Excerpt from Fifth Biennial Report of the State Board of Health of Maryland: January, 1884

As was urged by our lamented president, the late Dr. E. Lloyd Howard, the abatement of special nuisances, and such like acts, should form no part of the duties 'of a State Board of Health. Its work should rather consist in aiding local boards, in collecting statistics of sanitary value, in making investigations in the causes of disease and death, in advising proper measures for the prevention and suppression of epi demies, in making inspection of jails, almshouses and other public institutions.

To carry out these purposes fully and systematically, it is essential that the board shall have the cooperation of local boards in at least each town and county in the state, and also that there shall be enacted a comprehensive and effective system for the collection of vital statistics. The board has, from the first, realized the need of these agencies, and has been unremitting in its efforts to secure them. With this view, papers have been submitted to each legislature since the organization of the board, detailing plans by which it was thought most feasible to collect the vital statistics of the state, and on which it was thought local boards could best be estab lished effectually and economically. They have not been act ed upon, and the work of the board has, in consequence, been greatly impeded and limited.

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