroau of Engineering .
The State Board of Health Library . .


Dr. H&nry Hanson
Miss Ruth .t. Mettingor
Dr. F. A. Brink
Dr. Paul -aton
Dr. T.H.D. Griffitts
iajor Frod Safay
Mrs. Elizabeth Bohnenbergor.


Two other supervisors' conferences 'ere held during the year. The
Director visited each supervisor in her territory several times and attended
the one-day institutes which each supervisor conducts monthly for the nurses
of her district. Topics for discussion at these monthly institutes were sent
to the supervisors as follows:

Qualifications and.Education of the Public Hoalth Nurse.
Policies and Principles Relating to Organization and the Nurse's Place
in the Organization.
Present Status of Public Health Nursing..
Evaluation of Nursing Service and Medical Care.
Records.
Trends and Developments in Public Health Nursing.







-48.-


Mrs. Charlotte Heilman, assistant Director cf Public Health Nursing
and Home Hygiene for the American ied Cross, held three Home Hygiene and Care
of the Sick Institutes, which covered teaching methods, presentation of the
subject, and the value of Home Hygiene. These were held in Marianna, Ft.
Pierce, and Jacksonville, for two days each.

Meetings were arranged in Tampa, Lakeland, Orlando, Ft. Pierce, Miami,
Marianna, Jacksonville, and Pensacola for Riss Mary Jmaa Smith of the National
Society for the Prevention of Blindness, who gave eight talks on the causes
and prevention of blindness and demonstrated for the nurses the technique of
vision testing.

To stimulate interest in oUP Public Health Councils composed of lay
people, Miss Evelyn iC. Davis, representing the National Organization for
Public Health Nursing, in charge of Lay Commit tees, held six nantings in tbo
following places: St. Petersburg, Ft. Myers, Tampa, Orlando, Jacksonville,,
and Marianna. The total attendance at these six meetings was 152.

A five days intensive institute for instructors in First Aid was held
in Marianna, conducted by Mr. Raymon baton, Southeastern iepres5nt&tive of
the American Red Cross. 13 nurses attended.

at the Florida Public Health association meeting held December 3, 4th,
and 5th, in Jacksonville, Miss Pearl iicIvor of the United States Public Health
Service, conducted a round-table discussion for the nurses on "Public Health
Nursing". Approximately one hundred Florida Ra nurses'ard 25 permanently
employed nurses attended. All supervisors were present.


Demon s tra ti ons

Child Hygiene demonstrations were givon by Miss Groves at the following
places;

Orange Festival, Winter Haven
Tampa Fair, in connection with the City Health Department
State Conference of Social Work, Sarasota
Institute for Florida ERA Nurses, Tampa
Midwife Institute, St. Augustino
Miduiife Institutes, Tallahassee
Hospital Day, Morroll iospit&l, Lakeelnd
Orange Genural Hospital, Orlando, in connection ,ith talks and
demonstrations given to the student nurses.
Florida State Nurses -ssociation, Ft. Myers.
Florida Public Hbalth association, Jacksonville.

The ctateo board of Health moving pictures wero sho'n at the Midxife
Institute in St. Augustine; the two midwife institutes in Talloh&ssee; and
at the Orange General Hospital in Orlando.






-49-


Parent Education

On June 1, Miss Anniu Gcbriel, Parent Eucation instructor,
resigned her position for further study at the University of Iowa. Prior
to her resignation, five Parent Education classes wure held in Pascoo
&srasota, Columbia, Palm deach, and Brevard Counties. The total attendance
at these classes vas 517 and 121 certificates wore issued. Miss Gabri.l
also gave 31 Parent Zducation talks to Parent-Teacher Associations with an
attendance of 876.

May Day

Through the efforts of our supervisors and county nurses, May Day
\,Es observed in 54 counties. Various forms of celebration were conducted,
including May Pole dances, crowning of the May 4Quan, health talks to the
various schools, and health plays conducted by the children. The Public
Health Councils assisted greatly in those programs.

Indian Nursing Service

The Indian Service of the United States Government has supplied
Florida with a nurse for the Irdien Reservation. Miss Charlotte Conrad
was appointed to this service in Florida the first of MNy.

Midwifery

Under the direction of Miss Ely, Assistant Director and Supervisor
of Midwives, three midw,ifo institutes vwore hold during the year. At the
St. Augustine Institute, 66 midtvives from ten counties attended, and in
Trll~hsseo, August 11 to 17th, 125 midwives from 14 counties attended, in
Ti.llahassee august 18 to 25th, 107 midwives from 16 counties attended. 98
Florida iLi. nurses visited the midwife institutes for observation.

Local nurses have -ccoptod the responsibility of the supervision of
the midwives in 16 counties.

Survey of Public HRalth Nurses

a survey has been nado and it was learned thet there aru 91 public
health nurses employed in the state by cities, counties, and unofficial
agencies.






-50-


With one or more nurses in every county, a grout deal has been
accomplished. Many of those counties never before had a public health
nursing service.

The nurses have assisted in organizing and conducting mrny of theb
immunization and chest clinics and the crippled children's program.
Mnlaria and tonsil clinics for indigent patients wore held in several
counties, sponsored by the local physicians.

The Public Health Councils have furnished funds for glasses, dental
corrections and meaical supplies in Citrus, PCsco, and Sumter Counties.
approximately fifty counties have established loan closets financed by local
Red Cross Chapters. The county commissioners and the Red Cross have
assisted financially in equipping permanent Home Hygiene class rooms.

A permanent Visiting Nurse Society'has been orGoaized in Duvel County.
Conmittees Here designated to draw up the constitution and by-laws, draft a
budget, to contact the business firnsm ihiah might use this service, and
deterLtinJ the uxt.nt to vhich they might contribute. u committee of
physicians secured the endorsement of the County Medicr.l Sociuty. The
organization has been cople ted and pornanent officers elected, but
activities are not to be;in until the present Florida ERA Visiting Nurse
work is discontinued.

The Duval County Board of Education appropriated funds for a perma-
nent public health nurse, as a result of this demonstration made by the
Floride &EU under the supervision of the Steto Board of Health. unll E
nurse was assigned to this position.

The Nursing Service has worked very closely with the Bureau of
Sanitary Engineering in assisting to improve the sanitary conditions of
each county. The nurses hove made hookborm surveys and have presented
those figures to the Sanitary Engineer in the district. In Lafayette,
Levy, and Gilchrist counties, conferences have been held Aith county
commissioners and superintendents of schools, with the result that sanitary
coiwoniences have been Aroctod at all schools in those counties. This VD rk
was done under the direction of the District Sanitary Officer of the Stato
Board of Health.

Under the direction of Dr. Griffitts, Miss Sogacrd visited 32 white
schools, taking 1468 malaria smears, end 41 colored schools, taking 932
malaria smears.

All nurses working under the Flotida ERA project have been requested
to comply with the state law on registration. This has increased regis-
tration approximately twenty-five per cent.







-61-


Tabulated Repcrt
District Supervisors of Nurses


Number of counties visited 67 Number of visits to counties 2371

Number communities visited 1331 Number visits to communities 1999

Number of institutes held 63 Attendance: White 720 Colored 36

Number of classes held with nurses 311

Attendance: White 958 Colored 54

Number of Public Health Nursing Committees attended: 203

Number of talks given 301


Personal Interviews

Number interviews with Relief Administrators, Relief Directors,
and Case Aides: 2027

Number of interviews with nurses not employed: White 380 Colored 21

Number of interviews with Health Officers: 233

Number interviews with doctors, not public Health: ,ihite 797 Colored 39

Numoer interviews with interested individuals: White 4518 Colored 423

Number of interviews with members of state staff: 648


Midwife Work

Home Visits to Miduives: White 119 Colored 328

Investigations of midwives: White 63 Colored 203

Number classes and demonstrations held: White 67 Colored 84

Attendance: White 216 Colored 1360

Number midwives examined: White 7 Coltaed 58

Conferences with individual midwives: White 82 Colored 344

Number midwives practicing without registration: White 55 Colored 78


Number hours clerical work:


4031









VISITING NURSING


No. Carried Cases
Visi ted

Intake Total


a.E New


Health
Supervision
W. C.

43659 12771

20257 5346

16344 4295


Maternity
W. C.

19727 6148

4407 1428

3916 1317


Morbidity
\. C.

62194 18145

20557 7249

17902 6406


Total
W. C.

125580 37064

45221 14023

38162 12018


b. Re-admitted 3913 1051


Total Under Care
Visited

Dismissed


63916 18117

14158 3542


491 111


24134 7576

2558 1180


2655 843 7059 2005


82751 25394

15989 5745


170801 51087

32705 10467


COUNTY NURSES REPORT


HOME VISITS
Number Families Visited for First Time
Number Families Re-visited .
Total Number families visited .
Total Number visits to homes . .

HEALTH SUP4RtVISION VISITS
Infants to 2 years . .
Pre-school children (2 to 6 years)
School children ..
Adults . .. .. .
Prenatal . . .
Post Partum . . .
Newborn . . .

BEDSIDE NURSING VISITS-IIAT~RiITY
Prenatal .......
Post Partum . . .
Newborn .. . ...... .

NON-C 0MMUNICABLE DISEASES
Infants to 2 years .
Pre-school (2 to 6 years) .
School children . . .
Adults . . ....

COMIvUNICABLE DISE-SES
exclusivee of Tuberculosis) ..
Infants to 2 years . .
Preschool (2 to 6 years) ..
School children . . .
Adults . . .* .


White Colored
* 44,377 12,240
* 68,975 20,101
.108,884 32,887
. 98,232 29,697


10,539
13,342
12,241
32,494
9,320
5,243
4,463


2,767
3,572
3,099


1,329
1,869
2,325
5,916


2,325
3,401
4,502
2,359


2,675
2,423
2,527
8,510
2,745
2,021
1,457


931
1,424
1,148


325
346
520
2,970


664
738
889
821







-53-


TUBE&GULOSIS
Number of Positive Cases Visited .
Number of Suspects Visited .
Number of Contacts Visited and Listed

VISITS IN BEHALF OF
Health Supervision . .
Maternity . . .
Morbidity . . .


