[United States Public Health Service presents The Work of the Public Health Service. Produced by The Bray Studios, Inc. Copyrighted MCMXXXVI. R.C.A. High Fidelity Recording] [The average citizen usually takes little interest in the matters of public health until an epidemic brings imminent danger to himself and members of his family.] [When the epidemic subsides he quickly loses interest again, instead of directing his efforts to the prevention of future outbreaks.] [The advice, "In time of peace prepare for war," applies to the fight against disease as well as to that against a military enemy. Disease has destroyed more people than all the wars in history.] [Public health workers not only fight epidemics and diseases when they occur, but they must be ever alert and constantly working and devising means to prevent their occurrence.] [The protection of the health of the people against the invasion of disease from abroad, and the attack and spread within our borders, is the purpose back of the far-flung system of disease prevention and control that makes up the United States Public Health Service.] The United States Public Health Service as it exists today is the product of experience extending over a period of nearly 150 years. It was originally created as a Marine Hospital service for the purpose of providing medical care to American merchant seaman. The Marine Hospital service was established by an Act of Congress signed by the second president of the United States, John Adams, on July 16, 1798. This service was originally supported by a tax on American merchant seaman, but this tax was later abolished. The tax was collected by the collector of customs of the Treasury Department, and the Marine Hospital Service came under the jurisdiction of that department where it remains today. The first Marine Hospital, located at Norfolk, Virginia, was purchased from that state in 1881. The second was built in Boston, Massachusetts (unintelligible) and some of the medical personnel were utilized by both the Union and the Confederacy for the care of the (unintelligible) wounded of the military forces. It frequently happened that the medical officers of the early Marine Hospitals were the first physicians to diagnose such diseases as cholera, yellow fever, and smallpox, which seriously endangered the public health at ports of entry. As time went on, the work of the Service became of such increasing importance to the public health of the country that Congress gradually extended its duties until it became in function a federal health service. Recognizing the value of mobility and military discipline in an organization which had to combat epidemic diseases, Congress authorized the organization of the Marine Hospital Service along military lines, with officers holding commissions and grades similar to those of officers of the Medical Departments of the Army and the Navy. In 1912 the name of the Service was changed to that borne by this organization today, the United States Public Health Service. The Public Health Service is administered by the Surgeon General, who is responsible directly to the Secretary of the Treasury, to Congress, and to the President of the United States. We will now hear the Surgeon General briefly outline the work of the Public Health Service. Although the first responsibility for public health rests upon the states and localities in our country, the federal government, through the Public Health Service, does much to prevent disease and improve the health of all the people. This is done in many ways. One very skilled group of men and women (unintelligible) of disease and means of preventing it. Other Service officers guard the ports to prevent the introduction of disease from abroad. Others have the duty of preventing and halting the spread of infections within our own territory. Under the provisions of the recently enacted Social Security Act, the Public Health Service is cooperating with every state and territory in the development, in those states and territories, of a national health program. This cooperative work between the federal, state, and local governments should provide new standards of health for the people. In addition, the manufacture of all serums and vaccines sold in the country is carefully supervised by the Public Health Service. Studies are carried out concerning drug addiction and mental hygiene. It conducts Marine Hospitals in which are treated American sailors. In addition, this Service keeps in constant touch with health conditions throughout the world, through weekly reports from every consular officer. It encourages health education in various problems of disease prevention. In what follows, you will see, in much more detail, the ways in which this organization operates for human service. [Prevention of the introduction of diseases from abroad] For centuries it has been well known that epidemic diseases follow the lines of commerce and travel. [The deadly scourge.] During colonial times and in the early days of our republic, the introduction of yellow fever, smallpox, cholera, and other diseases from foreign countries by ship was by no means uncommon. [Death's yellow mask.] Epidemics of yellow fever from this source occurred as late as 1798 in New York, in Baltimore as late as 1832, and in Philadelphia as late as 1853. [The sombre shadow.] Many outbreaks of smallpox