REPORT OF THE PERMANENT SECRETARY OF THE BOARD. To the State Board of Health: GENTLEMEN: In accordance with our organic law and my duties as your executive officer, I beg leave to offer, for your acceptance and presentation to the State Legislature, the accompanying report. You will perceive, in that portion addressed to the Governor, that I have already referred to some of the leading topics which have occupied our time and deliberations, calling special attention to such questions as, in our opinion, required legislative action. Working as we do for the pub. lic, and writing, not for the professional, but lay reader, I now propose to give the results, rather than the details, of our labors, under appropriate headings or groups, in as simple and perspicuous a manner as possible; and afterward to arrange, in the order in which they were read, discussed, and amended at the several meetings, the papers, em bodying the investigations and studies of the committees and individual members of the Board. All of which, it is hoped, will meet your approbation. 1. THOMAS M. LOGAN, Permanent Secretary California State Board of Health, SACRAMENTO, July 1st, 1875. VITAL STATISTICS. In the last biennial report, certain suggestions were made, pointing out how the laws relating to the registration of marriages, births, and deaths might be so amended as to make provision, by compulsory fines, for more complete statistics, than it is found possible, to collect under existing circumstances. In accordance with these suggestions, some of the friends of progress in this matter drew up a bill for the amendment of the law, which received the approval of the Hospital Committee of the Senate, to which it was referred, but for lack of time it failed to become a law. The reasons why the law should be amended are stronger and more cogent now than ever, because the returns have been becoming more and more irregular and imperfect, and are, therefore, utterly worthless for the purposes of statistical compilation and discussion. As stated in my report to the Governor, society at large has an interest in these statistics over and above the personal interest of the few who record them, and the State should pay for their collection. Certainly no expense for recording them should be borne by persons placing them upon record. As the law now stands, "the Secretary of the State Board of Health shall prepare and furnish to the Clerks of the several Boards of Supervisors of each county, a model for blank forms, of suitable quality and size, to be used as books of records;" but no provision is made as to how these books shall be paid for, nor is the Secretary authorized to have them printed. This is, perhaps, the principal reason why the law has become inoperative. Some of the County Clerks have provided themselves with suitable books, and make prompt returns, but the law does not make distinct provision therefor. From the experience we have had, it would seem that the clerical work of so elaborate a kind as that involved in the registration of marriages, births, and deaths, requiring compilation from the original returns and the necessary computations, should be committed to the Secretary of State, who is charged, ex officio, with the duty of supplying stationery, books, printed matter, etc., for State purposes; while that part of the surveil lance and tabulation which exacts a certain amount of technical knowl edge to make them valuable, might remain under the control of the Secretary of the State Board of Health. This is the plan adopted in other States, where registration laws are now being carried out with better success, after many years of abortive efforts and trials. It is to be hoped that no longer time will be consumed in attempting to carry out the present defective plan The sooner a different system is inaugurated the better, for it must be borne in mind that the main value of such statistics is not in their immediate application to business affairs for a few days, weeks, or months only, but in those general principles which are only reached through long series of observations, extending through many years; and then it depends upon their accuracy, which is better secured by prolonged than by hasty labor. Life tables are of great pecuniary importance to the people, inasmuch as the life insurance business is based upon them; but no life insurance company would trust or venture their capital on the mortality-expe rience of a single year in a single locality; and what is true in this particular of this one item of vital statistics, is true of other items. By means of the commendable cooperation of the members of the medical profession in various parts of the State, I am now enabled to supplement, for such as it was expected would be furnished through the instrumentality of the registration laws, the following MORTUARY AND SANITARY STATISTICS. Pursuing the plan adopted in our former reports, I have prepared similar tables for the calendar year eighteen hundred and seventy-four, showing, as completely as it is possible to do under existing circumstances, the death-rate in twenty three towns and localities in different sections of the State. The population of these places has been put down, for the most part, in accordance with the estimate of the medical gentlemen (1) furnishing the monthly returns of mortality, and who are best able to judge as to the increase or decrease of the inhabitants within the area of their practice. By means of these monthly returns, which have been received continuously for a number of years, we are furnished with the various data that are required for making the present results comparable with those of our former reports. Unfortunately, owing to the difficulties which attend a correct diagnosis, such as the less definite employment of nosological nomenclature, which allows many deaths to be credited to the wrong disease, and the shameful fact that the most ignorant non-professional persons are permitted to give a certificate of death, but little reliance can be placed on such statistics as to special diseases. They may be trusted, nevertheless, in regard to total mortality, and to such particular diseases as consumption, diseases of the lungs, and of the stomach and bowels, scarlatina, diptheria, and typho-malarial fevers, which are popularly well known, and to which I have chiefly confined my investigation. My present purpose is only to show, in as condensed a form as possible, by means of tables, a few of the practical facts investigated in such researches, such as the death rate, as well as the total mortality from all causes, and from certain principal diseases, severally and in groups, with the proportion of deaths from all causes and to population-i. e., the prevalency and fatality of certain diseases. (1) The names of these gentlemen will be seen in Table No. 1, in connection with the results of their labors. I would here, also, take occasion to acknowledge the receipt of further returns of monthly mortality, as well as of sickness, from the following named contributors, with their places of residence, viz: Dr. A. Trafton, Woodbridge; Dr. Q. C. Smith, Cloverdale; Dr. A. H. Cochrane, Watsonville; Dr. J. J. Sawyer, Susanville; Dr. M. C. Parkison, Antioch; Dr. E. Parramore, Yolo County; Dr. Thos. Ross, Woodland; Dr. G. A. René, San Bernardino; Dr. H. F. Hall, Modoc County; Dr. J. P. Jackson, Stanislaus County; Dr. M. S. McMahan, San Jose; Dr. C. G. Kittredge, Oakland; Dr. J. H. Crane, Petaluma; Dr. C. B. Robertson, San Andreas; Dr. M. Baker, Tulare County; Dr. W. W. Davies, Sulinas; Dr. W. L. Graves, Centreville; Dr. W. Nichols, Pajaro; Dr. J. Bradford Cox, Healdsburg; Dr. L. F. Jones, Sierra City; Dr. W. B. H. Dodson, Kelsey; Dr. J. S. Hammond, Lockford; Dr. P. B. M. Miller, Oroville; and Dr. J. E. Pelham, Shasta. Although the reports from these various sources are not available for present purposes― because of want of continuity with some, and because of being of too recent a date with others-still they have proved useful in furnishing the Board with prompt and reliable information from so many important points, and will on a future occasion enter into our computations, provided no interruption is allowed to occur in the regular monthly returns. Such reports must cover the twelve consecutive months of the calendar year to fulfill all the purposes for which they are required. |