Visits for Special Activities


White Golcr.ed
. .. 4403 302
. .. 323 159
. 415 209


. 31,340
. 16,362
* 49,015


. . 14,406


Non-effectual Visits not seen .. .10,773
not found .... 8,792


Office Visits


. . . 5,631


H.ALTIE SUP.VWISION
Infants to 2 years . .
Pre-school children (2 to 6 years)
School children . .
Maternity . ..
Othor Adults . ..

PrIVENTTIVE
Number of Adults with Health Problems
Number of Individuals Referred for
Medical Examination .
Number of Cases Hospitalized .


1,867
2,374
3,673
1,731
6,742


S. 39,555

34,692
. 261


HOOKORM CONTrhOL
Number of Containers Distributed .
Number of Containers Collected .
Number of Treatments given .
Number of families with open or no toilets

IIUJNIZATIOC
No. Clinics held for Vaccination against
smallpox . .
No. Vaccinated ............
No. Clinics held for Administretion of
Toxoid, T.A.T. ....
No. Receiving Treatment . .
No. Clinics held for the Administration
of Typhoid Vaccine . .
No. Completing 3 treatments . .

INSTdUCTIONAL CONAERENCES IN 34EALF OF
Children . . .
Maternity . . .
Prenatal and Postnatal . . .
Delivery and Newborn . ...
Other adults . .. . .


35,038
24,660
3,679
20,696



153
1,571

334
2,608

201
4,563


27,842*
3,589
2,322
2,327
17,871


10,265
5,556
14,739

2,919

1,917
2,642

2,088


362
617
369
430
2,522


13,155

9,371
66


4,038
3,562
194
9,513


16
277

13
432


4,227
952
587
713
4,928







-54-


CC'ffNxCEOS INDIVIDUAL
Health Officers .
Other physicians .
Teachers ...
Social Service workerss .
District Supervisor of Nurses
Other nurses . ..
Interested Individuals .


. . .
rO


* .
* .


* 4


White Colored
14,215
22,641 2,220
14,057 2,063
44,433 3,768
5,939 320
23,954 3,579
43,986 8,393


BIRTH REGISTRATION
Registrars Visited .. ..
Unrepcr ted Births Discovered

SUJP VISION OF MITIVTES
Number Home Visits to Midwives
Number Conferences with midwives
Number investigations of midwives


*......


. . . .


Number found practicing without registration
within past 12 months . .
Number demonstrations, classes or institutes held
Attendance . . ...
Number bags inspected Complete . .
Incomplete . .


EDUCATIONAL ACTIVITY-COMMUNITY
Group meetings .
Attendance .
School children .
attendance . .
Teachers . .
Parents meetings in school
Attendance . ..
Institutes attendance .
Others . . .
Home Hygiene classes ..
Attendance


* 4 *


ACTIVITIES IN SCHOOL
Number schools visited .
Number schools given assistance .
Number individual inspections by nurse
Number routine examinations by doctor
Number children with one or more symptoms
of defects . .
Number special examinations .

NUMBER DEFECTS FOUND
Weight 10 or more under average .
Vision . . ..
Hearing . . .
Defect of teeth . .. .
Diseased tonsils . . .


* .


622
430


838
586
366

153
91
306
95
37


1,955
22,187
6,362
31,310
2,203
1,273
1,606
4,517
348
1,572
13,299


1,704
5,420
79,094
10,513

45,615
13,114


9,912
5,221
646
22,285
20,738


117
130


1,415
1,423
598

130
179
2,148
468
215


502
7.247
1,072
6,329
578
41
89
289
20
18.7
3,829


195
1,242
17,389
976

4,439
1,271


1,020
388
74
2,994
3,647







. ..'














DEFECTS C00RiCTED
Weight 103 or more under average
Vision . . .
Hearing .....
Defect of Teeth . .
Diseased tonsils . .


* .
* .
*. .

.


White Colored
157 10
205
76 2
899 88
512 71


SYMPTOMS OF DISEASE
Conjunctivitis ....... . 5,848
Nasal Obstruction . . 4,001
Enlarged Cervical Glands ...... 5,872
Skin Lesions ........ .. . 1,958
Hookworm .. .. . 8,744
Dietetic problems ...... .. . 3,279
Other .. .... .. . 3,595
No. Children not vaccinated against smallpox 25,586
No. Children not immunized against diphtheria22,315
No. Children not immunized against typhoid 18,435


CLINIC OR GONSERilNC.S
Infant New .
Returned .


. . . .
. . . .


Preschool New . . . .
Returned . . .


Prenatal New .
de turned

Orthopedic-4ew .
daturned

Dental New .
Returned
Treatment
Correction


Other clinics

HEALTH C JTTai
County Fairs
Others


. . . .



. . . .
.

e e o e e
@


207
99

394
160

104
77


. . .



... . . .
. . . .
>C*e e e

o e
o e o o e e


238
870
846
146
881
1,087
1,183
5,912
4,983
6,538












-68-
HOSPIhBL AND CLINIC NURSES

Hospital: Number relief cases admitted -- 664

Nature of cases: Surgical, medical, obstetrical, newborn,
leg amputation, tuberculosis, diphtheria, pneumonia,
hernia, appendicitis, rib resections, tonsillectomies,
rheumatism.

Length of time in hospital (average) 11 days.

Clinic: Number of relief cases treated: 2125

Type of cases: Number medical -- 1646; Surgical -- 479

Number referred to county nurses: 135

CAMP NURSES

Number of First Aid treatments: 684
Number of Illnesses: 36
Number of cases needing physician: 40
Number of talks given tr the groups: 159
Number of demonstrations: 18

MATTRESS FACTORY A.jPORT

Number of visits to factory: 173
Number of inspections made: 4414
Number of cases referred to physicians: 132
Number of cases referred to visiting nurse: 17




MATEUITY LETTER SERVICE

Prenatal Letters:

No. sets sent direct to expectant mothers 659

No. sets sent to nurses to distribute 509

Total 1168

Postnatal Letters:

No. sets sent direct to expectant mothers 189

No. sets sent to nurses to distribute 205

Total 394




-57-
LITerATURE AND SUPPLIES SENT OUT


School Supplies

Cards for inspection of school children by nurse 83,465
Cards for examination of school children by physician 12,118
Nurses Notice to Parents ... . 29,679
Doctors Notice to Parents .. . .* 14,953
Henryson Height & Weight Charts . 165
Snellen &ye Charts . . ..... 103

State Board of Iea Ith Pamphlets

Hookworm * 7,174
Malaria . ............ 1,655
Mosquito Pamphlets .. .. *** 321
Tuborculosia Pamphlets ... .1,303
What to Do When . ......... 1,703
Sanitary Privy .. . 1,916
Filthy Fly . . . 1,003
Why Births Should Be Reoisturod . 859

Children's B.reau a mphlets

Prenatal Care . . . 2,082
The Child from Ono to Six . 853
Infant Care . 1,441
Why Drink Milk . .... . 493
Why Sleep . 284
Minimum Standands of Prenatal Care . 567
Breast Feeding .. . . 611
Out of Babyhbod into Childhood . 282
Keeping the Well Baby Well . ..... 944
Sunlight for Babie . .. .. 286
Are You Training Your Child to be Happy 21
What Builds Babies . .. 421
Child Managoennt * 116

Midwife Supplies

Silver Nitrate . . .. boxes 5,796
Cord Dressing patterns. .. *... 489
Mask patterns . . .* 489
Joint Pledge blanl . . 783
i dwife Equipmeut shoots .. 500
Birth Certificates . . pads. 248
MidWife Manuals . . 1,303
Monthly Rdopct Cards .... . . 2,338
Miscellaneous

Hookworm Sp3cimon Reports Positive . .. 10,411
Hookworm Specimen Reports Negative . 16,621
Layette Instruction Sheets . 415.


Respectfully submitted,

(Signed) Ruth E. Mettinger, Director
Public Health Nursing.







- 58-


BUREAU OF ENGINEERING

Louva G. LenQrt, Director



The work of this Bureau during 1934 is comparable to no year's activities
of the past and will probably never be followed with a similar set of circum-
stances. During the preceding year the regular personnel was so drastically
cut as to prevent proper maintenance of routine duties, and the huge work
program of the CWA and FERA more than doubled the work of the depleted staff.
Shortage of funds necessitated a further reduction during the last three months
of the fiscal year. So many changes have been necessary in the attempt to care
for what was deemed most important work that space does not permit a full ex-
planation.



Regular Personnel

The regular administrative personnel consisting of Director, Assistant
Director (and Water Analyst), and Clerk has remained intact. In the field this
regular force was supplemented by five sanitary officers until April 1, then
being reduced to three until May 1, when one sanitary officer who had been used
as Assistant State Director of Community Sanitation resumed his former position.
Until November 1, the Bureau operated with four sanitary officers, and it was
then augmented by taking over the Field Engineer who had been furnished up to
that time by the Rockefeller Foundation for Malaria Control work.

With only four sanitary officers to carry on the regular functions of the
Bureau, nine counties in the northeastern part of the state were not assigned
in rearranging the districts, but nn attempt was made to handle routine matters
in this area from the central office. The arrangement was far from satisfac-
tory, but was unavoidable.



Emergency Personnel

In addition to the above regular personnel the extra duties under CWA and
FERA programs necessitated a tremendous expansion, the direction of which was
centered in the regular administrative staff of the Bureau. The complicated
mechanism involved is illustrated on the accompanying chart. In this the link-
ed line represents a cooperative arrangement in which payment of personnel was
made by the cooperating agency, and the work was directed conjointly, through
the State Health Officer and the Bureau of Engineering.

