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at Lebanon Junction, instead of running them on into Louisville, and we could still keep the guard at the station to keep the traveling public from coming in contact with the people at that point, and the quarantine restrictions, so far as it applies to passengers, could remain in force; or, in other words, leave the quarantine stand as you think best, except giving us the right to turn trains at Lebanon Junction, so as not to seriously interfere with the traffic, as explained above?
If you approve of this arrangement, will you kindly wire me to this effect, sending message by bearer of this letter, and very much oblige.
In the meantime, if you have any suggestions to make, or if we can serve you in any way, please command me.
Very truly yours,
B. M. STARKS.
Louisville & Nashville Railroad Company,
Office of the Superintendent,
Louisville, Ky., April 30, '99. Dr. J. N. McCormack,
Secy. S. B. of H., Bowling Green, Ky. My Dear Doctor: I have your favor of April 28th, with reference to small-pox situation at Lebanon Junction.
I am sorry indeed to see such a discouraging report, especially since I received in the same mail a letter from Mr. Hocker at Lebanon Junction, which letter ran their stock up to nearly par, on account of the way he described the precautions being taken to prevent the spread of the disease. You state in your letter that passengers buy tickets to near-by stations and then get off at Lebanon Junction, I have been unable to locate a case of this kind, but I do locate cases where parties living at Lebanon Junction buy tickets to Belmont, Booths or Smith's Switch—the three places nearest Lebanon Junction on either side and then walk into Lebanon Junction after getting off at any of these points, and then out of Lebanon Junction and get on the train again. Some gó horseback. Others move back and forth in buggy or spring-wagon, as it is only a short drive to either of the points named.
If the citizens of Lebanon Junction are going to be permitted by the health authorities to go into and out of the town by all of the country roads as they like, and come to near-by stations and board trains, it looks as though we might let railroad people go into and out of town as to permit the public in general to do so in the manner I have described above. We have been trying to do everything in our power to wipe out the contagion at Lebanon Junction by having all of the employes present certificates of recent vaccination, and not allowing them to go out on their runs until they presented such certificates, by moving our terminal away from Lebanon Junction at a heavy expense, giving up the earnings of the station, by hauling transfer passengers by to meeting points or into Louisville instead of transferring them at that station, placed a special agent at Lebanon Junction representing both the railroad and Health Department, to as far as possible keep the citizens of Lebanon Junction from coming in contact with trainmen and passengers passing that station, and it looks as though we were getting hold of the warm end of the hardships in this particular epidemic. It does look as though an out-of-the-way residence could have
been condemned, if necessary, to be used as an eruptive hospital, and let the afflicted be confined to this hospital and others sent there or to some other place for detention who had been exposed, all at a very much less expense and inconvenience than is being suffered by the present arrangement.
I suppose, however, that you leave arrangements of this kind in the hands of the local authorities, and as explained by you when in to see me, the local health people do not seem to be as energetic in wiping out the disease as they should be, but if you can now, at this late day, fix some other plan that could be adopted or some other arrangement that could be made, so as to give us some relief in the way of handling train service, the same will be very much appreciated.
It surely doesn't look fair to have the railroad tied up and put to an enormous expense on account of a few cases of small-pox that could be bottled up in some hospital and taken care of at a very small fee.
B. M. STARKS, Supt.
State Board of Health of Kentucky.
Executive Office, Bowling Green, Ky., May 1, 1899. Dear Doctor Johnson:
I enclose a letter just received from Mr. Starks, which is self-explanatory. There is much justice in his complaint, and it does seem that your authorities ought to be able to stop the practices to which he refers. It is just this kind of recklessness that took the disease to your town to begin with, and which has made it so difficult to control. This is such an important matter to your town, both now and in the future, that I think it better for you to see the letter. Please write me fully, returning Mr. Starks' letter.
J. N. McCORMACK,
Lebanon Junction, Ky., May 2, 1899.
Bowling Green, Ky. Dear Sir: Yours of 1st received, and in reply will say that I see no reason why the quarantine at this place should not be raised. There has been no new cases since you were here. Mrs. Thompson is the only case in the town, and she is up going about in her room. I consider her isolated, as you are aware of the location of the house.
Our people wrote you under date of May 1st, making some promises as to what they would do if you would raise the quarantine. I will guarantee you that they will carry out the promises as therein stated. Should any new cases develop, I. will personally see that they are immediately isolated.
Lebanon Junction, Ky., May 2, 1899. J. N. McCormack, M. D., Secretary State Board of Health,
Bowling Green, Ky. Dear Sir: In addition to the enclosed petition, will say that I have had both my houses thoroughly renovated. Have burned everything that was in the rooms, re-papered them and painted, scrubbed the floors, and now my house is in first-class shape.
We feel confident that our town is in good shape, and there is no further danger from the disease. Do what you can for us.
R. M. HOCKER.
Lebanon Junction, Ky., May 1, 1899. J. N. McCormack, M. D., Secretary State Board of Health,
Bowling Green, Ky. Dear Sir: We, the undersigned, physicians, business men and citizens of the town of Lebanon Junction, Ky., feel that the business interests of the town are being greatly damaged by the quarantine now existing here. We think the situation has greatly improved here. The negro that you saw when here last was promptly removed to the pesthouse, leaving Mrs. Thompson the only positive case in the town, and we consider her isolated from the rest of the town. Besides, Mr. Chappell, the L. & N. Co.'s special agent, says he will guard the Thompson house and allow no one to go to the house nor any of the family to leave it. Nearly all our people have been vaccinated, and we do not anticipate any further spread of the disease. If, however, any new cases should develop, we promise you that we will have them promptly removed to the pesthouse or have guards placed at their houses.
