persons unable to pay for the same will be vaccinated at the expense of the county.

A copy attest:

G. W. CANN,

Clerk Lee County Court.

LESLIE COUNTY.

Manchester, Ky., July 10, 1899.

State Board of Health, Bowling Green, Ky. Gentlemen: It is reported that there are a great many cases of small-pox in Leslie county. As many as 100 cases of this disease have been estimated by different reporters. They are doing nothing whatever in the county or by citizens to limit its spread or stamp out contagion.

Now, Clay county is in constant and daily communication with Leslie. Indeed, through Clay lay the main lines of travel to railroad stations and the outer world. The experience that Clay county had last year with this same disease cost her $2,000 direct outlay. We think the State Board should investigate the situation and take such steps as the menace to the public and the law would warrant. I am of opinion that any quarantine that Clay county might set up would be inadequate, and communication would continue at a lively rate.

Very respectfully,

I. S. MANNING,

President Clay County Board of Health.

Manchester, Ky., August 2, 1899.

State Board of Health, Bowling Green, Ky. Gentlemen: I went to Hyden, Leslie county, as requested; found plenty of small-pox, and nothing being done to stop it. Made arrangements with the county authorities to go to work at once, and think they will do so. I know they will. The Board of Health will consist of J. B. Walton, Abner Eversole, J. H. Lawrence, M. D., health officer. You can communicate with Dr. Lawrence, and he would like you to send him some little hand-bills for distribution among the people touching the main points as to its prevention, etc. I will send in my report at

once.

Truly,

J. R. BURCHELL,

Inspector for State Board of Health.

Hyden, Ky., August 26, 1899.

State Board of Health, Bowling Green, Ky.

Gentlemen: I am in receipt of your recent letter. We have about fifty patients with small-pox at present. The disease is gradually subsiding. We think in reasonable time can have it stamped out.

The adjoining counties are to some extent in danger of the disease, though they are fighting against us in Perry county.

I will keep you posted about the matter.

Very respectfully,

J. H. LAWRENCE, M. D.,

Health Officer of Leslie County.

LINCOLN COUNTY.

Stanford, Ky., March 13, 1899.

State Board of Health, Bowling Green, Ky.

My

Gentlemen: Your letter came this afternoon. Being from home, on the war path, riding my Rosinante, I didn't read it until just now. reply may not reach you in time for the Board's meeting, yet I trust otherwise. Sowders, the real estate agent, nominally is a resident of Stanford, but peripatetic in his habits-here today, yonder to-morrow. He went to Columbus, Ohio, in January, to make some land or other real estate deals. He is bibulously inclined. Shortly after leaving here it was learned by his friends that he was taking too much of the "biled juice of the cereal corn," and was in hard luck, his exchequer running low. One of his friends, in early February, went to Columbus. Incidentally, or accidentally, he met Sowders upon the street. The shoes and breeches were Sowders', but his other wearing apparel evidently had belonged to some one else, being tattered and torn. He had traded his "store" clothes, and with the "boot" was still "eventuating" in drinks. The friend inferred from Sowders' remarks, tho' he insisted that he was stopping at the "Chittenden," that his real local habitation, nightly, was at the Catholic Mission, where a fellow in need of a nap could get a balmy snore for the small sum of ten cents. This friend, also, saw in the city papers that small-pox had broken out in the mission only the day before his arrival. He returned here on Saturday, the 11th of February; the Wednesday following, 15th, Sowders came in, sick, high fever, head and backache. Thursday felt miserable, drinking just a little bit; too much nausea for "high-balling." On this night drank a quart of bone-set tea; woke up Friday morning with an eruption. Went down town, consulted two doctors; one said his eruption was "stomachal," the other that he had "Dutch" measles. Saturday he was up and about; was apprehensive that he had small-pox. His physicians didn't think so. Sowders knew where he had been, they didn't. On Sunday morning I was asked to make a diagnosis, which I did promptly -small-pox. In twenty-four hours we had him isolated in a nice, robustly-ventilated pesthouse. No other case has made its appearance. His was a confluent attack, with throat complications. He is doing elegantly; desquamation now complete. Will discharge him Thursday night.

