Secretary's Report. retains all the powers given him by law and such others as the board that appointed him may have conferred until the action of the appointing board is modified or annulled by itself or by some successor thereto. HEALTH OFFICERS. As a rule these important officers have been selected judiciously. In places where the choice of a physician is impracticable the tendency is toward the choice of some one who from the nature of his calling may be properly supposed to take an active and intelligent interest in sanitary matters, as a teacher, a clergyman, a school superintendent, a lawyer, etc. It is true that there are notable instances in which the fitness of things appears to have been wholly disregarded, and in which boards of health, in places where there are several physicians, have appointed others than medical men as health officers. Such appointments must be regarded as either violations of the law which requires that medical men shall be appointed to act as health officers wherever it is practicable so to do, or as official declarations on the part of boards of health that there are no reputable physicians in such places, or that no 'reputable physician in them will accept the office. As note-worthy instances of this kind of appointment, I may refer to the city of Cedarburg, where the health officer is reported as being a barber by occupation, and to the city of Fond du Lac, which ranks among the larger cities of the State, where the health officer is reported as being a shoe manufacturer, neither of these occupations, while honorable in themselves, implying the possession of the kind of knowledge which should be possessed by a heatth officer. Such appointments in places where there are known to be able resident physicians, do not seem justifiable on any ground whatever. Take for example, the important city of Fond du Lac, where three great railroad systems meet, bringing the place into intimate relations with all parts of Secretary's Report. the country, and the possibility, the probability even, that exists that dangerous contagious disease may at any time be brought thither; the position of health officer here is of the highest importance, and very clearly its duties and responsibilities should be intrusted only to one whose education. and training have been such as to fit him to deal promptly and effectively with any emergency that may arise, such for instance as the sudden introduction of cases of Small Pox or Cholera, in which the safety of the entire community depends on the immediate perception of the danger of the situation and intelligent, prompt and decided action to avert it. The situation is more dangerous than one that is a frequent subject of comment and condemnation by the press of the country, in which for example, an incompetent man is put in charge of a steam boiler which explodes and causes the death of perhaps a half dozen persons, or where the employe of a railroad company by carelessness, or forgetfulness, or ignorance, misinterprets telegraphic instructions and sends two trains crashing into each other; in these cases comparatively few people are involved, although the attendant circumstances are often of a character to attract public attention, while in the cases under consideration the safety of a whole community may be involved, together with the lives of a proportion which may be smaller or greater, the danger being none the less real because the sources remain hidden or unobserved. Notwithstanding these exceptions and a few others similar in kind, judging from the best information obtainable and as a result of such investigation and inquiry as have been practicable, and from the testimony given by the correspondence of many health officers with this office and by their reports, I am of the opinion that the health officers of Wisconsin are, as a body, men having a just and proper sense of the importance of the duties committed to their hands, and desirous to perform those duties conscientious and faithfully. Having to deal with matters of a delicat Secretary's Report. and complex character, standing between the community on the one hand, which is to be protected against dangerous contagious disease, and families on the other, jealous of any intrusion, especially jealous in many instances, particularly among citizens of foreign birth, of anything that looks like governmental interference, setting a high value on the right to come and go without restraint, it speaks well for these officers that few complaints are heard of their actions. Appointed to office, as is only too generally the case in this country, without special training, and usually with but a vague notion of what a health officer has to do or of the extent of his powers, called upon at times to act under circumstances of difficulty and perplexity, the fact that so little friction has occurred, while the work has on the whole been done so well and the community has been so efficiently protected, is worthy of special note. Such being the case, and the worth of the services rendered by health officers being what it is, there is reason for surprise that even in communities where better things might be expected, the health officer receives little or no compensation for his work, that he is even. as one of them forcibly states the situation, "expected to do the multifarious and important duties required by his position, without a pretence of recompense, except in the event of his being able to do something tangible and evident." I remarked in a former report on the curious anomaly often presented in connection with sanitary work, in that the better and more perfectly such work fulfils the end for which it was designed, the less the apparent need for it, and the more the tax-payers of the locality are inclined to regard it as needless and to oppose any extension of it. This condition it is that prevents the work of the health officer from being "tangible and evident" except in the course of time which may be longer or shorter, and which consequently prevents in many instances the provision for some adequate compensation. Thus it comes about that instead of a salary commensurate with the importance of the work, we find Secretary's Report. health officers reporting the receipt of such pittances as five or ten dollars a year, or "a per diem allowance of about the average wage of an unskilled worker, or in that proportion for each part of a day actually spent in the performance of his duties," no provision being made for their expenses! To this however it may be that there are exceptions; in one instance the health officer reports that he is allowed travelling expenses at the rate of ten cents per mile, and it may be that others receive the same but have omitted to mention the fact. I trust that such is the case, for the matter of compensation to health officers is not a wholly creditable one to a State so generally broad and liberal in its views as is Wisconsin. HEALTH LAWS. I have to call attention to the fact, once before brought to the notice of the Board and subsequently laid before the legislature, that the laws of the State relating to health matters are in a very unfortunate condition of complexity, being scattered through the Revised Statutes and the volumes of general laws passed by the legislature since the revision took place, so that at the present time it is a matter of considerable difficulty to ascertain exactly what they are. A question frequently asked of this office is whether a local board of health has power to do certain specified things, and the question is in many instances, one very difficult to answer intelligibly. For example, it is by no means unusual to receive a letter from a health officer or from some citizen, describing some abominable condition of things, and asking whether or not the local board has any power in the premises. Now while at first sight such a question seems susceptible of a brief and simple answer, examination of the statutes, and the various additions and amendments thereto, often results in the conclusion that such a response cannot be given, and that the best that can be done is to refer the inquirer to the district attorney of his county, or to his own legal adviser. An unfortunate Secretary's Report. consequence of this course is that the State Board of Health is sometimes credited with a disposition to evade responsibility, to dodge giving advice or an opinion upon a subject that should be well within its knowledge, and concerning which it should be competent to pronounce authoritatively. Now while I am well aware that there are numerous points that at first sight appear to be within the jurisdiction of local boards of health, but which on examination are found to belong to the courts of the State, and which must be taken thither for authoritative settlement, there are also many others that really do belong to the local boards, but the explanation of which is complicated by the necessity for examination of laws and amendments thereto scattered through a number of volumes. If it were practicable to have these laws collected into a single pamphlet, as has been done by the State Board of Health of Michigan, by that of Massachusetts, and by the Boards of several other States, and to place the pamphlet so formed in the hands of health officers and clerks of local boards throughout the State, it is highly probable, to say the least, that the work of the board in this particular direction would be much facilitated. SICKNESS IN THE STATE. Concerning the various forms of disease that have occurred in the State during the past year, information drawn from the reports made to this office from time to time by health officers and health boards will be found in the pages immediately following. A few special forms of disease appear to call for a word or two in addition to what is hereafter to be said. The indications at present are that faithfulness in reporting all suspicious cases of sickness, both by physicians and the people generally, and that vigilance and promptness in investigating such cases and in taking such precautions as are found necessary on the part of health boards and health officers are imperatively called |