At the conclusion of the Federal GWA on February 15, a plan for its contin-
uation as a State CWA project was submitted to the State Administration. This
was approved on February 23, the Public Health Service continuing to furnish
two Assistant State Directors and travel allowance for all district and county?
supervisors on malaria control and community sanitation.









DItt~
Bu or


CTOL
ENGINIEEIN G


BUO A AU of
ODG AN IZAT\ON


fN GINt NN G
CH A T


A. 1934.


C. w


DUr NG





- 60 -


The cooperative arrangement with the Bureau of Entomology, U. S. Depart-
ment of Agriculture, ceased entirely on February 15 and all of the expense
was borne by the State Energency Relief Administration, using the same super-
visory set-up as had been in use under the CWA.

On March 10 the CWIA was definitely abolished and the FERA continued the
State projects on the same basis as under the State CW7A.

March 19 marked the decentralization reorganization of the FERA, by which
the State was divided into ten districts, with a Regional Administrator in
charge of each. State projects wore no longer mandatory and it was therefore
necessary to have each work project approved by the County Administrator and
the Regiona. Administrator before labor would be assigned.

To conserve funds for the general supervision of malaria and sanitation
programs the Public Herlth Service on A.ril 1 discontinued paying travel allow-
ance of all county supervisors, and on April 15 the travel of all district
supervisors wcs discontinued. With travel allowance eliminated, district super-
visors were of no value so their names wore stricken from the State projects
on April 19.

The Public Health Service on April 19 approved a now arrangement in which
the salaries of ten District Supervisors were paid with no travel allowance.
A supervisor was thus to be att.hched to eoch FERA Rwgional office for advisory
assistance on all public health projects. The two assistant State Directors
were retained as before.

All State projects of the FERA wore discontinued on April 28. This
included all county supervisors on malaria and sanitation programs, as well as
the assistant director, district and local superintendents on post mosquito
Control, and one stenographer.

In line with approval of April 19 by the Service eight district supervisors
were appointed May 1 and two on May 7, but due to necessary retrenchments very
little labor was assigned by the FERA during the remainder of the month to any
projects, funds being usod only for direct relief.

Oa June 9 the FERA created Monroe County into a separate region making
eleven in all. Supervision of health projects in this region was assumed by
the Bureau through the district sanitary officer in that part of the State.

October 1 brought on another readjustment in the FERA in which the number
of regions was reduced to nine, changes being made in all of the boundaries
except the one comprising Monroe County. A readjustment was made then in hr.v-
.ing four of the districts looked after by the district supervisors coincide with
the FERA boundaries, but because of no travel allowance the remaining four
regions were divided into six districts, each -ssigned to a district supervisor.







- 61 -


A supplementary state project was revived on October 26 which permitted
the employment of six men on cross-connection surveys and nineteen privy sales-
men, but it was not in operation but a short time and cancellation was ordered
for December 7.

On November 1 the participation of the Rockefeller Foundation was with-
drawn and one assistant state director was withdrawn by the U. S. Public
Health Service.

One District Supervisor resigned December 1.

Thus the emergency organization for the last month of the year consisted
of one assistant state director with travel allowance, and nine district super-
visors. Advices have been received from the Service that the services of
district supervisors terminate on December 31, with the prospect that they may
be reinstated if and when an expected now work project is inaugurated.



WATER SUPPLIES


The Bureau has continued the routine inspections and analyses of the public
water supplies in the State, the submission of samples being required either
monthly or quarterly according to the plan inaugurated during 1932. Quarterly
samples only are required from those water supplies from deep wells, involving
no treatment, which have given consistently satisfactory results over a period
of years. Monthly samples are required of all other supplies. As shown in the
accompanying tabulation, 4749 samples have been examined for bacterial quality
during the year. Standard Methods of water analysis of the American Public
Health Association are used in all Laboratory work.

The Public Works Administration approved but three applications for water
works in Florida, contracts for which were all let during the year. These were
as follows:

Miami New reservoirs and replacement of wood stave pipe mains with cast-
iron pipe.

Pahokee Complete water treatment plant and distribution system. Raw
water obtained from Lake Okeochobeo.

Lake City Now well supply, with chemical treatment, storage and pumping
equipment, including new housing for all,

Other cities and communities requesting assistance in solving water problems
include

Panama City New supply and treatment desired for removal of excess iron.
PWA application made.






- 62 -


Pass-a-Grille New supply needed due excessive salt in present supply.
Distribution system needs remodelling. PWA private loan requested.

Marianna New well supply at Boys Industrial School. Chlorination added.

Foley Excessive iron removal treatment recommended.

Lake Placid Installation of cover on treatment plant.

Palatka Install-tion of ammoniator for chlorcmino treatment of city
wrter supply.

Live Oak Modern chlorinator installed.

Gainesville Florida Farm Colony new reservoir and chlorinator to be in-
stalled.

Weleka New water supply developed under CWA proves unsatisfactory for
purposes intended. No health problem involved.

Yankoetown Chlorination recamnended because of repeated unsatisfactory
bactoriological showing of samples.

Ft. Myers New water supply recommended to replace present highly saline
supply. Numerous shallow wells drilled indicate satisfactory quantity avail-
able if financing of treatment can be provided.

The treatment recommended for Palatka was not only to overcome the period-
ical occurrence of bad water conditions, but to anticipate the future as well.
The source of supply is from springs originating in the ravine uzRlea gardens
which are opened to thousands of visitors afoot and in automobiles during the
azalea blooming period.

The amoebic dysentery outbreak was a vury vivid example of whrat may
happen in any community which does not maintain a system of inspection and re-
cording connections with the public drinking water supply. The Bureau has
consistently reminded city and water works officials of the necessity for this
information and the elimination of cross-connections as is required by Rule No.
98 of the Board.

Partial surveys were made in Pensacola, Panama City, Ocala and Tallchassee
by regul;..r staff members, and investigations on an intensive scale were begun
in Tampa, St. Petersburg, Miami, Daytona Beach and Jacksonville with FERA
assistants. Much valuable data was obtained which is being compiled for refer-
ence back to the municipality for corrective study. The' city of Miami is
proceeding with the investigation and elimination of all cross-connections, in-
cluding defective plumbing. St. Petersburg has eliminated the majority of its
three or four hundred cross-connections and continues its efforts in this
direction through the water department, and determined efforts are being made
in other cities to overcome as much as possible this menace to the public water
supply.










Certification to the Treasury Department


Cooperation with the Domestic Quarantine Division, U. S. Public Health
Service through inspection end certification of water supplies used for drink-
ing on common carriers engaged in interstate traffic has been continued and for
the seventh successive year every supply in the State so used has been certified.

Supplies in eight cities which had in the past been given full certifica-
tion were placed on provisional status. This was done because of the existence
of a considerable number of cross-connections with no records or control being
exercised by local officials. The provisional status will remain until this
condition has been satisfactorily removed.

Certification is furnished thirteen railroads, twenty-four steamship lines,
and six airports, covering all forms of interstate travel except by bus.



Bottled Water

Rule No. 26 of the Board requires every firm selling bottled water in
Florida to secure a permit from the State Board of Health. Sixty-one such
permits were issued during 1934. Five of these were issued to out-of-state
firms in which the necessary physical inspection of plants has been made by the
respective State Health Department officials.

Permits are granted when bacterial analyses are satisfactory and physical
examination of the plant indicates proper sanitary methods. The Bureau only
certifies to the bacterial quality of the water when examined, and this does
not include medicinal properties nor so ccllod "R.dio-activity." The Federal
Food and Drug Administration is very strict on the labeling of water shipped
interstate in which medicinal claims are made which cannot be substantiated,
and the Bureau in cooperation with that Department eliminates indiscriminate
labeling wherever possible.



Chemical Analyses

Lack of personnel and equipment prevent the making of complete chemical
analyses of water in the Bureau laboratory. Such partial studies as Alkalinity,
Chlorides, Sulphates, Hardness, Color, Iron, and Total Solids are made in con-
nection with improvement studies on municipal water supplies. There is a
definite need for a greater service to public water works through a more com-
plete chemical laboratory.

Some temporary assistance in this line will be obtained through a special
arrangement made with a commercial laboratory by which a large number of
samples will be examined during the coming year for a sum approximately one
fifth of the usual charge. Standard Methods of the American Public Health
Association are used and the results given in a form similar to that used in
publication 596 G of the U. S. Geological Survey, in which the Bureau cooperated
with the Survey in examining more than 400 water samples from Florida in 1923.










In recent years a condition of human teeth known as mottled enamel has
boon definitely associated with the presence of fluorides in the drinking
water supplies. Appearing in early childhood this not only causes an unsight-
ly appearance of the teeth but usually does severe damage. While the condition
is particularly prov-lent in the Middle West, becr-use of the extensive phos-
phate areas in this State, it wa:s deemed advisable to make investigations to
determine its prev-lence in water, both surface and underground, in this State.
Tue phosphatic deposits contain an average of 4% fluorine, according to Dr.
A. P. Bl?.ck of the University of Florida, and water in contact with this
mineral dissolves appreciable quantities of fluorine.

Through the assistance of the Florida riorgency Relief Administration,
Dr. Bl-ck was able to enlist the aid of advanced students in chemistry to make
the laboratory determinations, and this Bureau assisted in sample collections,
so that 421 samples wore examined. Taking the results from Dr. Black's report,
29 samples showed an excess of 1.00 part per million, two of which wore in
excess of 2.00 parts per million. Twunty-six of the 29 samples were taken
from deep seated wells in a anall area of the State embraced by Mannteo, Hardee,
Sarasota, DeSoto, Onairlotte, Glades, Lee, Hendry, and Collier Counties. There
is a need of more intensive study of the problem in this area ind the State
Board of Hoalth should mrke this possible.