Pardon the scribble, I'm writing with my wife's best pen-a regular hole-sticker.

Yours truly,

STEELE BAILEY,

County Health Officer.

Stanford, Ky., September 10, 1899.

State Board of Health, Bowling Green, Ky.

Gentlemen: The first case of small-pox in this vicinage since the summer of 1887 (at which time a negro railroader, after a few days' illness, died promptly from the confluent form of the disease) was presented in the person of Jos. Sowder, white, forty years of age. He came to town on the 11th of February, from Columbus, Ohio, whither he had gone from this village about the first of January. He arrived at night, stopping at a tavern near the Louisville & Nashville railway station. Feeling uncomfortably bad the morning after his arrival, he sent for a doctor, who reported to me that he found him with a temperature of 104 deg. F., violent headache and severe muscular pains; sore throat, and that it was probably a case of epidemic influenza. On the 12th, at noon, Sowder was able to report at the doctor's office, and further related that he had had a fever for several days. An eruption, at this time, was seen over the forehead, in the pharynx, on the chest-wall, etc. Not suspecting variola, the attendant changed his opinion, and called it measles. On the 14th a vesicular rash covered the whole body. Complying with the request, as the health officer, I visited the patient in his room in the Interior Journal building-he remained but one day and night at the hotel-made a critical examination and pronounced the case one of small-pox. At this time there was almost complete subsidence of the fever, but a beautiful, plainly visible eruption covered the body. The diagnosis was made known to the mayor and County Judge Bailey. By the afternoon of the following day a two-room, well ventilated house, with first-class sanitary surroundings, was made ready for occupancy, and by courtesy dubbed "an hospital." Pending the time of Sowder's removal, the room he was occupying on Main street, the most business part of the village, was securely guarded, and from its portals the yellow flag was flown at full mast. I removed him at night to quiet the mental perturbation of the villagers, as a great many of them were ready for flight. The case was a full-fledged, confluent one; the ordeal severe, but the rubicon was passed safely with only cicatrices on the site of the eruption, by which, in the future, he may be identified. On the 25th day of his detention he was given his discharge papers. Every precaution was taken to prevent an outbreak in the community. Our efforts were crowned with success at Stanford. Vaccination was made compulsory, lymph tubes being employed instead of the points, with failure in the operation in not more than 5 per cent of the cases. Sowder had never been vaccinated. From the best information obtainable (we could learn nothing from him, as when asked about it, he only answered, "sharp words butter no parsnips"), the disease was either contracted while East (either Pittsburg or Philadelphia), or more likely at a Catholic mission at Columbus, Ohio, where this peripatetic gentleman had "babbed an eye" for a good many nights before his home-coming. The compound effect of liquor had reduced his exchequer; the mission was handy and cheap. The papers gave an account of an outbreak of small-pox at this hostelry three days before Sowder came upon the scene here.

On the 25th of February, news having reached the county judge that small-pox was in the "Deep Well Woods," a negro settlement, ten or eleven miles from Stanford, I was asked to go and verify the statement. I found John VanDevere with a case of the discrete variety, which ran a typical course, the patient recovering. Then followed in this neighborhood twenty-six other cases, all being of the mild form of

the disease, except Tim Welch's wife, whose case was severe in the confluent form. These Deep Well cases were under the immediate care of Dr. W. J. Edmiston, of Crab Orchard. On April 11th I visited Crab Orchard at night, in company with County Attorney Harvey Helm, to examine four suspects-young white men a diagnosis of small-pox was easily made. A pesthouse was established one and a half miles from town, and Dr. J. D. Pettus put in charge. Each case proved a confluent one. All recovered.

