PUBLIC HEALTH REPRTS VOL. 29. JANUARY 30, 1914. No. 5. PIORKOWSKI LABORATORIES NOT LICENSED. Information has recently becn received from various sources to the effect that, through agents and printed circulars, the statement is being circulated that the Bacteriol. physiolog. Institut (Piorkowski Laboratories), Berlin, Germany, has been licensed by the Treasury Department for the importation and sale in interstate traffic of "turtle tuberculin." These statements seem to emanate from so- called Piorkowski Laboratories, located, or represented as about to be located, in various cities in this country. This statement is contrary to fact. After an inspection of the establishment by a representative of the Treasury Department and an examination of samples of the products at the Hygienic Labora- tory of the Public I-lealth Service, the Bacteriol. physiolog. Institut (Piorkowski Laboratories), Berlin, Germany, was refused a license by the Treasury Department for the importation and sale of their products in interstate traffic. Under the act approved July 1, 1902, regulating the sale of viruses, serums, toxins, and analogous products in interstate traffic, such preparations applicable to the prevention an(d cure of diseases of man may be imported without license, provi(led they are not sold or intended for sale but for scientific experiments. The above-mentioned act requires that each package of virus, seruni, toxin, antitoxin, or analogous product must be plainly marked- with the proper name of the article contained therein, and the name, address, and license number of the manufacturer. Since this provision is strictly enforced, no difficulty should be experienced by anyone in determining whether a particular product has been propagated in a licensed establishment. Persons or firms engaged in the sale of unlicensed products in interstate traffic are liable to a penalty consisting of a fine not exceed- ing $500, imprisonment not exceeding one year, or both such fine and imprisonment in the discretion of the court. 17 (221) January 30, 1914 222 PUBLIC HEALTH ADMINISTRATION IN MARYLAND. A STUDY OF THE STATE DEPARTMENT OF HEALTH AND OTHER AGENCIES HAVING SANITARY FUNCTIONS. By CARROLL Fox, Surgeon, United States Public Health Service. The Federal, State, and local governments are so closely related in public health matters as to make it highly desirable for each to have full knowledge of the organization, powers, and duties of the others under law, and the extent to which these powers are beimg exercised. Such knowledge will prevent duplication of effort, con- duce to more thorough cooperation, and stimulate to greater uni- formity in public health administration. The act of February 15, 1893, authorizes the Public Health Service to examine State and local laws and regulations for the prevention of the introduction and spread of contagious diseases, and the act of August 14, 1912, contains authority for investigations of sanita- tion. Under the former provision, an analysis has previously been made by Kerr and Atoll of laws and regulations in respect to the organization, powers, and duties of State and local health authorities, and the results published.' These authors have also made an analysis of the State laws and regulations relating to the control of communi- cable diseases.2 It was logical to undertake a closer study of public health admin- istration under these laws, and an invitation of the State Board of Health of Maryland afforded an excellent opportunity. The work of -which this report contains the results was begun in July, 1913, and continued for a period of approximately six months. During this time studies were made of the organization and operations of the Maryland department of health and its controlling body, the State board of health, and the health machinery of counties in different parts of the State. The work was greatly facilitated by the officers of the respective departments and healthi officers visited. Acknowledgments are due and here made to these officers for their uniform courtesies, and especially to Dr. John S. Fulton, secretary of the State board of health. STATE DEPARTMENT OF HEALTH. The State department of health was reorganized in conformity with chapter 560 of the act of 1910 (sec. 21h, art. 43, of the Public General Laws of Maryland) from the then existing "State board of health." The State department is divided into the board of health, the ruling body; the executive office, in charge of the secretary of the board, who is also executive officer; the clerical division, in charge of the I Public Health Bulletin 54. 2 Pijblie Hlealth Btilletin 62. 223" January 30, 1914 chief -clerk of the department; the division of foods and drugs, in charge of the State food and drug commissioner; and the bureaus of communicable diseases, sanitary engineering, vital statistics, chem- istry, and bacteriology, each in charge of a bureau chief. State Board of Health. Membership of the board.