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another for doing. I have been through two epidemics of small-pox, and have no fear of the disease personally, but I have no desire to contribute to the spreading of the disease. I expected to meet Dr. Ragan, and was not prepared to go into such a pesthole as I saw out there. There were only three rooms in the house, Occupied by eight or ten persons, and as filthy in appearance as possible. I called the father to the back door and talked to him, and told him he must have all his family vaccinated. He said he didn't believe it was small-pox. He pointed to his daughter (about 14 or 15 years old), and said she had nursed them all and had never been vaccinated, “and she has not taken it.” I told him it was not time yet, but that she would probably have it. He was also told that he and all his family must remain on their premises, and if they did not they would be liable to fine and imprisonment.

I wrote Dr. Ragan, asking him to take every precaution to protect the public; to notify me if any other cases developed; to destroy all furniture and bedding that could not be disinfected otherwise, after the family recovered, and thoroughly disinfect all clothing and the house, and render the bill to the county.

Our laws are extremely inefficient. We are empowered and directed to do certain things, and no provision made to defray the expenses. The judge and fiscal court may allow whatever they see fit. It you have a liberal judge and court you are all right. Judge Brown will not spend a cent unless the law specifies the amount. I talked to him an hour yesterday before he would take the responsibility of paying for a carriage to take Dr. Tingley and myself to the Gray farm, eight miles out. He will not make an order for any amount toward isolating the cases or keeping them on their premises. I do not see how we could guard the place; there is no place nearer than a quarter of a mile where a guard could stay—the weather is at and below zero. I told Dr. Ragan in my letter that I would have to make him a special health officer in that case, to see the constable for that district and tell him to arrest any of the Brown family found off of their premises. I think all the damage that will be done in the case was done before last Sunday, but I would like to have such suggestions and instructions as you may see proper to send me, and if you deem it necessary for one of the members of the State Board to come and investigate for you we will be glad to receive him. Our greatest danger is from Cincinnati. The negroes from that side coming to this, and vice versa, carry the disease. I suppose you have our annual report by this time, as I signed ready to send some ten days ago. The county judge wanted to incorporate it with the county report, is the cause of our delay in sending it.

I have not received a copy of the rules of the State Board of Health. Will you kindly send me a copy?

This is a voluminous communication, which I hope you will pardon me for inflicting you with, but I could not very well state the situation more briefly to make it clear to you just what we were doing or not doing, as you may be pleased to view it. Hoping to hear from you soon, I am,

Fraternally yours,

C. B. SCHOOLFIELD,

President County Board of Health, Newport, Ky., September 22, 1899. To the State Board of Health, Bowling Green, Ky.

Gentlemen: The Campbell County Board of Health met at the office of Dr. W. A. Young. All the officers present. Dr. C. B. Schoolfield in the chair; Dr. W. A. Young, Secretary. Dr. Schoolfield stated that the object of the meeting was to make a report to the State Board of Health, with especial reference to small-pox in the county during the year.

In making this report we feel that the county is to be congratulated in having, through the efficiency of the various municipal and county Boards of Health, escaped an epidemic of small-pox, notwithstanding the proximity to Cincinnati, where the disease existed in epidemic form, and to a greater extent than in any other city in the United States, in proportion to its inhabitants, and that we were not quarantined against said city. The few cases that occurred in our midst were SO successfully handled that in two instances only was the disease allowed to get beyond the house of original infection.

