252 State papers and Addresses

The work of the State Department of Health is obviously of paramount
importance. The Department was much concerned about illness and deaths
resulting from pneumonia. With modern control methods, it is now possible
to reduce sickness and death from this disease. In the past, pneumonia in
Maryland has been fifth in the causes of death. It has been exceeded only by
diseases of the heart, nephritis, cancer and cerebral hemorrhage, but exceeds
deaths from accidents, tuberculosis, diseases of early infancy, diabetes and
syphilis. I included in my budget an appropriation of $10, 000 to the State
Department of Health for pneumonia control.

Dr. Maurice C. Pincoffs, whom I appointed a member of the Board of
Health, developed a State-wide program of pneumonia control which last year
was effective in reducing the mortality rate from 94. 8 to 77. 8 per 100, 000 of
the population. This was accomplished by free distribution of drugs and serum
to physicians for treatment of patients who could not afford to but the same,
and by assisting doctors in diagnosis and treatment by examinations of speci-
ments in bacteriological laboratories. The promptness and reliability of this
service has been of great help to practicing physicians. A total of 50, 000
sulfaphradine tablets (the drug largely used in the treatment of pneumonia)
were distributed to physicians last winter.

Bacteriological laboratory service is a vital element in the program of
public health and medicine. More and more the essential nature of laboratory
service in these two fields is becoming apparent. Laboratory service is not
only of vital importance to both public health and medical practice, but is a
most valuable link in bringing these two groups into an harmonious relation-
ship which is necessary to a realization of the potential good which both these
fields can be to society as a whole.

There has been a marked increase in the work of the Bureau of Bacteri-
ology reflecting the greater activity of both groups. Examinations have in-
creased from 131, 140 in 1935 to 244, 510 in 1939. New branch laboratories have
been opened at Frederick, Elkton, and Annapolis. Two other laboratories are
planned for opening before long. One of these will be at La Plata and will,
through close affiliation with three small hospital laboratories, give public
health and medical laboratory service so badly needed in Southern Maryland.
The other will be at Easton and serve Talbot County and adjacent counties
and aid in the public health control of the shellfish industry in this area.

Two matters of supreme importance to health authorities are deaths from
diseases of the heart and the 'hygiene of maternity and infancy. Within the
last year, the Health Department has organized two demonstrations in Anne
Arundel County; one offering obstetrical services to women unable to pay the
cost, and the other a study of heart disease in children. These studies are
being made in cooperation with the Federal Government and, because of the
efficiency of the State Health Department, Maryland was selected as the
demonstration area for this important work.

The above statement recites a gratifying increase and expansion of activi-
ties which have become accepted as public health procedures. It is not enough,
however, to stop there. I have been much interested in and have supported
two other constructive projects which will be most beneficial to our people.
Reference should be made, first, to the work of the Committee on Medical
Care and, second, to the work of the Almshouse Commission. With reference
to the first, I have approved and made available sums of money for a survey