CASES OF COMMUNICABLE DISEASES REPORTED TO THE SECRETARY OF THE STATE BOARD OF HEALTH FROM DECEMBER I TO The Medico-Legal Work of the State Laboratory in Its Relation to the State, by Importance of Pure Foods to the Physician, by H. W. Wiley, M. D., Chemist Notes of a Typhoid Outbreak in Mill River Valley, by Charles S. Caverly, M. D., Report of Examinations at the Laboratory from February 20 to May 10, 1907. Milk Standards at the State Laboratory, by L. P. Sprague, M. D. BRATTLEBORO, VT, ITS RELATION TO THE STATE. BY H. L. WHITE, A. M., MEDICO-LEGAL CHEMIST TO STATE BOARD OF The Laboratory of Hygiene in this state is unique in one respect, at least, and that is in its medico-legal department. As far as the speaker knows, there is no other state or national organization that has any arrangement for medico-legal investigations where the parties making such investigations are retained on a permanent salary basis. In some states there are appointed "state assayers" or "state chemists," and in some cases "state pathologists," who are available for expert service when called upon by the state and who are paid for work on each case as it arises. A close watch of the news columns of the papers of the New England States discloses the fact, however, that under such arrangements there is far less medico-legal work performed than is done in our own state under the present arrangement. The establishment of the Laboratory of Hygiene of the Vermont State Board of Health was authorized by the General Assembly of 1898 and was organized for the purpose of making chemical and bacteriological examinations of water supplies, milk and all food products, and examination of cases and suspected cases of diphtheria, typhoid fever, tuberculosis, malaria, and other infectious and contagious diseases. The sum of $8,000 per year was appropriated for running expenses. The work of the laboratory having increased so rapidly, it was found necessary in 1900 to ask the legislature for a larger appropriation, and so an increase of $4,000 per year was asked for, making a total of $12,000 per year for running expenses. This brought the Act of the Assembly of 1898 up for review. During the two years of the laboratory's existence, its officials had been called upon in a private capacity to give expert testimony in several important cases and had charged expert's fees; so when the Act of 1898 was being reviewed, some of the lawyers and state's attorneys conceived the idea of having the laboratory staff and equipment organized for the assistance of any state's attorney who might require chemical or pathological examinations. The idea was finally incorporated in Section 4, Act No. 90 of the General Assembly of 1900, which reads as follows: "Section 4. The use of the laboratory, and all investigations mentioned in this act therein made, shall be free to the people of this state. And whenever the state's attorney of any county, on the order of a judge of the supreme court, shall request for use in any criminal case pending in his office, an expert investigation chemical or pathological, of any substance, such investigation shall be made at the laboratory forthwith, without charge to the state, and the expert making such investigation shall submit the results of his work to the state's attorney at whose request it is done and shall attend court as a witness at any place in the state when required to do so by subpœna and submit in court the results of his investigations, and shall be paid as such witness his actual expenses of attendance, when summoned by the state." In the meantime the desired increase of $4,000 per annum had been reduced to $2,000, and so the net result, as far as the laboratory was concerned, was an increased appropriation of $2,000 for running expenses, and a corresponding increase in the amount of work to be done. According to the report of the laboratory for the years 1901-05 there has been an increase of nearly fifty per cent in the amount of work done in the laboratory since this appropriation was made. As indicated in Section 4 of Act No. 90 of the Assembly of 1900, medicolegal investigations are made only upon order of a judge of the supreme court. This order is only obtained by the attorney-general or state's attorney of the county in which an investigation is desired. Therefore it is highly important that any health officer who desires the services of the laboratory for medico-legal investigations should communicate with the state's attorney of his county as soon as possible so as to obtain this order. Otherwise the examination is postponed until the authorization is obtained. The amount of medico-legal work done in this department is considerable as the following figures will show : From Dec. 1, 1900, to Dec. 1, 1901, 12 cases (1 year) 34 cases 13 cases These figures do not include a large variety of material sent to the laboratory for which no order for the examination was obtained. These cases cover a wide range as regards material, and in their examination call for a wide range of scientific work. They include chemical and pathological examinations of organs and tissues in homicidal cases; the examination of bodies of domestic animals for poisonous substances; the examination of suspected blood stains and the determination of the nature of these stains as to whether they are human blood stains or not; the examination of clothing and secretions in cases of alleged assault or rape; the examination of miscellaneous food products and medicinal compounds for poisonous substances; and the determination of the percentage of alcohol in samples of liquors from the no-license towns. The value of the work done in this department reckoned on the basis of amounts paid for similar work in other states is about as follows: |