and cholera were the result of cases brought in by vessels. The danger of introduction of diseases from abroad has paralleled in growth the remarkable development of transportation on the sea, on the land, and in the air. The transportation of disease has been as much facilitated by improved mechanical methods as has the transportation of persons or property. Maritime quarantine was at first undertaken by the states and cities, but is now administered by the Public Health Service at all the ports of the United States and its possessions. To perform these functions, the Service has been given quarantine jurisdiction over all ships and all persons, both citizens and aliens, coming into American ports from abroad. In its quarantine work, the United States Public Health Service maintains a fleet of trim and speedy boarding tugs, which carry the quarantine officers out to the vessels arriving at United States ports. When a vessel arrives at quarantine, the medical quarantine officer, a nurse, and an inspector go out to it in one of these boarding tugs so well known to seaman and ocean travelers. They draw alongside the vessel and go aboard. The quarantine officer meets the ship’s doctor and the purser. The purser turns over to him certain records of the vessel's voyage for inspection, especially the bill of health and health record en route, which shows all cases of illness occurring on board during the trip. Ah, the list here shows a suspicious case of illness in a member of the crew. Let’s see now what happens. The quarantine officer is taken to the sick bay in the crew's quarters to examine the patient. His experience and training in the detection of the symptoms of rare, as well as common diseases, tells him that this patient is suffering from typhus fever. He orders the patient to be removed from the vessel, and put aboard the quarantine tug to be taken ashore. All persons who have been in contact with the patient, and thus have been exposed to the disease, are also ordered on board the tug. The patient and the contacts are taken to the detention hospital, in this instance, Hoffman Island in New York Harbor. On their arrival, the sick patient is taken directly to the hospital. Here he is given appropriate treatments and cared for until he has recovered. Every facility is made available in such cases, both for the benefit of the patient himself, and for the protection of others. As this happens to be a case of Old World typhus fever, which is known to be spread by the body louse, the contacts, those who have had association with the patient during the voyage, are first taken to the delousing plant. Here they must remove all of their clothing, Thoroughly sprayed with soap and water. Next they are sent under the shower. And finally, each one is sprayed with an insecticide that kills any lice or nits that may still remain in their hair. The clothing of these contacts is placed in net bags, and these bags are sent to the fumigating room. This clothing, together with the baggage of the contacts, is placed in fumigating chambers, were it is thoroughly disinfested. If necessary, the contacts are isolated in the detention hospital for observation. Every precaution is taken by the quarantine officers to prevent the introduction of disease into the United States. When the quarantine work has been completed, and the ship declared free from danger, the medical officers of the Public Health Service then turn to the inspection of immigrants. This scene shows the well-known immigration station at Ellis Island New York. During the busy period of a few years ago, more prospective citizens of this country arriving from abroad entered through this world-renowned station than through any other port of the country. In past years thousands of aliens arrived at Ellis Island daily, and each one had to undergo an examination at the hands of the medical officers of the Public Health Service. In past times too, many of them arrived only to be turned back at our very gate, because of mental or physical defects. This was a necessary, but somewhat cruel procedure, and caused many heart aches, untold hardships, and much unnecessary expense. To avoid this condition, a new system was inaugurated by international consent in 1925, since which year, intending immigrants have been examined in foreign countries by Public Health Service officers who are assigned to American consulates for this purpose. The prospective immigrant makes application through the American consul, who, if the applicant comes within the quota prescribed by Congress, arranges for an examination by the Public Health Service medical officer. If the applicant passes these physical and mental tests successfully, there is little chance that he will be refused admittance later. [Historians have recorded that the Bubonic Plague or the "Black Death" almost depopulated Europe during the Middle Ages.] [Webster on pestilence] Among other old records, Webster's book on pestilence gives vivid descriptions of the many ravages of bubonic plague. [Panning shots of book pages] This disease is constantly present in the Orient, and this fact makes it an ever present threat to the United States and its possessions. The germ that causes bubonic plague is carried by fleas that live on rats and other rodents. Rats are great travelers, and vessels at wharves must use rat guards to