AMERIC.N WATER YORKS ASSOCIATION


The annual meeting of the Florida Section, A.W.W.A. was held in Daytona
Beach, April 16 and 17th, with a fair attendance of water works operators and
superintendents. The Director of the Bureau serves as Secretary of this
Section. Through this organization the water works officials are brought into
a closer relationship which serves to improve the interchange of ideas of public
benefit, also the work of the Bureau in supervising sanitary control of water
supplies is thereby further coordinated.

The Short School for Water Plant Operators usually held in conjunction
with the annual meeting was postponed until the.Spring of 1935. This school
is conducted through the cooperation of the University of Florida, the Exten-
sion Division, and the State Board of Health.

It is unfortunate that the change of management of city affairs so often
results in the uprooting of efficient management of a public utility of as
great public health importance as the water department. It is hoped that this
organization may be of benefit in overcoming this drawback.

The Director is also a director on the Board of the national organization
and as such attended the sessions at the annual convention, held in June at
New York City.








- 65 -


SEWERAGE AND SEWAGE DISPOSAL


A safe water supply and proper treatment and disposal of human Wastes are
essential public health requirements in every community, large or small. A
most important function of the Bureau is to see that they are obtained.

Progress in proper sewage treatment and disposal continues very slowly.
A new plant has been installed at Tallahassee, which includes settling and
trickling filters. No progress has been made in obtaining funds for the much
needed improvements in Tampa, notwithstanding public meetings and journeys to
Washington. It is doubtful whothur satisfactory works can be completed in
this area without special legislation enabling the inclusion of the suburban
area outside of the city limits.

PWA funds have been allotted to Pensacola for two sewage treatment plants
to eliminate present rqw sewage outfalls into Pensacola Bay, which are re-
sponsible for restricted shellfish areas and condemned bathing benches in that
vicinity.

Other improvamonts include:

Ocala new chlorination equipment to complete treatment of all city sewage.

Sanford Rebuilding of sower lines.

Pancna City New sewers with relief Inbor.

Clormont Cleaning and sterilization of mains and elevated tank.

Jacksonville Gontinuation of installation of sewers with relief labor
and under CWA.

Zolfo Springs Municipal septic tcank.

Lrgo Cleaning Septic Tank.

Bradenton Sewer outfall.

Winter Pa'rk Maintenance and rehabilitation of treatment plant.

Chattahoocheo Plans for complete sewage treatment plant (settling,
trickling filters and separate sludge digestion) were propaerod in Bureau, for
State Hospital for Insane, at request of Superintendent.










THE FLORIDA SANITARY PIT PRIVY


The disposal of human wastes in unsewered areas is one of great importance
in this state. During the beginning of the CWA program designs were prepared
in the Bureau for use by those engaged in privy building on a mass scale. The
Florida type of privy was called for, using precast concrete slabs poured at a
central plant, hauled to the point of erection and set up by a separate crew.

This type of privy vault, designed in the Bureau prior to 1920, has been
illustrated in all privy bulletins issued to date. These were built of wood,
brick and concrete. Concrete vaults were poured in place, or precast in a
central yard, and in 1927 were built of precast slabs poured in a central yard
and assembled at the point of installation, the slabs being joined together
with bolts.

In 1929 application was made to the U. S. Patent Office for patent on a
tank of the same design as had been in use in this State for nine years previous,
claiming:

"In an apparatus of the class set forth, a tank made of precast concrete
slabs partially imbedded in the ground and embodying front, rear and end
slabs formed with means at their vertical edges for locking them together
when assemblQd in a box-like shape, said rear slab being of less height
than the front slab and the top edges of said end slabs being inclined
downwardly and rea-wardly for a portion of their length, a front and a
rear top slab also precast and supported by the vertical slabs, said rear
top slab being positioned on the inclined portion of the end walls and
said front top slab being formed with seat openings, and a housing cover-
ing the front upper portion of said tank leaving the upper rear portion
exposed outside of the housing for the purposes set forth."

k. A patent was granted by the U. S. Patent Office and on August 12, 1931, Mr.
E. L. Filby, then director of the Bureau, endorsed the plan showing the patent-
ed tank, as follows:

"This Privy is in accord with plans and specifications of the Florida State
Board of Health."

Privy building is usually the owner's problem and was not generally looked
upon as being worth consideration by building contractors. Being the only one
in the business the above patentee was recommended to numerous municipalities
when privy building was ordered by the sanitary officers, with the result that
the impression was created in his mind that patent rights were supported by the
State Board of Health.

With the need of mass construction during CWA the precast slab vault was


- 66 -








S67 -


decided upon, but many obstacles were thrown in the way by the patenteet letters
being addressed to the President of the U, S. A.,, bringing down an investiga-
tion by the Federal Trade Qommission. This investigation was dropped, but in
order to avoid further interference with the program a new set of plans and
instructions were drawn up adopting the U. S. Public Health Service type of
privy. The issuance of these plans did not meet with public favor, not being
as adaptable to Florida conditions and being slightly more expensive to build.

The result was that a number of communities continued to use the other type
and a complaint by the patentee was then addressed to the Federal Relief Ad-
ministrator in Washington as relief labor was used in building the privies.
This complaint alleged that "any pit toilet extending into the ground, the sides
and walls of which tank carry the seat, is covered by U. S. Patent #1780099, re-
gardless of kind of material used in the construction of said pit toilet tank."
There being no middle ground to take under.the circumstances the Bureau
definitely challenged the validity of the patent on the following points:

(1) prior design by State Board of Health.

(2) patentee claims too extensive, even covering housing of privy.

(3) materials of which a structure is built cannot be patented, even
though more lasting.

(4) precast concrete slabs were used in Jacksonville and in Lakeland more
than two years prior to application for patent.

(5) publication of design and extensive use of same for more than ten
years prior to patent application.

(6) the approval of Director of Bureau in 1931 indicated that the design
and construction of the patentees tank followed the plans and specifications
of the State Board of Health.

A complete sot of working drawings was then drawn up showing "The Florida
Sanitary.Pit Privy," with instructions for each stage in its construction and
directions for its operation. This has become the approved type. Distribution
of the plans to supervisors, inspectors and officials engaged in construction
was accompanied with the statement that patent claims thereto were considered
invalid and any infringement claims would be contradicted by the Bureau on the
points mentioned above. No further controversy has arisen to date.

A model of the above privy, one-fourth size was demonstrated at the meet-
ing of the Florida Public Health Association in December. Taero was an
immediate demand from the district nursing supervisors for smaller models for
use in sanitation promotion. Ten more models, one-eighth size, were constructed,
eight being distributed to the nursing service and one being sent to the U. S.
Public Health Service at Washington, D. C. at their request.








- 68 -


The Bureau recommended in October that the privy resolution adopted by the
Board in 1920, approving septic tank privies, the Florida tank privy, can or
receptacle privies, chemical toilets and pit privies with concrete bottom, be
rescinded and a new resolution be adopted approving only the Florida Sanitary
Pit Privy, the U. S. Public Health Service type privy and the Incinerator or
Dry Toilet for School. The excellent work of Mrs. Caldwell of the Rockefeller
Foundation at Andalusia, Alabama, has demonstrated that Pit Privies can be
used under almost any conditions when properly constructed.

The privy construction program will be considered under Energency Health
Projects.



SCHOOL SANITATION


This has been a large part of the unfinished business of the Bureau for
many years and no amount of coaxing, pleading, wheedling, etc. has been suf-
ficient to educate the "educational" authorities to the necessity of safe
water supplies and sanitary toilets for schools.

During 1933 in cooperation with the State Department of Public.Instruption
plans were made available to all county school superintendents for srnitary
toilets.. If one was built there is.no record of it.

During the CWA an effort was made to have schools take advantage of that
opportunity to improve their sanitary facilities. Loss than 20 percent of the
counties replied to the letter offering assistance in securing such a project
and mray of those replies ca:me too lr.te to permit a survey of roquirmnonts,
leaving no time to do the work.

In June 1934 a complete p:mphlot, covering water supplies, their protec-
tion and distribution, and sanitary toilets and their construction, was prepar-
ed and distributed to every county superintendent. This followed a letter from
the State Herlth Officer, approved by the President of the State Boar of
Health, to the State Superintendent of Public Instruction, a copy of rwhih was
sent to each county superintendent, advising that schools not properly equipped
with water supply and sanitary toilets would not be permitted to continue dur-
ing the 1934-35 session.

Some coopor..tion has been received under this program. To obtain a
picture of the needs of the schools a brief survey form was adopted, epyoring
only water supply and sewage disposal, and the services of all district -s.ni-
tary officers of the Bocrd, the assistant state directors and district supor-
visors furnished by the Service, and the field engineer furnished by the
Rockefeller Foundation (17 in all), were used in gathering data. The result
of the survey is indicated in the following tr.bulation:

Number of schools inspected ............................... 2179







- 69 .