-Section 1 of article 43 of the Public General Laws of Maryland provides that the State board shall be composed as follows: Four members, one of whom shall be an expe- rienced civil engineer, and three of whom shall be experienced physi- cians, to be appointed by the governor, with the advice and consent of the senate; a secretary, elected by the board, who shall be an educated physician and experienced in sanitary science and who shall be execu- tive officer of the board as well as a member; the attorney general for the State; and the commissioner of health of Baltimore City. Tenure of office of members.-The secretary holds office as long as he faithfully.discharges the duties thereof. He may be removed for just cause at a regular meeting of the board. The term of office of the other appointive members is four years. The law provides that every two years the term of office of two of the appointive members shall expire and that then two other members shall be appoirfted1t fill their places. (Secs. 1 and 5., art. 43.) Meetings.-The board is required to meet quarterly in the city of Baltimore, and at such other times and places as they shall appoint. Under this authority the board meets on the first Thursday of each month in the city of Baltimore, a majority being necessary to con- stitute a qu6rum for the transaction of business. Salaries and expenses.-The secretary receives $2,500, other mem- bers'of the board $5 per day for each day's attendance at a meeting of the board. The secretary and members of the board receive actual and necessary traveling expenses. (Secs. 5 and 20, art. 43.) Pnwers and duties of the board.-By legislative enactments t.he State board is given rather broad general powers in respect to its internal administration and public health matters within the State. These powers and duties are summarized from the laws as follows: 1. To have general care of the sanitary interests of the people of the State. 2. To make sanitary investigations and inquiries respecting the causes of diseases, and especially epidemics, the causes of mortality, and the influence of locality, employ- ments, habits, and other circumstances and conditions upon the health of the people. 3. To inquire into and investigate all nuisances affecting the public health. 4. To abate such nuisances by applying to the court for an injunction. (Sec. 2, art. 43.) 5. To elect a president from among their members and a secretary to be executive officer. (Secs. 3 and 4, art. 43.) 6. To organize in any city, village, or legislative district, local boards or advisory committees to serve without pay. -anuary 30; 1914 224 - . To send their secretary or a committee to any part of the State to investigate any nwusal sickness or mortality. 8. To take all needful sanitary measures and precautions in emergencies. 9. To adopt all needful rules and regulations subject to the provision of this act. ISec. 3, art. 43.) 10. To take such action and adopt and enforce such rules and regulations as will prevent the introduction of communicable diseases into the State. Penalty for dis- 'obeying any such rules and regulations-a fine of not more than $500 for every such offense. 11. To call a public conference of health officers whenever necessary, or to send a 'delegate to any conference of local, State, or national hlth officers. (Sec. 21, art. 43.) 12. To decide questions arising between local boards as to their jurisdiction or their 4relative duty in the abatement of any particular nuisance. (Sec. 12, art. 43.) The State board of health early devoted its attention to the investigation of the prevalence and c'auses of diseases and their sup- pression, and to the registration of births and deaths. The urgent .need of a chemist soon became manifest, and provision was made for the employment of such an official in 1887. Ten years later the eq-uipment of a bacteriological laboratory was recommended, and the vwork was begun in June of the following year (1898). In 1910 the work-of the board was organized into bureaus, systemizing its per- formance and enlarging its sphere of usefulness. The number of employees was also materially increased. TFrom the foregoing it is seen that tie State board of health has been merged into a department in which, however, it retains the executive control and quasi legislative powers. Since the board does not sit constantly, however, in the interim of meetings the duties aiising must be performed by the executive officer of the department. At least theoretically, therefore, the responsibility and the power of i.nitiation to meet emergency does not appear to rest squarely enough on the administrative official whose dutv it is to handle the execYitive work. Furthermore, by reason of the method of appointments on the State board of health it would be possible at any time for its personnel to be so changed for political reasons as to include members without the necessary knowledge of public health needs.