We kindly ask that you have the quarantine raised from our town. Trusting an early and favorable reply, we are
Lebanon Junction, Ky., August 4, 1899. The origin of small-pox at this place was caused by a man coming out from Louisville and going around the town, with little suspicion as to his case until several were taken down with the disease.
There were about thirty cases in all, and were all in a light form. The outbreak occurred about the 1st of April, lasting until about the last of May. All the cases were treated in the families in which it occurred, except three, which were moved to the pesthouse.
The total cost to the town and county will reach two hundred dollars. The estimated cost in business will reach two or three thousand dollars.
· J. E. JOHNSON, M. D.,
Local Health Board.
Morgantown, Ky., August 26, 1899. State Board of Health, Bowling Green, Ky.
Gentlemen: In pursuance of my duty as secty. of Local Board of Health of Butler County, I herewith present you this my official report of small-pox in Butler county, Ky.:
On April 4, 1899, Mr. Harry Butler, who had been living in Louisville, came home. He soon was taken sick with fever, a physician called, diagnosed malarial fever; in four or five days was out at church, with papules on, but I saw him on the street in the vesicular stage. I called his physician's attention to the case, but failed to get him to realize that it was a suspicious case; but two days later I called the Board together, and quarantined the infected house. One case developed from the exposure in the papular stage at the church, and one case developed from the infected house. Then two cases developed in fourteen days after exposure. We had several meetings of the Board to decide the best way to stamp out the disease, encountering from the first much opposition. We had six cases in all, and finally succeeded in getting all of them to the pesthouse. The first house was burned, and valuable time was lost by slow action of our county judge and the influence of the laity. I can not say what damage was sustained by having smallpox here. I estimate $15,000. I believe we will be able to control it better if the disease should break out again. I am under many obligations for your visit and valuable assistance in getting this disease checked.
County Health Officer.
Dayton, Ky., February 11, 1899. Dr. J. N. McCormack:
Dear Sir: I write you to-day in reference to small-pox in our county. During the month of January a case developed in Newport. As soon as discovered the health officer, Dr. Locke, went to the house and notified all in the house to remain there; went to the mayor to get guards stationed at the house. The mayor refused, and he went to the chief of police. It was two days before the guards were obtained. One girl, who had been nursing the case before it was diagnosed, lived in the country, and before the house was quarantined skipped out and went home. In due time she developed small-pox, and another member of the family has since taken the disease in a mild form. Dr. G. W. Ragan, of Cold Springs, is in attendance, but failed to report the case to me or any of the Board, and it was only through the health officer of Newport that I heard of it last Sunday (February 5th). It seems that the mother and two or three of the sons, belonging to the family in which the small-pox exists, was in Newport on Saturday (the 4th inst.), in a dry goods store full of people, and remained there for half an hour. Dr. Locke telephoned this startling news Sunday. I tried to get Dr. Houston, of Alexandria (whom we appointed health officer of the county last year), but telephone connection had been cut off by the storm Saturday night. I then went to Newport and had a consultation with Dr. Locke and County Judge Brown, and through the latter goit a messenger to go to Alexandria, to Dr. J. F. Houston, to whom I sent a letter stating the case and asking him to see the cases at once, with Dr. Ragan, and confer with Judge Brown, who would hold court in Alexandria on Monday (the next day). On Tuesday I called up Dr. Locke and inquired what had been done. He replied that he had not heard. At my request he went to see Judge Brown, who said that Dr. Houston was sick in bed, but had asked him to call and see him before leaving Alexandria, but the judge had forgotten to call. On Wednesday Dr. Shaw, of Alexandria, called me up from Cold Springs, and said he had been sent by Dr. Houston. He went to Dr Ragan's office, but the doctor was not at home. I asked him if he had been to see the small-pox cases; he said he had not and did not intend to; so his visit amounted to nothing. Thursday Dr. Ragan called me up in answer to a call from me, and I asked him about the cases; if he had reported them; if the house had been posted or placarded; if all who had been exposed to infection had been vaccinated. To all of which he answered in the negative. There are several children in the family, but the parents refused to allow the doctor to vaccinate them. I asked if any one outside of the family had been exposed. He said, “Yes, about 20 or 25 persons.” I asked if they had all been vaccinated. He did not know. I told him that I had heard that the mother and two or three of the family had been in Newport. He said: “I guess that is about true.” “Well,” I said, “Doctor, do you not know that in failing to report those cases, to placard the house and vaccinate those exposed to the disease, you are violating the law and laying yourself liable to a severe fine, and the family are doing the same?” “Well, I think I am doing all I can do. I have notified the people around that there is smallpox in that house, and the family to remain on the premises.” On Friday morning I telephoned Cold Springs to have Dr. Ragan meet me at the Gray farm, where the Brown family resides. Mrs. Ragan answered that Dr. R. was not at home, but she would tell him when he returned, and she was confident he would meet us. Dr. Tingley and myself went out, arriving at Brown's at 3 p. m. Dr. R. was not there. The house is about fifty yards from the road; the nearest house about one-quarter of a mile distant. I did not go in to see the cases, as I had no means of disinfecting myself. There was neither outhouse or barn where I could make any change of clothing, and the temperature 6 deg. below zero, so to have gone in would have been doing just what I would arrest