WATER SUPPLY:
Muni'.ipal or Public supply.................................. 569
Local pressure system........................................ 196
Cisterns............... .............. .................... 21
Driven or drilled wells ................................... 954
Spring Supply............................................... ... 23
Dug wells* ... ...... .................. ............. ...... 89
Dug wells Supply protected....... ....................... 3
Force pump................................... ....... ..... 193
Pitcher pump ................ ................................ 480
No water supply.......................................... .. 471

DRINKING WATER DISTRIBUTION:
Covered water containers. ............................. 12
Sanitary drinking fountains........... .............. 180
Bubbling fountain Unapproved............................... 567
Ordinary spigots or pumps. .............. ............... 619
Open bucket and dipper....................................... 33
Individual drinking cups....... ....................... 65
Common drinking cups........................................ 31

SEVTERAGE FACILITIES:
Adequate flush toilet system................................. 840
Flush toilets inadequate in number......................... 73
Disposal thru city sewers ................ .................. 412
Local septic tank..... ............................. 401
Dry or incindr:.tor toilets.................................. 2
Can privies......................... ......... ....... 4
Boys toilets with urinals provided.. ...... ............. .. 987
Boys toilets with no urinals............................... 994
Illegal surface privies...... ...... .......... 933
No toilet facilities at all.......................... .... 279
Number of Pit Privies (various stages of disrepair)..........1018

It is impossible in the space allotted to make a careful analysis of the
information shown above. More than one-half of all schools get their water
from unprotected springs and dug wells, are equipped with common pitcher pumps,
or have no water supply at all. 'The drinking water distribution to pupils was
satisfactory in only about eleven per cent of the schools. M ore than fifty
percent of ill were equipped with upright bt~lers, inverted faucets, or the
pupils drank directly from the pump spout. This was approximately 70% of all
schools having water supplies. In an analysis of sewerage facilities it is
seen that 840 have adequate flush toilet systems, 73 only partially adequate
flush toilet systems, and two with incinerator toilets, leaving 1264 with privies,
or no toilet facilities at all. In most of the schools having flush toilet sys-
tems urinals, of some sort are provided, but in prr.ctically all other cases none
have been installed, a condition which makes it impossible to maintain any
toilet system in a reasonable sanitary condition.- One school with an enrollment
of more than 200 pupils had no water supply or toilets of any description. 279
schools had no toilet facilities and 933 privies were of the open back illegal
type.







-. 70 -


The business of gathering this data consumed so much time that it was far
from complete on the school opening date. It was necessary that this be done
along with other duties and it was therefore slow in completion. Recommendations
were prepared for every school requiring improvements, setting forth what was
needed. A copy of this was also furnished the State Planning Board. Since
then every'asbistance possible has been extended to the counties in securing
aid from the FERA fbr labor involved. 'A second survey of accomplishments has
been started, but the data is still incomplete. It definitely indicates a
considerable number 6f swivel chair officials unwilling to exert themselves,
who prefer to respond by pleading a lack'of finances. This problem is being
met in maWy counties by a little ingenuity and effort.

Though the State Health Officer has approved summarily closing those
schools not complying with sanitary provisions, this step as a general thing
does not seem advisable just now. Some counties would welcome this act inso-
far as it covers negro schools, presumably because they would have more funds
for those raeainizng. In vieo of'tho'known shortage of finances some leniency
is being granted to permit the installation of facilities with the least
possible nib-rrassment to school authorities.

1he State Board of Health should maintain a full time supervisor of sani-
tation for schools, who is fully informed on water supply installations,
plumbing and general construction methods, to advise local school authorities
on details of construction which would conform to public health principles
and at the scme time conserve the funds of the school board as much as possible.
It will be impossible td hlinddl all of this through present district sanitary
officers. The samo supervisor could review plans of now construction and
repairs; a duty at present falling on the -iroctor.



*SWMvMING POOIS AVID BATHING PLACES

In compliance with Rule #42 and the State Swimming Pool Law annual permits
have been issued for swimming pools during the past ton years as follows:

1925 .......... 28 1928 ......... 49 1932 .......... 58
1926 .......... 29 1929 ........ 54 1933 .......... 58
1927 .......... 47 1930 .......... 58 1934 .......... 61
1931 .......... 59

The expiration date of permits is June 1 and no doubt before the end of the
present season there will be several additions to the 1934 list. A number of
pools were constructed during the CVOA, some of which had to be closed because of
non-compliance with public health practice. Plans were not submitted as ia re-
quired by law.







- 71 -


Plans were passed upon for pools at Barton, Gruen Cove Springs, a4Dolray
Beach.

AB aftermath of the exclusion of Brevard County by the Legislature in 1933
from the provision of the State Swimming Pool Lawt was reflected in a novf pool
built at Melbourne Beach, which does not comply with current structural
practice for swimming pools. An inquiry from the editor of the Titusvil+ Star-
Advocate asking if a permit was issued for the water hole at Indian River City
as a swimming pool, was replied to by stating that it was not only disap ov*d,
but it should be condemned as a menace to public health. It is certainly poor
advertisement for health regulations of the State and its location is such that
a majority of Floridats automobile visitors are given the impression that this is
the type of construction permitted throughout the State. The local law of
Brovard County should be repealed. The Director feels this very keenly being
a member of the Joint Committee on Swimming Pools and Bathing Places o
State Sanitary Engineers Conference and the Public Health Engineering ian
of the American Public Health Association.

In addition to initial inspections of swimming pools for permits t district
sanitary officers maintain routine inspections of the permitted pools throughout
the season as well as the many bathing places at lakes and at the boechb .* Tha.f
the latter are not required to have permits under present practice they are ex-
pected to maintain the necessary sanitary facilities in a satisfactory manner.


TOURIST CAMP SANITATION

As required by law and regulations of the Board poerits were issued during
the past seven years for tourist camps asafollows:

1927-28 ............... 213 1930-31 ............... 173
1928-29 ............... 178 1931-32 ............... 215
1929-30 ..'......... 163 1932-33 .......2...... 218

1933-34 .......... 218

The expiration date for tourist cr=p permits is September 1 and no doubt
the number of permitted camps will be greatly increased before that date

Tourist craps are entering a new stage. The original tent city is n) sel-
dom seen, but the present season shows an enormous trend toward travelling with
the house car trailer, which nay be dfachod leaving the car for sioe trips and
local communication. The situation on the lower East Coast before the end of the
year was becoming very acute. It is difficult to supervise this type of tourist
outside of approved tourist camps and the latter are rapidly becoming over-crowd-
ed. Improper disposal of human wastes is the greatest menace to the uncontrolled
trailer house car visitor in our midst. Some assistance is received on'this
problem in the cities but on the outskirts and in rural areas the district sani-
tary officers are finding this a very difficult problem requiring muchyime.
*Ak










The increase of trailer traffic often overbalances sanitary facilities of
permitted tourist camps which are prepared to handle only a limited number of
campers outside of cabins. A requirement for registration of all visitors
set up in the rule No. 91, which has not been enforced for some time, will
have to be insisted upon so as to determine whether facilities provided are
sufficient between inspections. The latter are mado at some weeks intervals
and without registration there is no record of patronage except during inspection
periods.

Conference was had with a supervising architect of the State Hotel Commis-
sion regarding conflicting legislation on tourist camps. That Department is
uncertain as to overlapping of inspections on these places. This Department has
no choice except to exorcise supervision over all places whGre "three or more
tents, tent houses or camp cottages are maintained for use most generally by
transients." In the opinion of this Bureau such establishments should be ex-
cluded from the jurisdiction of the other Department by which they are classi-
fied as "rooming houses." A clarification of the law on this subject should be
requested at the next session of the Legislature.



MOSQUITO CONTROL


Malaria and Pest Mosquito Control will be included in 2ncrgency Health
Projects later in this report.

Mention should be made however of a cooperative arrangement in the newly
created Broward and Dado County Anti-Mosquito Districts by which -. superintendent
has been appointed to supervise the work in both counties. He will taku up his
duties on January 15, 1935. Under this plan the overhead expenses of supervision
to each county is greatly reduced and it is possible to pay a salary sufficient
to attract a man of experience to the position. The Bureau acts in an advisory
capacity in the mosquito control work of these districts.

Special mention should be recorded of the untiring efforts of Dr. W. W.
McKibben of Miaimi and Dr. B. F. Butler of Hollywood, which were responsible
for the creation of the two anti-mosquito districts in their respective communities.

The meeting of the Florida Anti-Mosquito Association, postponed in 1933,
was again postponed in 1934. The meetings of the Association are usually sponsor-
ed by the Bureau, and it was impossible to arrange the meeting for the time sot,
due to illness of the director and assistant director, the latter also being
secretary of the association.


STATE INSTITUTIONS


The Bureau has continued to recommend cooperative arrangements for a water


- 72 -








- 73 -


supply between the town of Belle Glade and
be necessary for either place to use water
supply the installation of one plant large
satisfactory economical arrangement.


State Prison F;rm No. 2. As it will
from Lake Okeechobee as the initial
enough for all would bu tLo only


A sanitary survey was made of the Girls Industrial School at Ocala for
determination of source of flies and mosquitoes. Improper manure disposal and
faulty sewage disposal practice was found to be the cause.

Upon the recommendation of the Bureau, chlorinators will be installed at
the water works plants of the Boys Industrial School at Marianna and at the
Florida Farm Colony at Gainesville.

A complete sewage treatment plant was designed in the Bureau for the treat-
ment of sewage from the State Hospital for Insane at Chattahoochee. The
installation of this plant was ordered following recommendations of the Bureau.


A survey was made
This is to be followed
final discharge of the


of sewage outfalls at the State Prison Fbrm at Raiford.
up and some method of treatment should be provided before
effluent into the creek now creating nuisance conditions.


OTHER INSTITUTIONS


An arrangement with the State Department of Public Welfare provides that
certain child-caring institutions shall be approved by the State Board of
Health before licenses may be issued. A number of these inspections were
made. One, a negro orphanage in Miami, was so bad that legal notice had to be
served for immediate correction of sanitary conditions. The Bureaus of
Communicable Diseases and Engineering make the inspections for the State Board
of Health.

Jails, court houses, road and contractors ctmps, recreation camps and
playgrounds have been visited by Bureau representatives on routine and special
investigations throughout the year.







- 74 -


CANNERIES


Canneries permitted during the 1932-33 season numbered 66 according to the
last annual report. For the present season permits have been issued for 88
canneries.