The mayor of Crab Orchard telephoned me to visit his town on the 14th of August, to make a diagnosis in the case of John Turnbull, who was reported to have small-pox, but who would not permit any local doctor or one of his neighbors to enter his domicile. I went, bearded the lion in his den, and found a confluent case, fully developed, and two of his children, who were recovering from the discrete form. As he was in his own home, and it isolated, he was permitted there to remain. In August there appeared at Rowland, a suburb of Stanford, eight cases of the discrete variety. All recovered. Whether other cases are to follow deponent sayeth not, but he is of the opinion that the Augean stables are about cleaned out. While vaccination has been pretty general, there are some people with foolish fears who will not, with any amount of persuasion, have this simple protective operation performed. All praise should be bestowed upon the officers of the county for their supreme efforts to stamp out the disease. County Judge Bailey and County Attorney Helm, at all times, have been ready and willing to give aid and comfort to the local Board of Health. Not deeming it necessary, we did not quarantine against anything, or body, at any time. No one, so far as we know, willfully or knowingly obstructed or resisted the powers given to the Board of Health. The cost to the county because of this epidemic of small-pox will not exceed in money value more than three thousand dollars; the estimated loss of business, etc., would be thrice that sum.

Recapitulation.

Number of cases in the county to date, 41; first case imported by Sowder, probably from Columbus, Ohio; first case in Deep Well Woods, contracted from a case, a negress, who came on a visit from Cincinnati, O., and who returned to that city and died from the disease. The epidemic sprang from this source. The young white men caught it, possibly, from some indiscreet visits made to the Deep Woods. This has been suggested; I would not aver it. The poison was and is still in the force, as evidenced by the cases of Turnbull and those recently occurring at Rowland.

Yours truly,

State Board of Health, Bowling Green, Ky.

Gentlemen: I report a case of small-pox; it is positive, at the Gravel Switch, one mile west of Grand Rivers, on the Illinois Central Railroad. This pit is operated by the above company, employing about

150 men. On the 19th inst., Supt. Surgeon Dr. D. G. Murrell, of Paducah, reported two patients that came to the company's hospital from this pit, which proved within a few days to be small-pox.

To-day Assistant Superintendent Dr. J. Q. Taylor saw, with me, a patient-evidently small-pox. The patient is isolated in a car, though doubtless fifty men have had an opportunity, and these fifty men many of them come up to our town; some live in town. I have successfully vaccinated the layout of employes of the company. I am expecting a great outbreak of small-pox; what can and will the State Board suggest and do to help us? Act quickly. I am vaccinating the entire community, all who will accept of it. Answer.

Yours,

A. J. DRISKELL,

Member County Board Health.

Office Health Officer,

Jefferson County, Ky., Louisville, Ky., May 6, 1899.

State Board of Health, Bowling Green, Ky.

Gentlemen: I found things in a bad way at Gravel Pit, one mile west of Grand Rivers. They have four cases of small-pox now in negroes confined in an old boarding car on the side track of the I. C. R. R. One eruptive case got away from them and was found, so I learned, at Princeton. Fifteen suspects, actual exposures, also got away and have gone, the Lord only knows where. The trouble there was the same as at other places-delayed diagnosis. Two cases left and went into Paducah. I found on my arrival that Dr. Driskell had done all he could, backed up by Drs. Murrell and Taylor, of Paducah, the I. C. surgeons. No guard had been placed over these men. No guessing the number of exposures. I went to Smithland the same day I reached Grand Rivers. Did not get to Smithland until 9 p. m. It is twenty-five miles from the railroad, over as rough a road as you found in the mountains. Judge Evans, of the Livingston County Court, very promptly called his court together, and I took much pleasure in placing the matter in a strong way before them. The trouble with the magistrates was that they insisted that the railroad company should take care of these negroes. I explained to them that the railroad could not restrain the movements of a single citizen without laying themselves liable for heavy damages. Your local Board of Health at Smithland had done nothing. It had not even occurred to any one that they existed, or that they had any authority in the matter. Mail the young Dr. Duling a commission as member of Board. I believe his initials are the same as his father's. Driskell is a good man, but a very timid one. The fiscal court had taken action by making an order that each magistrate should appoint a physician to vaccinate the poor and take charge of any one of their citizens who should become afflicted with small-pox; that the state and the d-d railroad should be made to care for those negroes at Grand River. They seemed to feel like they were sorry they had a railroad in their county. You know just about how they talked about the matter. I succeeded in getting them to order everything I recommended. Had to threaten them with a state quarantine before they would vote. The judge and county attorney were all right. They will be very fortunate