keep them from coming aboard. Notice how this rat balances himself with his tail. Now he attempts to clear the rat guard. Will he succeed? It looks like he'll make it. No, he admits defeat and he returns to the wharf. Yellow fever, the fearful Yellow Jack which once struck terror to the South, is one of the best examples of a dread disease now almost entirely wiped out by science. It is transmitted principally by a particular kind of mosquito. With the mosquitoes that transmit the disease exterminated, yellow fever is eliminated. Although yellow fever has been banished from our shores since 1905, it still exists in South America and Africa. And recent development in air travel again make it a menace to the United States. To combat this menace, the yellow fever mosquito must be eliminated from ships and airplanes, and infected persons must be detected and isolated. Although the mosquitoes which spread yellow fever usually fly but a relatively short distance, they have been carried by airplanes for thousands of miles. It's only by the exercise of the utmost care and constant watchfulness that this dangerous, ever-threatening disease is kept outside our borders. When there arrives at a port of entry an airplane which might bring in the yellow fever mosquito, the passengers and crew are inspected for symptoms of the disease. An important part of the inspection is the taking of the temperature for evidence of fever. The plane is gone over thoroughly with a vacuum cleaner to recover any yellow fever mosquitoes that might be aboard. Then the cabin and all enclosed spaces in the plane are sprayed with insecticide that destroy these dangerous pests. The opening of air routes to the Orient has created serious problems in preventing the introduction of diseases, particularly cholera and smallpox, into Hawaii and the United States. [The prevention of interstate spread of disease and the suppression of epidemics] [Under the Constitution, the local health powers, regarded as police powers, were at first left to the States, while the control of foreign and interstate commerce was given over to the Federal Government.] When the country was small, travel was slow and distances in travelled time were much greater than they are today. Then there was less need for action on the part of the federal government itself in preventing the spread of epidemics. But with the increased proclivity of travel, the expansion in territories, and the concentration of populations, this work became important. With increase in interstate traffic, the need for uniform quarantine regulations became apparent. And by the consent of the states, and under the commerce clause of the Constitution, Congress provided for federal control of both interstate and international quarantine. The sanitary control over all water supplies used for drinking or culinary purposes on interstate carriers is one of the activities of the Public Health Service in connection with the prevention of the interstate spread of disease. It is obvious that this is a tremendous task. The water included in these supplies comes from almost 3,000 sources. In this work, the cooperation of state and city health authorities is given to the Public Health Service. In taking supplies of drinking and culinary water onboard vessels, connections are made directly to the supply pipes. And the possibility of contamination of the water during this process is thereby reduced to a minimum. Here we see a supply of drinking water being taken aboard a steamship at one of our ports. The same sanitary precautions are carried out when drinking water is taken aboard trains. Frequent inspections are made of this procedure. The passenger can therefore feel a sense of security when he quenches his thirst from the water cooler, or drinks water with his meals in the dining car. The fight against bubonic plague is a fight against the rat. He must be trapped, poisoned, starved out, built out - everything must be done to rout this animal. The rat has been called man’s most destructive and dangerous enemy. He is certainly a most dangerous pest in the case of bubonic plague. He is sturdy, furtive, and crafty, and he readily matches his cunning against that of his enemies. The rat catcher must know the habits of this animal, and it is only with such knowledge, combined with actual experience, that he can qualify as an expert in what may indeed be called a specialized field. The rats are tagged to show the locality in which they are caught, and are then sent to the laboratory for examination. Some of the rats that are taken alive are put into bags to preserve for identification and examination of any fleas that they may harbor. Here we see a sample day's catch of rats in one of our large cities. At the laboratory, the rats are combed for fleas, and their fleas are collected for study and for testing to determine whether or not they are infected with bubonic plague. In certain western states, plague has spread from rats to ground squirrels, and the fight against these animals is being constantly carried on there. [Trachoma, a communicable disease of the eyes, often resulting in blindness, flourishes when once implanted, where lack of personal hygiene obtains. It occurs chiefly in the mountainous east central section of our country.] The following are typical scenes of the regions in the east central sections