Recommendations were made to the State Health Officer concerning changes
in the cannery regulations to clarify certain sections of the rule on that sub-
ject. One relates to handwashing "after each absence from post of duty" instead
of "aftir using toilet." Approved water was recommended for cleaning as well
as drinking and culinary uses, and "steam where necessary" was a.ddAd. The changes
also included definite clarification regarding floor cleanliness and disposal of
wastes. *

Th': emergency meat canning operations of the FERh were followed up as care-
fully as limited personnel permitted. The canneries were all required to meet
the sanitary standards of commercial canneries and in this excellent cooperation
wns given the Buroau. Some difficulty was experienced in proper disposal of
wastes from the canneries and slaughter houses handling F~Ri cattle, and in this
emergency work it was nacssary to use thd district supervisors furnished by the
U.S.P.H.S., as regular personnel was too busy to adequately handle thu situation.

The s.verar freezu of December extending to most of the state has dcla.y3d
tomato canning this season. Coming as it does at thi height of th- tourist season
the cannery inspection work cannot be addequately cared for with regular personnel.
For the six months period at least m-,rgancy inspection service should bu made
available for tomato, grapefruit and juice canneries. With the plan of the FEA
setting up community c-anning centers throughout the state more pressure will be
brought on Bureau personnel in maintaining sanitary standards. Many of these
contemplated in rur,'al kitchens ar. very crude, and though perhaps suitable for
limited individual uses they ar. not satisfactory for volume output where many
persons are involved.



OYSTERS


Permits for oyster shucking plants and shellstock shippers numbered 100 for
1953-34, as against 95 for the previous season. expiration date of certificates
is September 1.

Shuckd oysters from all certified houses in the Apalachicola area were
examined in tho Bureau laboratory in October, November and December, and scores
were computed.

U. S. Public Ha.lth cSrvice sanitary engineer in charge of Intersatut
Sanitary District No. 2 visited shellfish houses on the &ast Coast '.s far South










- 75 -


as New Smyrna during December, houses in the other areas to be visited early
in 1935.

The work of .posting signs warning the public against promiscous collection
and consumption of shellfish from polluted areas was extended so as to include
all condemned areas and a considerable portion of other waters where oyster
growing is not carried on commercially but where individuals may endanger their
own health by using oysters therefrom.

New sketches were made of the condemned or restricted shellfish areas,
but it was impossible to find time for check surveys during the year. Those
are needed particularly in the Fernandina, Jacksonville, St. Augustine, New Smyrna,
Escambia Bay, Blackwator Bay and Apalachicola Bay areas. No surveys have been
made in the vicinity of Apalachicola and this should be arranged for immediately
to avGrt possible dangers from unknown pollution conditions in the area.

The recommendation made in the last annual report is repeated: "A special
law setting forth a penalty for taking shellfish from an area declared polluted
by the State Board of Health is noodod and should bc requcsted of the next
legislature." This law should also require that every shipper, re-shipper,
packer, repocker and wholosalor of shellfish comply with tha sanitary regulations
of the State Board of Health.

During December several cases of typhoid fevur in Tallahassoo wore investi-
gated by the Bureau of Communicable Diseases, and eating oysters from Spring
Creek seemed implicated. A check on the beds however showed no foundation for
condemning the oysters at their source. Thcrn; was some suspicion regarding two
houses which had boon erroneously certified and their permits were canceled.



MILK SANITATION


Little has been done in advancing the policy of the State Board of Health
in carrying on the approved program of milk sanitation through operation of
the U. S. Public Hoalth Service Milk Ordinanco and Code, including the rating
of cities. Shortage of personnel has not permitted the release of sanitary
officers for this work.

With the expectation that this work would be resumed after January 1, the
Milk Investigations Division of the Servioc assigned an Associate Milk
Specialist to work in Florida during Deccmber for the purpose of coordinating
the Florida program with that of other States.

It is planned that all sanitary officers will assist local municipalities
in their inspection service and one sanitary officer will be assigned to make
all ratings throughout the State at least once o:uch year.








- 76 -


Several inspections were made of dairies at the request of authorities in
charge of 0CC camps and numbers of small dairy inspections were made throughout
the State. Concentrated surveys were made of dairies serving Crestview, DeFuniak
Springs and in Pinellas County by district sanitary officers.

For some time considerable pressure has been brought to bear urging the
Bureau to undertake State wide inspection of small dairies of five cows and
less which are exempted from the provisions of the State Milk Products Law ad-
ministered under the Stato Department of Agriculture. The Director has consistent-
ly held to the position that two agencies cannot expect to divide inspection work
of dairies on the basis of number of cows. Jurisdiction of the State Board of
Health is based entirely upon public health significance of milk sanitation, and
this is not determined by number of cows milked. Being impossible to inspect all
dairies in a satisfactory manner it was felt that only special inspections called
to the attention of the Board as n3sding attention would be made.

Conferences with the Director of th, State Milk Control Board were had with
n view of learning what dairies wore properly conducted and equipped and thus
qualified to be licensed by that Board. Arrrgcments were madG to furnish an
inspector to visit all dairies in question, reporting to the director of the
Milk Control Board the condition of each and whether or not they complied with
the regulations of the State Board of Health. Salary and expGnses of this in-
spector arc paid entirely by the milk control board.


RABIES


Excellent progress in reduction of rabies was reported in the last annual
report, but the year 1934 shows a marked increase in the number of specimens
submitted and positive findings in the State Laboratory. The last months of
the year show a more decided increase, proving definitely that the intensive
work which was done in 1952 and 1933 in securing wide spread vaccination of dogs
has worn off and will need to be repeated. Criticism of th. vaccination program
by a representative of the Anti-Vivisection League was responsible for holding
up the work in one locality during the year, but no change is suggested from
previous recommendations for compulsory universal vaccination of all dogs every
twelve months. Towns and cities should consider this as a health measure and
every effort should be made to reduce the cost to the dog-owner to the lowest
possible amount. A rabies vaccination clinic, where vaccine may be administered
at cost, is suggested.


DRAINAGE WELLS


Permits for 15 drainage wells have been issued during the year, located
near the following centers of population: Orlando 4, Ocala 2, Bartow 1, Tampa 1,








- 77 -


Eastis 1 and Miami 4. All of these wells will receive only condenser and excess
storm water free from sewage contamination.

Information has been requested of the State Road Department regarding wells
drilled by that Department for the disposal of surplus storm waters for high-
wy drainage. This information has been submitted only in part. No permits
were issued by the State Board of Health for these wells and this should be brought
to the official attention of the Road Department io that in future the proposed
locations might be studied before the wells are drilled.



"DOG PLIES"


In the Gulf Coast section of North West Florida during the late summer and
early autumn of every year there is an infestation of Stomoxys Calcitrans,
locally known as "dog flies." They have no known connection with disease
transmission at present, but because of their pestiferous nature many appeals
have been made to the State Board of Health for aid in their control. Dr. W. V.
King of the U. S. Bureau of Entomology was taken through this territory on a
preliminary survey in 1933 by the Director of the Bureau and his cooperation
arranged for during 1934.

Some seasons infestations in this section arj worse than others but when
they do occur they cause largo economic losses readily comparable to her.vy
salt marsh mosquito invasions of other localities. Dairymen report reductions
in milk production as great as fifty percent within a week after their appearance.
Cattle grow poor as they stand in water of the bays and bayous up to their backs
to escape the bites of this fly. Fishermen find them unbearable on a land breeze
fifteen miles from shore. Bathing beaches and summer cottages are deserted
during six weeks to two months of the most delightful part of the season.

Peculiar brooding habits of the "dog fly" may account for its prevalence in
late summer and early autumn. Heavy production has been noticed in drifts of a
particular seaweed, or more properly called algae, largo quantities of which
drift in from the Gulf during the latter part of Juno through July and August and
are deposited along the beaches. Eggs are presumably laid by preference in this
seaweed or algae after it has reached the beach and if kept sufficiently moist
by seepage and capillary attraction their development follows through the larval
and pupal stages to the adult fly.

The algae mentioned has been identified as Gulf Weed or Sargassum. The
cooperative studies made with Dr. King during the past summer led to finding
definite breeding under thu conditions mentioned, but need to be continued.
sponsorship of this program will hrv. to be assumed by the State Board of Health
if there is to be an early solution of this problem.








- 78 -


Trapping attempts carried on during the last season with FERA and local
assistance in five counties proved conclusively that Stomoxys do not readily
enter traps baited with carrion or saccharine substances. Such a program
was discouraged as being impracticable.



KEY WEST REHABILITATION


Upon the acceptance of the task of rehabilitation of Key West by the FERA
in July, the Administrator requested the assistance of the Bureau in the
organization of a sanitary department under a plan which could later be
absorbed by the municipality.

A sanitary officer of th6 Bureau was assigned to this task and remained
for a considerable time in getting the organization in operation. A former
sanitary officer of the Bureau was appointed Chief Sanitary Inspector with
Sr-nitary inspectors, food and dairy inspector, privy construction supervisor
and garbage and scavenger superintendent. As many as twelvc trucks were assigned
by the administrator to this department which was operated for some woeks as
a branch of this Bureau. A tremendous amount of clean-up work was done in the
city, food inspection was put on a firm basis and regular dairy inspection under
the Standard Milk Ordinance was inaugurated.

A novel plan for caring for small dairics which could not rebuild in a
satisfactory manner was put into ust~. The cattle and equipment wore appraised
and purchased outright by the Relief Administration.

Garbage and scavenger service was also organized on a regular basis and
all property owners were furnished new covered metal garbage cans at cost.
Use of these cans was hastened by instructions to garbage collectors to take
up all containers into which garbage was placed unless they were standard
approved cans.

Through this department a severe dongue fever epidemic was no doubt fore-
stalled as it was when clean up work was started one of the most fertile fields
known for production of Aedes Aegypti mosquitoes. The sanitation program in-
cluded oiling of cisterns, filling or recovering being the permanent curo.

During December arrangements were made to have the responsibility for the
sanitary work assumed entirely by the new sanitary department.

la the plans for permanent improvement in Key West there are included
proposals for a new salt water supply and sewerage system. The bureau has been
requested to collaborate on these plans.