The first case occurred at No. 425 West Fifth street, Newport. Before steps could be taken, after the diagnosis was made, to place guards at the house, a domestic in the family, Maggie Brown, whose home was in the country, made her escape and went home, and in due time took the disease. There were 25 or 30 persons exposed to the disease in this case, all of whom were vaccinated by Dr. J. F. Houston, the county health officer. Dr. Houston made seyen visits to this case and vicinity, vaccinating those exposed to the disease, and spending one day in disinfecting the premises. The articles destroyed amounted to seven dollars. Drs. Schoolfield and Tingley made one visit and took steps to prevent the family from leaving the premises, and through our efforts the disease was limited to this one case in the rural districts. The origin of the disease in Newport is not known, but supposed to be from Cincinnati. There were ten cases in all; actual outlay, $350, all of which has no doubt been reported by the city health officer, Dr. F. Locke. There were eight cases in Dayton, four of which were in one family, the father having quite a severe case; the mother and two children having it in a very light form. Two other cases occurred in one family; both were children, and had never been vaccinated. The two mentioned in the first family also had never been vaccinated. The other two were in separate families, and had not been vaccinated. All were discrete forms and mild in character. There were five cases in Bellevue, four of them in one family. Three had not been previously protected, but were vaccinated as soon as it was recognized in the first patient. All three took well, but had the disease in a very mild form. The cost to the city was $150." In every case guards were placed at front and rear of premises, and perfect isolation maintained. After recovery the premises were disinfected with formaldehyde, and such articles as could not be disinfected were destroyed. The estimated cost in business and wages in Dayton was $245. The actual outlay to the city was $125. The cost to Bellevue, $150 actual outlay. No estimate of business loss given.

There were a number of cases of cerebro-spinal meningitis in the county, but not epidemic. Lagrippe was epidemic in January and February, but in very mild form. We also had an epidemic of measles, with few fatalities.

There is one thing in connection with the small-pox in this county that we deem worthy of special mention, that is the mild character of the disease in the unvaccinated children. Of the eight cases in Dayton only two had been protected, yet they were all benign. We can account

for this only through an immunity inherited from parents and ancestors who had been vaccinated. None of the parents had had small-pox. We mention this peculiar experience for your consideration, hoping to hear the experience of other Boards of Health in this particular, through you.

Respectfully submitted,

C. B. SCHOOLFIELD, M. D.,
W. A. YOUNG, M. D.,
J. FRANK HOUSTON, M. D.,

County Board of Health.

CARROLL COUNTY.

Carrollton, Ky., August 7, 1899. To the State Board of Health, Bowling Green, Ky.

Gentlemen: In accordance with request of secretary of State Board of Health, herewith submit report of a recent epidemic of small-pox in Carrollton:

On the morning of February 11th last a negro man presented himself to me for medical advice. Upon examination discovered at once a suspicious eruption on forehead and wrists, and while the number of papules did not aggregate more than fifteen or twenty, and a conspicuous absence of any constitutional symptoms, yet considered the case of sufficient importance to report it to the city authorities, and advise his immediate isolation. But while they were taking steps to carry out my orders the patient made good his escape, but not until he had informed me that he had been put off the Madison and Cincinnati packet three days before, and that he had spent the nights with three separate families of his own race. Just fourteen days from this date small-pox broke out simultaneously in the three families referred to. We hastily improvised a pesthouse two miles from the corporate limits, and removed the patients (six in number), of two of the families, thence. Two patients in the other family were allowed to remain at home, as the house was not nearer than two hundred yards from the town proper, while we instituted a rigid quarantine. Five days thereafter three other persons were attacked, two whites and one black. It was an unusually mild type of the disease, as no treatment was deemed necessary after the initial stage had passed. All of the patients (eleven in number) made uneventful recoveries, leaving but slight evidences of the malady.

On April 12th following was notified by a homeopathic practitioner that he had a suspicious case, and desired me to see it. I found it more than suspicious, as it proved to be a confluent case of small-pox in the pustular stage. The patient was a white woman, aged 48. Ten days later her son was attacked and died. Have never been able to discover origin of second outbreak. The woman's husband was an engineer on the steamer Big Kanawha, and made frequent trips to Madison and Louisville with him, and we suppose she contracted it on one of these trips. No medical treatment at all in last two cases. None of those attacked had ever been rendered immune by vaccination.

The cost to the city, in round numbers, was $1,200. Estimated cost in loss of business, $5,000.

To briefly recapitulate:

We had 13 cases of small-pox; four were whites, and 9 were blacks; 11 males, and 2 females, of the latter one each of white and colored; 11 were discrete and 2 confluent and 1 death.

Respectfully submitted,

F. H. GAINES,
President of Carroll County Board of Health.

CASEY COUNTY.