of this country in which trachoma is chiefly found. In these rural sections, life was somewhat primitive, and the sanitary conditions were conducive to the spread of the disease because of the habits and customs of the people. They did not know that trachoma was spread by means of the hands, and by towels and handkerchiefs, and other articles which may carry the discharges from the eyes. Simply described, trachoma is a chronic infectious disease of the lining membrane of the eyelid. If the lids are turned back, a number of small granular bodies resembling Sago grains will be noticed. The disease produces a roughened condition of the inside of the lid which irritates the front of the eyeball, causing an inflammation which often leads to blindness. For many years, the Public Health Service has conducted a campaign against this ancient disease. As early as 1912, Dr. John McMullen of the Public Health Service was sent to Kentucky to make a survey of the situation there. "Dr. McMullen, what was found in Kentucky and what was done there?" "Well, more than 18,000 persons were examined in 1912, and between 7 and 8 percent were found to have trachoma. Many had already been blinded by the disease. Many others remained in dark rooms concealing their eyes with their arms. Some had not seen light for months, while many cases had existed for years. In checking up some years later, the changes were remarkable. Instead of many sore-eyed people, and the almost universal practice of wearing colored glasses observed during the first survey, scarcely colored glass was seen, and few cases of active trachoma. From the standpoint of humane and economic considerations, there is no way to estimate what this trachoma work has been worth. Much of the work was done in mountain regions, where roads even now are not good. Usually medical officers travelled by horseback, and often they had to walk. The work has now been turned over to the States." Instead of painful and sightless eyes to destroy the joys of youth, we now have the precious gift of sight. The future must be dreary to one destined to live in darkness. Fortunately this boy was discovered in time. Instead of blindness added to other infirmities of old age, we have the ability to assume an economic role in family affairs. Numerous outbreaks of typhoid fever have followed the use of shellfish grown in contaminated waters. This was a danger that could be combatted by examination of the waters where oysters were grown, and forbidding the interstate shipment of oysters originating in areas, the sanitary conditions of which, were not approved by the Public Health Service. Because oysters from beds in contaminated waters will not be certified, and shucking plants and canneries are required to be conducted under proper sanitary conditions, the consumer can now enjoy this seafood with a greater sense of security than formerly. [Cooperation with state and local health authorities in public health matters. An act of Congress authorizes an annual conference between the Surgeon General and the state health officers to discuss important health matters. Here the Surgeon General opens a recent conference. "This annual conference of state and territorial health officers will come to order. I am delighted to greet you here today. One of the most significant events in public health which has occurred in our lifetime transpired last month, when President Roosevelt signed a bill appropriating funds to launch the health security program. This bill and the funds authorized under it offer a great promise to the people of this country for better health. It is your task and my task to see that this promise becomes a realization. It is to discuss the detailed means by which we may obtain the objectives held forth in the Social Security Act that this conference will be concerned. I welcome your advice." These conferences provide opportunities for planning effective methods for state and federal cooperation in attacking health problems of mutual concern. For many years, the Public Health Service has cooperated with the state health officers in an effort to develop and improve state and local health work. When necessary, experienced Service officers are assigned as shown here, for periods of time to aid state and local health departments in their special health problems. Funds made available by Congress have been matched by state and local agencies and used to develop local health services. Under the Social Security Act, provisions for this cooperative aid to these health services has been greatly extended. [Another form of cooperation with State and local health authorities is assistance in the diagnosis of unusual or rare communicable diseases.] [This is well illustrated by a recent epidemic in a Western city.] The city health officer of a western city receives a telephone call. He picks up the receiver and finds it is from a local physician. This physician has a case the symptoms of which resemble epidemic encephalitis, but there are some features which make this diagnosis uncertain. The city health officer remarks that he is greatly concerned, as he has had several similar cases recorded in the past few days. The city health officer decides to notify the state health officer. He calls him by telephone and outlines the local situation. The state health officer immediately reports to the