- 79 -


LEGION CONVENTION IN MIAMI


With the expectation of 150,000 visitors to the Legion Convention in
October, in which from 400 to 600 Pullman oars were to be used for hotel
accommodations during the meeting, three sanitary officers were assigned to
duty in Miami to supervise extra sanitary services. Such excellent preparations
were made in advance by the railroads that no special burden fGll upon the
Bureau during the meeting. There was a considerable reduction in numbers of
oars handled over expectations, but it is believed that the full capacity of
the yard could have been handled with equal ease.


DISASTER RELIEF


Several meetings were held with representatives of the American Red Cross,
The State Adjutant General, State Health Officer and Alexander Blair represent-
ing the Roobling Estate, for the purpose of making plans for action in case
of tropical storms requiring evacuating the population from the Lake Okeechobee
section. Temporary camp sites were chosen at Lake Placid on the West side and
Okoochobeo City on the East side. Plans wore drawn for box car latrines as
well as latrines to b. used at the concentration points. These wore furnished
to Alexander Blair, the Rocbling Estate furnishing both materials and labor
for providing this equipment. Fortunately the plans were all complete and tB
absence of storms during 1934 made thim unnecessary.

It is assumed that before another "hurricane season" the dykes around
Lake Okeechoboo will be completed sufficiently to make it unnecessary to plan
future evacuations of this territory because of flood waters.


EMERGENCY HEALTH PROJECTS


This subject is divided into four subheads: Malaria Control, Community
Sanitation, Post Mosquito Control and Dongue Fever Control. Information re-
garding personnel used in those projects was given in the first part of this
report and only the work accomplished will be covered here.


Malaria Control


Malaria Control projects were supervised in 33 counties under the Federal
CWA from Dccumbar 19, 1933 to February 15, 1934. The estimated population of
these counties is 649,110 and approximately 347,055 received some benefit
from the work. No estimate is available of the work which was done on local
projects during this period, but an approximation may be secured when it is








- 80 -


known that an average of 1000 men was used on Federal CWA for four weeks and
more than 1300 men were used for the same period on local projects.

The period from February 15 to April 28 marked that under which the work
was supervised under State OWA and State ERA projects. It will be noted in
the tabulation below that no screening was done under the Federal project as
this was not considered a legitimate expense under the CWfA.


Character of Work Accomplished
Main Ditches
Lateral Ditches
Old Ditches Reclaimed
Right of Way Cleared
Fills
Ponds Drained
Houses Screened


Federal CWA
15.5 miles
7.0 miles
5.25 miles
34.75 miles
6222 cu. yds.
15


State GWA
15.25 miles
4.50 miles
17.75 miles
72.50 miles
500 cu. yds.

373


Under the program followed April 28 to December 27 the following is
takjn from the report of the Assistant State Dircgtor to the Office of Malaria
Investigations U. S. Public Health Service, Washington, D. C.


Character of Work Alcomplished
Main Ditch (Linear fuct)
Lateral Ditch (Lincar feet)
RGolaimed Ditch (Linear feet)
Fills (Cubic yards)
Reconditioned Streams (Linear feet)
Right of Way Cleared (Acres)
Ponds Cleaned (Acres)
Houses Screened
Doors Screened
Windows Screened
Porches Screened (Linear feet)


F.E.R.A. April


28 to December 27
571,559
259,025
684,159
44,778
48,167
503.794
123.092
1,599
3,019
10,158
8,512


Malaria control through the drainage program alone is not expected to
have great permanent value, however, unless it is followed by continued
maintenance. To this end it is recommended that the Legislature be
memorialized to make it possible for cities and counties to use convict
labor for ditching and maintenance of ditches for mosquito control, provided,
that it shall only be permitted when such a program is approved by the
State Health Officer. The inclusion of this provision makes it possible to
prevent exploitation of prison labor for private purposes.



Community Sanitation


Community Sanitation included the construction of privies at homos and
at schools, the property owner paying for the cost of materials, the labor








- 81 -


being furnished by relief labor through OWA and ERA sources.

During the Federal CWA 1106 privies were constructed and 41 weru repaired.
During State CWA 127 privies were constructed. Under the regional plan of the
FE3A, during the eight months of its operation 4916 privies wore built, 1352
privies were repaired and 73 septic tanks were built.

In most of the smaller counties whore it has been difficult to set up privy
projects either due to failure to finance materials or failure of the FER to
assign labor for the projects, some work has been done in assisting the county
school superintendents in getting labor assigned for building sanitary toilets
at schools. In numbers of instances the program also included new water supplies
or improvements to the system then in use.



Post Mosquito Control


This project started under the Federal CWM under a direct assignment to
the Bureau of Entomology, U. S. Department of Agriculture, which in turn made
a cooperative arrangement with the State Health Officer to supervise the work
through the Bureau of Engineering. At thi conclusion of the Federal CWA
the program was continued by the Stato CWMi through an irrc.ngumont between the
Stats Board of Health and the EPR. This was later continued under local super-
vision with advisory assistance from the district supervisors assigned to the
regional EW, offices. The work accomplished under thes, projects is tabulated
below:

Work Accomplished CWA ERA
To April 28 To Docoombur 27

Main ditch (Lineal feet) 1,499,239 ( 228,825
Lateral ditch (Lineal feet)I ( 204,388

Reclaimed ditch (Lineal feet) 55,941 769,027
Streams Reconditioned (Lineal feet) 87,293 15,172
Fills (Cubic Yards) 13,046
Right of Way Cleared (Acres) 350.57 158.46
Ponds Cleaned (Acres) 2.7

This work was done in 18 counties along the East Coast and the southern
part of the West Coast.



Dengue Fever Control


The dengue fever epidemic in Miami brought an order from the State Health







- 82 -


Officer to mobilize all forces in preventing its spread into other sections of
the State. The Bureau personnel and emergency personnel were thrown into the
work. Letters with instructions on procedure were sent to mayors of all cities
in the state, railroad superintendents, district sanitary officers, district
supervisors and regional engineers of the ERA. The State Health Officer had con-
tactzd the State ERA Administrator and orders were issued to all regional
offices to render whatever assistance they could.

The response was magnificent. The entire State received a clean-up which
has never been equalled. Bureau personnel contacted city officials, helping
to organize inspection services and clean-up campaigns, some of which were
financed by th: local governing bodies, but labor was usually furnished through
the ERA.

An outstanding piece of work was dona in Tampa in which the City Health
Department, the Sanitary Department, the Hillsborough County ERA and the State
Board of Hoalth arranged a cooperative inspection and clean-up campaign. A
district sanitary officer of the Bureau was placed in charge, under the City
Health Officer, City Sanitary Officers serving as district supervisors over
crews of men furnished by the Rit. Prior to the organization of this cooperative
program the City Health Department in 11 weeks work in Ybor City up to October 19,
had made 66,619 inspections, removed 111 loads of trash and containers and
found 178-207 water containers in 12,526 of which mosquito breeding was found.
The peak of reported dengue fever cases numbering 77 was for the week of
October 15 to 22. The cooperative project was closed on December 13 after 8
weeks work. An average of 75 men was used; calls made 73,233; containers found
1,091,828; containers breeding mosquitoes, 20,864. The first inspection of the
entire city required 4 weeks, the second inspection required 3 weeks, including
one inspection through outlying sections. The last week was spent exclusively
in outlying sections.



PUBLICATIONS


With the cooperation of the ERA through furnishing of office personnel it
has been possible to publish in mimeograph form four pamphlets which were pre-
pared or rewritten in the Bureau, viz:

1. Water Supply and Sanitary Toilets for Schools.
2. Sanitary Privy Booklet.
3. Mosquito-Proofing Your Home.
4. The Filthy Fly.

Detailed sketches were made of water supply lay-outs and cross-connections
from notes of field men engaged on those investigations.








- 83 -


A complete set of maps of the 67 counties, consisting of 169 sheet,
20" x 40" were made on a scale of 1 inch equal one mile. Locations of all
schools from information secured in the school survey wore platted on all of
the maps except for Gadsdon County.

Enlargements were made of the U. S. Engineer Corps and U. S. Coast &
Geodetic Survey Maps of the coastal areas from tha Georgia line to Key Largo
and along th' West Coast as far north as the south line of Pasco County.
This set consists of 180 sheets, 20" x 35" in size, drawn on a scale of 1 inch
equal 800 faut. On thase 'maps have been platted the salt marah mosquito control
ditching on which it has boon possible to get reliable information.

Nine maps, 26" x 36" in size, woro enlarged from the railroad and sectional
map of the state prepared in 1930 by the State Department of agriculture. Each
of these shots represents one of the nine regions through which the E3r is
administered in Florida.

Copies of all of the maps listed above have been placed on file in the
University of Florida Library at Gain;sville in accordance with an agreement
made with other state agencies comprising the Florida Mapping Luthority.





RBpect fully submitted,


Chief Engineor and Director7
Bureau of Engineering.






- 84 -


Dr Henry Hanson,
State Health Officer

My dear Dr. Hanson:

I submit herewith the report of the Library for the year 1934:

Books in the Library ... .....................3270
Books added during 1934 ....................... 719
Gifts .................. ............***** 605
Purchased ..........2............... ..... 27
On hand .................................. 87
Bound periodicals in the Library ..............1077
Bound during 1954 ....... .......... 74
Pamphlets,reprints,etc. in the Library .......5006
Added during 1934 ........................r 1254

Reference searches ......................... 511
Letters of inquiry ....................... 308
Books loaned to public health workers, etc.
throughout the State .................... 342
Pamphlets loaned .............. ........... 283
Periodicals loaned .............. ...... ..... 122
(The three items above do not include
material used by the State Board of Health
personnel in the building.)
Bibliographies complied ....................... 2
Translations ....2.......................... 2
Abstracts ................................... 20

Use of the Library has more than doubled during the past year.
This applies not only to the State Board of Health personnel, but to public
health interests throughout the entire state. Requests for literature have
been received from numerous doctors, nurses, sanitary engineers in the state,
as well as from lay groups such as school teachers, social welfare workers,
public libraries interested in health education material.