Middleburg, Ky., August 17, 1899. State Board of Health, Bowling Green, Ky.

Gentlemen: I have just returned from the infected district near Clementsville, and found your letter on my return. Clementsville is near the western border of this county, twenty miles west of here. There are about fifteen cases of small-pox in the community in this county, and we have it from reliable authority that there are several cases across the line in the counties of Adair and Taylor. We have quarantined the families where the disease exists, are erecting some pesthouses, have appointed vigilance committees, etc., and are having the people vaccinated as rapidly as it can be done.

This is the first time our county Board have been called to take action in matters of this sort, and we labor under some embarrassment; but we are doing the best we can, and any assistance from you, by your presence, suggestions or orders, will be gladly received and as faithfully complied with as possible. Dr. Hood, of that community, is nobly standing by the people. Dr. Lowde, of our Board, has moved from our county. I will furnish you another name soon. I will confer with the county authorities, and we will do all in our power to control the disease. Should there be further developments I will report to you at once.

Very respectfully,
J. T. WESLEY, M. D.,

County Health Officer.

Middleburg, Ky., August 18, 1899. State Board of Health, Bowling Green, Ky.

Gentlemen: I have but little to report from our small-pox district. I understand one of the patients died yesterday. No new cases reported. I learned this afternoon that there were two persons in an adjoining neighborhood who were thought to have been exposed that were taken sick yesterday. I sent Dr. Hammonds to see them and investigate and report to me by telephone in the morning. If anything should develop we will look after it immediately and report to you.

We are vaccinating throughout the county as rapidly as possible, but we meet with some opposition—don't know just how to meet. Some parties absolutely refuse to be vaccinated, or to have their children vaccinated. We have consulted our attorneys, but they appear to be undecided as to our power and authority, so if you can give us a few points touching our duty and authority along this line you will confer a favor. For instance, a man living on the public highway (turnpike) has seven or eight children, who have not been vaccinated, says positively: "I will not be vaccinated, and no man shall vaccinate my children.”

Another, a merchant, living in a village on a public highway, regular hack line, where drummers and traveling men are daily going in and out from all parts of the county, and that merchant says: You shall not vaccinate me nor my children.” What shall we do?

Any instructions or information you can give us touching any of these matters will be gratefully received. Will report again soon.

Very respectfully,
J. T. WESLEY, M. D.,

County Health Officer.

Middleburg, Ky., August 21, 1899. State Board of Health, Bowling Green, Ky.

Gentlemen: I have just received a telephone message informing me that there are two new cases of small-pox at Clementsville, each in families that had the disease; also that Dr. Hood, who had been the attending physician, was sick, and that he had all the characteristics of small-pox.

I sent Dr. L. J. Godbey with a nurse to Clementsville this afternoon. Dr. Godbey will remain with them if necessary. I will have a conference with Dr. Beeler at 10 o'clock to-morrow.

Any instructions, orders or suggestions will be gladly received and carried out to the best of our ability.

Very respectfully,
J. T. WESLEY, M. D.,

County Health Officer.

Middleburg, Ky., August 23, 1899. State Board of Health, Bowling Green, Ky.

Gentlemen: There are about three more new cases of small-pox in the vicinity of Clementsville. Dr. Hood now has the disease, and Dr. Godbey has the entire thing under his care. There has been twenty-one cases and one death to this date. I had a conference with Dr. Beeler yesterday. We have ordered the entire county to be vaccinated. We have had some temporary buildings erected; have furnished mattresses, sheets, towels, sponges, tubs, medicines, provisions, nurses, doctor, etc., and are caring for them the best we can.

As I stated to you a few days ago, we meet with considerable opposition in some of our work, and would be glad you would give us all the information you can as to our duties and powers. We hope to hear from you at your earliest convenience, doctor, touching all these points, and if we are likely to transcend our bounds you must haul us down. You will please add the name of Dr. James Wesley, of Liberty Ky., to our Board, and send me his commission. Also, I would love to have Dr. Hood on the Board as soon as he recovers. Hoping to hear from you at your earliest opportunity, I am,

Very respectfully,
J. T. WESLEY, M. D.,

County Health Officer.

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