Surgeon General and asks him for aid. The city health officer calls an assistant and instructs him to consult with the local physician; he is definitely alarmed. A little later a telegram is received from the Surgeon General. After the Public Health Service officers have conducted a preliminary investigation, they call a conference to discuss the situation. "Gentlemen this epidemic is growing. At least fifty new cases are being reported daily. We must encourage close, harmonious cooperation between ourselves, as representatives of the Public Health Service, and the city, county, and state health authorities. The local medical schools have made available their laboratories and other facilities." "What will be our policy as regards information for the general public?" "The city health departments are notifying the public frankly of the situation. Business must proceed as usual. There must be no panic." "There is an unusual plague of mosquitoes just now. How long has that been connected to this outbreak?" "We’ll test that theory as fairly as possible." The mosquito tests were conducted on prison inmates who voluntarily submitted themselves as laboratory animals. After these experiments were made, another conference was called to discuss the results. "Dr. Williams, what are your results so far?" "The mosquito apparently does not transmit this particular disease, however our investigations must be continued in other directions. The epidemic, despite all that has or has not been done, is subsiding. We will transfer our studies to the National Institute of Health in Washington." As result of intensive studies at the laboratory, it was concluded that the disease was due to a virus, and several important new facts regarding it were deduced from these investigations. In preventing diseases spread through unclean milk, a safe milk supply is essential. Tuberculosis, (unintelligible) undulant fever, typhoid fever, and other diseases are spread through contaminated milk. The Public Health Service feels that clean milk, properly pasteurized, is the only safe milk to drink, and it has conducted studies to determine the efficiency of pasteurization procedures. These precautions assure a safe and clean milk supply to the ultimate consumer, that is, if ultimate sanitary precautions are observed by the ultimate consumers themselves. Another form of assistance to and cooperation with the states is special aid in times of emergency. The disastrous floods which frequently occur in the United States illustrate an emergency that may arise suddenly. During these floods, the states frequently request the help of the sanitary engineers of the Public Health Service in providing emergency purification and protection for town and city water supplies in the affected areas. These requests for aid are met with prompt response. In many instances, water purification machines are quickly dispatched to the affected areas, and are put into operation by the sanitary engineers. As the water is pumped into the reservoirs or distributing systems, it is treated with chlorine to make it safe for human consumption. [Keeping currently informed on the prevalence of disease] [Smallpox, meningococus meningitis] In the fight against disease from a public health standpoint, it is fundamentally important to know when, where, in what numbers, and under what conditions various diseases are occurring. [Measles, diphtheria, typhoid fever] The Public Health Service records the important communicable diseases on charts which show their seasonal prevalence. [Poliomyelitis] Note on these charts how closely the cases for different years follow the same general seasonal patterns. [Influenza, scarlet fever] Each separate line across the chart represent a year for the particular disease. The Service maintains an intelligence office regarding the occurrence of epidemic diseases in the United States and foreign countries, and reports are received weekly from all American consuls. Their wide distribution is shown on the map. Whenever there's an outbreak of a quaratinable disease anywhere in the world, the American consul at that place promptly cables this information to Washington. Information is also obtained from many other sources. From local health officers and state health officers who report regularly by telegram, and on cards like the card shown here. Reports are also received from officers of the Public Health Service stationed abroad. Health officers of foreign governments, and international health organizations such as the International Office of Public Health, the Health Section of the League of Nations, and the Pan American Sanitary Bureau. The information so collected is compiled and published and is used by quarantine officers of the Public Health Service, by our own local state health authorities, and by other governments throughout the world. [The Directors of Health of the American nations hold conferences from time to time to discuss the health problems and activities of their respective countries.] Dr. L.S. Rowe, Director General of the Pan American Union, addresses a recent conference: "Gentlemen of the conference: at this, your closing session, I want to express to you, individually and collectively, the deep appreciation of the Pan American Union for the privilege of having had you with us during the period of your deliberations. It is no