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Imports entered for Consumption during the Year ending June 30, 1889, with accompanying Diagram, showing the Relative Values of the Respective Classes of Free and Dutiable Imports, and the Relation of the Duty collected on each Class to its Value.

Summary of Values of Imported Merchandise entered for Consumption, by Groups, according to Degree of Manufactures and Uses, from 1880 to 1889.

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Early in the administration of President Cleveland I ventured to suggest to Assistant Secretary Fairchild to carry back this classification from the year 1884, in which it was first established, to the year 1880, so that we now have the result of ten consecutive years, 1880 to 1889 inclusive, which I now submit for consideration. I think all will agree with me that no committee of any party or under any name can fail to be governed by the logic of these lines in preparing measures of tariff reform.

SANITARY WORK IN GREAT DISASTERS.

By G. G. GROFF, M. D., LL. D.,

PRESIDENT OF THE PENNSYLVANIA STATE BOARD OF HEALTH.

THE suggestions offered in this paper are derived from the

experience of the past summer at Johnstown, Pa., and in the other flooded regions of the State, where a large share of the organization of the sanitary measures fell to the writer. Although one ninth of the inhabitants of the devastated district perished and were buried in the débris, along with thousands of domestic animals; and although typhoid fever, measles, and diphtheria existed in the district before the calamity, they never spread to any great extent, and certainly never became epidemic.

The region was a peculiarly difficult one in which to conduct sanitary relief. Along a narrow mountain valley for twenty miles were scattered some twenty-eight towns and villages, forming Johnstown. Of these, twenty were devastated by the flood, which left almost every village isolated from the others, all bridges and roads being destroyed, as also all horses and vehicles of the inhabitants, thus rendering communication extremely difficult or impossible. The members of the State Board of Health were unacquainted with the geography of the region, and with the local physicians, as well as with those who volunteered their services. There were no disinfectants on hand, and the whole appropriation of the Board for sanitary purposes was but two thousand dollars for the whole year. When, therefore, on June 1, 1889, representatives of the State Board of Health of Pennsylvania reached the desolated Conemaugh Valley, to do what could be done to prevent the occurrence and spread of disease among the exhausted and stricken survivors, the best estimates that could be hastily secured showed that ten thousand human beings, one thousand horses, one thousand cows, together with a great number of hogs, dogs, chickens, cats, etc., were drowned and buried in the débris at Johnstown, and in the drift-piles down the river, while ten thousand sufferers were without shelter, wet, hungry, and distracted. There were slime, mud, carcasses of domestic animals, and human bodies everywhere.

"No pen has yet fully described the condition that existed the next day after the waters of the South Fork Lake had swept the valley. The pen will never picture the desolation that existed, or tell of the difficulties that confronted the inhabitants of the stricken valley. The homes that were not swept away were left in the most unsanitary condition imaginable. The flood in many localities reached a height of thirty feet. This water contained

or was heavily laden with débris and every kind of filth, and whatever this water touched it contaminated. As a result, every house in the flooded district was filled to the second floor, in most cases, with offensive matter. In many cases dead animals were found in parlors, and scores of dead horses were removed from dwellings and business stands. Everything was covered with mud. There was not a place where the flood touched that man could lay his head with safety."

The State work began June 1st and ended October 12th. The result at Kernville, a ward of Johnstown, is a truthful index for the whole district. "With the concentration of twenty-five hundred people in three hundred and eighty houses, all subjected to intense mental strain by reason of the calamity and the radical changes in their habits of living, it is very gratifying to know that during the continuance of the Board's operations not a case of infectious disease developed in the district which should be attributed to bad sanitary condition." In the past history of national disasters we do not read of such gratifying results, but dire pestilence has too often followed great earthquakes, floods, fires, famine, and the disasters of war.

There are several measures not strictly sanitary, but most necessary, to which the sanitarian should give heed before his own special work occupies his attention. If the officers of the district have been lost, or in any way rendered inefficient, a strong government must be at once organized, and the district placed under efficient police control, that lawlessness and anarchy do not prevail. At Johnstown the people named a "dictator," who decided all questions of government and kept the region in order. The distress which lawlessness produces must not be tolerated. The organization of relief corps to succor the injured and dying, and to organize temporary hospitals, should receive next the attention of the sanitarian. So soon as the government is assured, and temporary relief is progressing satisfactorily, he may advise the proper committee as to what will be needed in the way of food, clothing, shelter, and medical stores. These will be required in large quantities; but in the United States, at least, we can safely rely upon the country at large to supply these things promptly. For shelter, tents can be had from the State Governors by applying to them.

At Johnstown the people did not like tents, preferring any kind of houses, and suffered great inconvenience from overcrowding rather than go into the tents. There were two forms of readymade houses used-one, familiarly known as "Oklahomas," were of two sizes: the smaller, eighteen by ten feet, with one room, and a larger, eighteen by twenty-four feet, with two rooms; and the Hughes house, which was larger and better built, consisting of

four rooms. When tents or temporary houses arrive, the proper location of these should be decided by the sanitary officer in charge. These preliminaries having received attention, the work proper of the sanitary officer begins:

1. The supply of disinfectants should be ordered at once. This order should cover all that will be needed while the emergency lasts, and is necessarily larger in summer than in winter. It was found at Johnstown that the moral effect of a large supply of disinfectants was very great and for good. In ordering disinfectants it is well to provide that what is not needed may be returned to the manufacturers. Pure chemicals and those easy of application are the best.

2. The region should be divided into convenient districts, and each placed under a local physician as sanitary inspector. At Johnstown the local physicians named one of their own number as health officer, and he nominated to the State Board of Health the inspectors, and this plan worked very well. Inspectors are also needed for the camps of citizens and laborers, for the morgues and burial-places. These inspectors should all make a daily report in writing, stating the exact sanitary condition of their districts, and in these reports they should also state any need of food, clothing, shelter, or medical stores. So long as is necessary, the inspectors should give their whole time to their duties.

3. The burial of the dead needs early attention. In summer, this must be hastened if the number be very large; in winter, more time for identification can be given. If the number of dead is very large, and the distress of the survivors too great to permit of accurate identification, bodies should be buried in their clothes, so that identification can be made out at some future time, when the bodies may be lifted for reburial. Very careful and accurate descriptions of the bodies should always be taken before burial. If possible, the bodies should be brought to one point for identification. At Johnstown, for ten days, a large proportion of the bodies were embalmed, but if buried in their clothes this is not necessary. Great care should be taken to number the graves as the bodies were numbered at the morgue, so that when lifted the record may be found to be correct.

4. The water-supply of the district should be inspected at once, and frequently while the emergency continues. Wells and springs had better be closed if any other water is available. Impure drinking-water must not be tolerated for a moment. in these emergencies. Chemical analyses should be made frequently.

5. One or more hospitals for contagious diseases should be established at once, and every case of such disease, as it arises, should be transferred to these hospitals, there to remain until all

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