The purpose of the State Board of Health Library is to build up
and maintain a collection of literature on public health and medicine, and
to make that literature available to the members of these professions in the
state. The demand for such a source of reference is increasingly apparent,
and the service of the Library will only be limited by the funds available
for such service.


Very respectfully submitted,

(Signed) Elizabeth Bohnenberger,
Librarian.







- 85 -


Deceoier 31, 1934




Dr. Henry Hanson,
State Health Officer

Dear Dr. Hanson:

I herewith submit to you the report of
activities of the Multigraph Department for 1934.

The following tables are self explanatory,
giving the various operations to complete printing for delivery.
Items such as cutting paper and trimming aro not listoi as they
are too numerous to mention. A report for each department is
also listed giving the name of form and the total prints re-
quired.

I have also listed the tvo F.E.R.A. projects
for the several departments. The projects have used this depart-
nont to advantage; they have also furnished such materials to
completoeprints as were necessary.

It is to be noted that the Multigraph Depart-
mont has been used extensively, the volume of printing having
increased considerably over that of last year.


Respectfully submitted,

(Signed) E.F.H. Ganten,
Operator.







MULT I GRAPH DEPARTMENT
STATE BOARD OF HEALTH
TABULATIONS SHOWING OPERATIONS FOR THE YEAR 1934


Sheets
through
Multigraph

225,600
329,545
337,875
310,360
98,816
38,216
191,184
137,105
156,803
255,813
262,237
154,090
2,49.,644


Sheets
Punched


Sheets
through
Mimeograph

22,686
33,715
44,720
11,580
37,616
36,060
58,698
137,450
79,675
22,585
52,487
30,500
567,772

Pamphlets
Stripped


Number
Sheets
Perforated

25,000


75,000
35,000

19,000
31,000

16,000


201,o000

Books
Wrapped


2,200


6,000
10,000


2,200


2,000


20,200


2,200 30


Number
of
Pads

1,020
2,357
960
1,067
104


1,950

215
1,590
10
.9, k73


Sheets
Assembled


8,200

154,000

12,465

26,000
4,500

2,090
10,945
218,200


Number of
Multigraph Forms

49
35
29
26
35
14
38
24
45
47
32
29
403


Pamphlets
Stapled

486


4,173
76
500

2,000
905
2,000
110
1,380
11,630


Sheets
Numbered


2,200


2,000

4,200


Number of
Mimeograph Stencils

89
80
104
39
158
67
43
205
127
85
100
48
1,145


1934


Jan.
Feb.
March
April
May
June
July
August
Sept.
Oct
Nov.
Dec.


1934

Jan.
Feb.
March
April
May
June
July
Aug
Sept.
Oct.
Nov-.
Dec.







- 87 -


Printed forms, Bond paper, Onion paper,
Envelopes furnished to Administration by Multigraph Department:


ADMINISTRATION


Letterheads .......................6,350
Envelopes ................... .......** 7,650
Bond Papor.............................1,000
Onion paper ...................... .. 7 50L
Scratch pads .......................... 20
Letters ............... .. ....... ..*... 315
Yellow paper .......................... 500
Report of County Health Unit ..........1,000
Mailing Wrappers ..................... 500
Wrapping Annual Report ................ 30
Mineographed letters ................. 30
Annual Report ........................ 610
Directory Chart ...................... 6
Addition to letterheads ...............2,360
Government Envelopes (Dr.Griffitts) ..... 504
A New Deal in Health ..................25,000



DIVISION OF ACCOUNTS


Letterheads ...........................2,000
Envelopes ............................. 2,038
Bond paper .......... .. .. .............. 500
Onion paper ..........................5,000
Onion paper letterheads.............. 625
Purchase Orders .......... ..... .....4,200
Absent of Leave forms ................ 506
Post Office address notices........... 20
Addition to expense statements ....... 975
Gas tax exemption.................... 100
Voucher forms..,................... .8,000
Scratch pads ...................... 10
Mimeographed letters ................ 500






-88 -


Printed forms, Bond paper, Onion paper, etc.
supplied to the Bureau of Vital Statistics.


Letterheads.............. ........ 23,C00
Envelopes (all sizes) ............... 83,900
Burial Permits (books ............... 1,485
Letterheads F.P.H.A................ 3,000
Death Certificate Pads .............. 1,000
Marriage check sheets ............. 4,000
Report of Divorce ................... 10,000
Death Index ....................... 1,500
Voucher forms ...................... 6,000
V.S. 136 A & B .................. 4,000
Marriage Index Cards ...;........... 44,260
Trade Mark'dheets ................. 40,000
Birth Certificates .................. 5,000
Birth Index Cards ................... 25,500
Death Index Cards ................... 20,500
Divorce Index Cards ................ 4,500
Scratch Pads ....................... 430
V.S. 138 .......... ....... ......... 500
V.S. 137 ............................ 500
Birth Certificate Books ............. 2,200
Cemetery rec rds .................... 1,973
Signature Notice ................... 5,000
Death Certificate books ............. 200
Death Certificate pads .............. 1,067
V. S. 13 .......... .... ............. 2,450
Copy on Second Sheets ............... 2,000
Receipts (Emnons) .................. 950
V. S. 18 ......................... 2,000
V. S. 122 ..... ..... .... ........... 2,000
M. L. 7 ............................ 4,000
M. L. 8 ................... ...... .... 1,000
Health Notes sheets ..*............ 400
Birth Supplemental ................ 4,000
V.S. 136 D & C ...................... 2,500
Health Notes Notice ............... 200
Death Supplemental ................ 8,000
Acknowledgment ............... ... 2,200
Divorce check sheet ..............,.. 784
V. S. 102 ......... ................. 1,000
Current. record ..................... 500
Signature of Health Officer ........ 471
Personal report .................. ... 1,825







.- 89 -


Printed forms, Bond paper, Onion paper, etc. supplied to the
Bureau of Engineering:



Letterheads ............................. 9,000
Envelopes ............. .......... ....... 10,720
Onion paper ......................... 5,500
Bond paper ........ ................. ... 2,500
Second sheets ........................ 5,500
Daily Report ........................... 6,000
Wator Analysis letter ................. 3,000
Addition and blank out ............... 2,000
Onion paper letterheads ................ 2,000
Mimeographed letters ................. 45,058
Identification Cards .................. 50
Miueograph papor ................ 1,500
Dairy Regulations & Rules ............. 3,000
Post cards (water) .................... 662
Scratch pads .......................... 30
Dengue Noticas ......................... 1,000
Dongua3 over Control ................... 5,300
Dengue Daily Reports ..................15,500
Sanitary Pit Privy book .............. 2,000
Water Container tags ,................... 2,000
Application for Certificate(shollfish). 350
State .Certificates for Shellfish....... 500
Application for Certificate (Cannery).. 250
Rule No. 79 ........... .. *.............* 250
Auto Camp Inspection .................. 350
Concaemned Shellfish Area books ........ 310
Appointxont .form ...................... 175
3x5 Cards ............................. 300
'Water Supply and Sanitary Toilets for
Schools (Mimeographod book) ......... 110
Mosquito -Proofing your Home(mnimo book) 500
The Filthy Fly (nineo. book) .......... 500







- 90 -


Printed forms, Bond paper, Onion paper, etc. supplied to the
Bureau of Laboratories:


Letterheads ................................. 4,000
Envelopes (Manila) ......................... 1,000
Envelopes (Tampa) ................#13-2 ...10,000
S. .*.. ....#1-3~- ... 7,900
Sn ...... ...... .... # 9-3 ... 500
Envelopes (Jacksonvillo) ............#13-2 ...23,480
".. ... ......#13-39.. .29,000
............# 9-30... 845
Envelopes (Miami) ..................#13-29... 7,000
S- .................. #13-32... 2,000
Envelopes (Tallahasseo)..............#13-2 ... 2,500
-. ............. #15-3-... 2,500
.. "......... # 9-20... 250
.. ........ ..# 9-30... 250
Envelopes (Pensacola)................#13-2 ... 1,000
.............. ........#13-30... 500
it ....... ........# 9- .... 250
Container labels (Tarnpa)................... 8,000
(Jacksonvillo) ............20,000
Bond paper .............. .... .....'.. ..... 8,500
Chip Board *99999999999999999999999999999999 4,300
Chip Board .................................. 4,300
Kahn Reports 9.9....................... .....54,000
Certificate of Indigent ..................... 2,000
Yellow Second shoots ....................... 3,500
Onion paper ....... ........ ............... 1,500
Malaria data ............... ............1.2,000
Agglutination &ata ... ....................12,000
A. P. Data .................................56,000
A.P. Daily report .......................... 6,000
Malaria Enveloops (Jacksonvillo) ...........17,400
H H (Tampa) .................. 1,500
Mailing labels (Jacksonville) ............... 2,100
(Miami) .............. .... 327
(Tallahassee) ............... 327
(Tampa) ..................... 327
(Pensacola) ................ 8,000
Kahn Report blanks ........................10,000
Diphtheria Data o.................... ........24,000
Kahn Data ..... ...........................24,000
Instruction on Tetrachlorethylone ........... 6,000
Gonorrhea reports .........................16,097
Agglutination reports .......................16,000
Malaria Reports .............................16,000
A. P. Reports ............................ .. 30,000
Diphtheria Reports ...........................16,120
T.B. Reports ................... ........ .....12,000
Report of Laboratorios on Malaria ........... 5,000




University of Florida Home Page
© 2004 - 2010 University of Florida George A. Smathers Libraries.
All rights reserved.

Acceptable Use, Copyright, and Disclaimer Statement
Last updated October 10, 2010 - - mvs