exaggeration to say that the Third Pan American Conference of Directors of Health marks a distinct step forward in that struggle of the nations of this continent to improve the conditions of life, to eliminate the causes of disease, and to augment the efficiency of the masses of the people. I wish therefore to congratulate you, and at the same to time assure you that in the future, as in the past, you may count on the earnest and enthusiastic cooperation of everyone associated with the Pan American Union." Dr. H.S. Cumming, Director General of the Pan American Sanitary Bureau now speaks: "Gentlemen, as Director of the Pan American Sanitary Bureau and President of your conference, for which honor I thank you, I want to join Dr. Rowe, in expressing our appreciation to you for leaving your important administrative functions and to your respective governments for sending you to this, the most successful sanitary conference we’ve had. A point of progress reported by you and your countries, practical plans formulated, is by far the most successful conference we’ve ever had. I wish you Godspeed back to your respective homes." [The investigation of the diseases of man] Scientific studies dealing with the diseases of man were made by the Public Health Service as early as 1886. These studies have gradually expanded until today the research of the Public Health Service on the cause, method of spread, and means of prevention of disease, is among the most important work that it performs. A research laboratory for the Public Health Service called the Hygienic Laboratory, was established in 1901. In 1930, Congress changed its name to the National Institute of Health. At this famous institute in Washington, D.C., most of the investigative work of the Public Health Service is conducted. The diseases and conditions studied by the Service include a long list. Heart disease is public enemy number one. It is first on the list of causes of death. More than 300,000 persons die each year in the United States from this cause. [Principal causes of death in the United States. Heart disease, cancer, apoplexy (cerebral hemorage, etc.), nephritis (Brights Disease)] The electrocardiograph has aided greatly in the study and diagnosis of heart disease. Next in importance to the cause of death is cancer. This disease results in the death of about 135,000 people in the United States annually. Malaria is still an important public health problem in at least 16 states of the Union. This mosquito born disease exacts a toll of sickness of more the 2 million cases annually. This patient is having a malarial chill. The fight against malaria is the fight against the malaria mosquito. The prevention of mosquito breeding by seeing that no containers are left lying around to catch and hold water, and thus provide breeding places for mosquitoes, and by eliminating all refuse piles, in so far as possible. In certain regions effective mosquito control has been accomplished by dusting water areas with a poisonous mixture. This dusting is done from trucks, by hand dusting machine, and by airplanes according to the conditions met with. Another effective method employed is the killing of larvae, or wiggle tails, by the oiling of stagnant water. Other preventive measures include ditching for draining and keeping mosquitoes out of the home by screening. The protection of the health of the industrial worker has become a matter to which much attention has been given. New manufacturing processes have frequently introduced new hazards to the health of workers. The control of occupational disease has come within the province of the physician and the engineer. In many industries, dust has been found to be a serious hazard to the health of the employees, and exhaustive studies of the various types of dust in industry have been made by the Public Health Service. Dusts are collected at the plant and atmospheric and other data are recorded. These dust samples are then taken to the laboratory, where they are carefully examined to determine the concentration, the size distribution, and the chemical and other characteristics of the particles. This young lady is seen making a dust count from a sample that was taken at one of the plants. The Public Health Service has conducted studies on the mottled enamel of teeth, a disfiguring condition caused by an excessive amount of fluorine in the drinking water of certain areas of the United States. These studies have shown that mottled enamel is more prevalent in this country than had been realized. The Public Health Service conducts studies on stream pollution, a subject of growing importance with our constantly increasing and concentrating population. New problems have arisen from the increase of human waste discharge into streams but also from the increase and changing types of industrial waste. [Public health aspects of venereal diseases] From a public health standpoint the venereal diseases are one of the most important problems confronting those whose duty it is to conserve the health of our nation. Special laboratories are devoted by the Public Health Service to the study of various phases of this subject. One day simultaneous surveys of all sources of treatment have been conducted by the Public Health Service in representative areas of the United States covering approximately one fourth of the entire population of the country. Estimates derived from these surveys indicate that more than a million and a half new cases of the venereal diseases seek treatment anually in this country. Cooperative studies conducted by the Public Health Service with five of the leading venereal disease clinics in this country indicate that syphilis is largely curable. To obtain recovery however treatment must be started within the first year of the disease. The Public Health Service cooperates with state and local health departments in the development of campaigns directed against the venereal diseases. [The marine hospitals and medical care of beneficiaries of the Public Health Service] [Background music playing] From time immemorial, the Law of the Sea has required vessels to provide medical attention for their seamen. This was a difficult matter for the owners of ships in the early days of the republic. Therefore in order to encourage its struggling merchant marines, Congress established the Marine Hospital Service in 1798 to relieve the ships of this burden. The first Marine Hospital in Boston, which was the first General Hospital in that city, furnished hospital care for sailors from some of the famous war sloops and frigates of the war of 1812. Today there are 25 modern, thoroughly equipped hospitals in this service located within the United States. These hospitals have an aggregate bed capacity of approximately 6,000 beds and give treatment to about 300,000 persons annually, while almost as many more apply each year for other service including physical examination. New marine hospitals have recently been built in Baltimore, Cleveland, Detroit, Galveston, Memphis, New Orleans, Norfolk, San Francisco, and Seattle. The Marine Hospital at Stapleton, New York, which is the one shown here, has been enlarged to make it a 1,000 bed institution. These hospitals are professionally staffed by medical officers both competent and humane secured by examination and selection. Only qualified graduate nurses, professional dietitians, and skilled therapeutic aides are employed. These hospitals have all the specialized services: eye, ear, nose and throat; a thoroughly equipped x-ray department; dental department with the most modern equipment; hydrotherapy; physiotherapy; venereal disease; and some have a psychiatric service. They are provided with the most modern appliances for the diagnosis and treatment of disease. Dental treatment is furnished at all Marine Hospitals by dental officers. Most of the patients entering, especially the merchant seamen, are suffering from septic mouth conditions. With the elimination of dental infection, many remarkable recoveries have been reported. The facilities of the marine hospitals are available without cost to American seamen employed onboard any registered, enrolled, or licensed vessel of the United States; to officers and enlisted men of the Coast Guard; to officers and crews of vessels of the lighthouse service; to certain keepers and assistant keepers of the lighthouses; to immigrants detained at the immigration stations; to seamen from vessels belonging to the United States Army; to beneficiaries of the United States Employees Compensation Commission; to members of the Civilian Conservation Corps in various sections of the country; to patients of the United States Veterans Administration; and to persons afflicted with leprosy. This is the National Leprosarium at Carville, Louisiana. (unintelligible) for license as pilots, other officers of vessels of United States registry, and lighthouse keepers, must pass an examination conducted by medical officers of the Public Health Service. These examinations are for vision, for color blindness, and for hearing. The service must also pass upon the physical ability of sailors qualifying as able-bodied seamen. Regulations require all ships officers be versed in first aid, therefore the Public Health Service has organized courses of instruction for such candidates in a number of the larger ports. Not only does the Service furnish medical aid to the Coast Guard, but it also sends its medical officers with the cruising cutters on the North Atlantic ice patrol to furnish medical care to the officers and crews of these vessels. The Service also sends medical officers with the Bering Sea's seal patrols. The Coast Guard makes an annual cruise along the coast of Alaska. Medical and dental officers of the Service are sent on this cruise. They give medical examinations and treatment to the natives. These include dental treatment and extraction. This is the only medical service available to many of these native Alaskans. The National Leprosarium, which is a Marine Hospital at Carville, Louisiana, has under treatment more than 300 patients who are lepers. The Leprosarium has an administration building and a main hospital. Treatment by the various methods and agents used has yielded most encouraging results and there have been many recoveries or arrested cases. During the last ten years, over 150 patients have been discharged to their homes no longer a menace to the public health, and the leprosy arrested. Sports are provided by baseball diamonds and tennis courts, and the younger patients greatly enjoy these outdoor recreational activities. The cottages for the patients are comfortable and are provided with ground for gardens in which many of the patients take much delight. Life for these unfortunate persons is made as comfortable and as pleasant as possible. In the attractive inner court two leper children may be seen playing around the pool. Medical aid to vessels without a physician has been made possible by the development of radio. Frequently, men are injured or suddenly develop an acute illness on board ships far out at sea. If there is no physician aboard, the Public Health Service is notified by radio. Many lives are saved each year thanks to this radio service. "[Hold Chatham] radio for medical advice." "Aye, aye, captain." [Morse code signals being sent] The message from the vessel is received by a commercial radio station which immediately relays it by telephone to the nearest Marine Hospital. "Seamen suffering from sore throat for two days. Now has temperature 104. Slight cough. Face flushed. Appears seriously ill. Request medical advice. Signed, Master of SS Columbia." "Send this reply: man apparently has acute tonsillitis. Put him to bed on liquid diet. Have him drink cold water freely. Use hot alkaline gargle every two hours. Give 10 grains of aspirin every three hours for four doses. Report progress in 12 hours. Sign this, 'U.S. Marine Hospital'" "Very well sir." A merchant seaman may have been suddenly attacked by illness on approaching port. Here again, the medical officers of the Marine Hospital are notified by radio. But in this case an ambulance is sent from the hospital to the dock to meet the boat. The patient is taken off the vessel on a stretcher. He is placed in the ambulance and rushed to the Marine Hospital. On arriving at the hospital, he is taken directly to the ward for examination and diagnosis. The medical officers examine him carefully, and with the aid of the history of the case that is furnished them, they make their diagnosis. In this instance, it is definitely an acute attack of appendicitis. The patient must be operated on at once. He is therefore taken to the operating room where the troublesome appendix is removed. [Medical service in federal penal and correctional institutions] [background music playing] An act of Congress requires that the medical care in federal penal and correctional institutions be furnished by the Public Health Service. The prisoners are given thorough physical examinations: eye, ear, nose, and throat; chest; dental; and other examinations. They are also given various types of mental tests. These mental tests will afford valuable data for the study of different types and characteristics of prison inmates which differentiate delinquents from non-delinquents. When the United States Public Health Service Hospital was established in Lexington, Kentucky, the problem of narcotic drug addiction was put under the banner of medicine. Until that time, this problem had been regarded almost solely as a correctional one. The hospital, consisting of a group of buildings, covers an area of approximately 12 acres. The buildings are constructed in quadrangular form, providing a large central court serving as an entrance plaza to the various departments and units of the hospital. From here one gains access to these units, especially provided for the reception and treatment of new admissions, for the treatment of those suffering from inter-current diseases, and for the intensive study of patients and to those requiring special forms of treatment. This part of the institution constitutes the professional center of the hospital. To meet the needs for a better treatment for drug addiction, special studies of patients are necessary. The hospital is fully equipped and adequately staffed for this purpose. Opportunities for outdoor work are afforded the patients through the operation of a thousand acre farm. These farm activities include the operation of a modern dairy, the raising of hogs, and poultry, and intensive truck farming. Indoor work for patients includes the operation of a laundry, a modern garment shop for the manufacture of clothing worn by the patients not for sale, and other activities that are necessary for the maintenance and operation of the hospital. Supervised outdoor recreation is desirable and necessary for the health of the patients. It promotes good fellowship and normal human relationships. The career officers of the Public Health Service constitute a mobile sanitary corps whose members are available for service whenever needed in the United States or foreign countries for epidemic duty, for quarantine duty, or for investigation work. The honor roll contains the names of many men and women who have contracted diseases in line of duty, and of many who have made the supreme sacrifice. These workers conducted their investigations fearlessly with full knowledge of the dangers that confronted them. They've dedicated themselves to humanity and made their sacrifice on the altar of science. Other workers were not less fearless, but more fortunate; not less assiduous in their devotion to duty, but more favored on the field of battle. The Public Health Service conducts its relentless fight against disease silently and steadily, no martial music to inspire, no tumult or shouting to sustain. The battlefield is silent. But the grim fight, the personal danger, the satisfaction of accomplishment are there, even though the fight is frequently directed against an unseen and an unknown enemy. [The end] [Bray Studios]