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REPORT OF THE PROCEEDINGS OF THE

STATE BOARD OF HEALTH

CALLED MEETING.

The Board met in special session at the office of Dr. Arch Dixon, Henderson, Ky., at 10 a. m., Tuesday, November 21, 1899. Present, Drs. J. M. Mathews, J. H. Letcher, Arch Dixon, and J. N. McCormack. In calling, the meeting to order Dr. Mathews stated that the meeting had been called by wire by the secretary to consider an extraordinary and alarming prevalence of smallpox at Uniontown, and the adjacent county. Dr. McCormack reported that he had just returned from that place, where he had found at least five hundred cases of smallpox existing or recently recovered. The facts had been systematically suppressed by the local authorities, although the county health officer had pronounced the disease smallpox some weeks ago. From Uniontown the disease had spread to the country districts in the county, and to the adjoining counties of Crittenden and Henderson, as well as to Hopkins and Muhlenberg counties. After full discussion it was ordered that Uniontown and all houses in Union county where smallpox exists be placed in quarantine, and the secretary was instructed to issue and promulgate the following:

QUARANTINE PROCLAMATION BY STATE BOARD OF HEALTH.

Whereas, It has come to the knoweldge of this Board that smallpox exists as a widespread epidemic at Uniontown in this State, it being estimated that at least five hundred cases have occurred or are now there in various stages of the disease, and

Whereas, The authorities there have failed to take any efficient measures to prevent the spread of the disease in their own or to other communities until such indifference to the disease has developed and euch conditions prevail as to greatly endanger the health and lives of the people of the entire State.

Now, therefore, be it known, that the State Board of Health, in the exercise of authority vested in it by law, and in the discharge of a pressing public duty, hereby declares the town of Uniontown, and each of its inhabitants, to be in quarantine; forbids any person to enter or leave said town without a permit from the chairman of the Union County Board of Health, based upon a certificate of recent vaccination, or that the person has had and is entirely recovered from smallpox; forbids any person with smallpox, or from a house where smallpox exists, to come upon or near any public street or highway until every person in said house is well and cleansed and the house officially disinfected and a permit of release given; it is ordered that every house where smallpox exists be officially flagged and that this flag shall remain until officially removed, and that no one enter such premises except physicians and designated attendants; it is ordered that every person in said town be vaccinated or re-vaccinated within the next forty-eight hours.

All other houses in Union county where smallpox exists are also placed in quarantine and the above precautions are ordered to be enforced as to each of them and their inmates.

Any violation of this proclamation and contained regulations will subject the offender to the pains and penalties of law. The health officers and other authorities of Union and adjoining counties are authorized and requested to enforce them.

By order of the Board.

J. M. MATHEWS, M. D., President.
J. N. McCORMACK, M. D., Secretary.

The secretary was also instructed to issue a similar quarantine proclamation, against the whole of Union county, and to order all trains to run through the county at not less than ten miles an hour without making a stop unless the fiscal authorities of the county make provision for a pest house and for stamping out smallpox in the county within the next forty-eight hours.

PROCEEDINGS OF THE

STATE BOARD OF HEALTH

REGULAR ANNUAL MEETING.

The Board met in regular annual session at the Gait House, Louisville, at 3 p. m., Friday, June 1, 1900. Present, Drs. J. M. Mathews, president; J. H. Samuel, J. H. Letcher, G. T. Fuller, William Bailey, appointed to succeed himself, L. L. Robertson, appointed to succeed Dr. Arch Dixon, and J. N. Mc'Cormack, secretary. The oath of office was administered to Drs. Bailey and Rohertson. Upon motion the reading of the minutes of the last regular and intervening called meetings was dispensed with.

The secretary read his annual report, including his financial statement for the year, as follows:

REPORT OF THE SECRETARY.

Like the preceding one, the past year has been one of continued activity and anxiety on account of the wide prevalence of smallpox within our borders. The experience of the health officials developed new and unexpected conditions everywhere, those in one community varying but little from all of the others.

The country has been so long exempt from this disease that a generation had grown up unprotected by vaccination. The intelligent classes in and near centers of population and the old slave negroes had nearly all been more or less perfectly vaccinated, but the younger negroes and the poorer people of the country districts were nearly all without this protection. A generation of doctors had also come on who had never seen a case of smallpox, and many of them were practically without college instruction on the subject. As if to add to the difficulty, the disease has usually been so mild in form and caused so small a percentage of deaths that it inspired little respect or fear, and subjected physicians who made mistakes in diagnosis to small criticism or risk.

In many instances first cases fell into the hands of competent and careful medical men, who at once recognized and easily confined it to the individual or family. More frequently, however, as the disease was mainly confined to negroes and the more ignorant whites who "had neglected vaccination, first cases either fell into the hands of the young and inexperienced or the older low grade physicians who naturally minister to these classes, and numerous exposures had occurred and the foundation for an epidemic laid before the health authority of the locality was notified. Frequently, too, the doctor was as positive as he was ignorant and, while admitting that he had never before had experience with the disease, would dispute the diagnosis of experts and sometimes secretly encourage his credulous following to conceal the cases or to otherwise avoid or hinder the protective measures to be enforced.

As a result of these conditions mainly smallpox has prevailed more or less extensively in eighty-one of the one hundred and nineteen counties of Kentucky, costing in cash from the county and municipal treasuries in two years, as has been gathered from official reports and careful estimates, over $150,000, to say nothing of the far greater loss from interference with business and travel, or the inconvenience and suffering it has brought to many poor but most worthy families.

In my extended experience the trouble in getting people vaccinated is due to carelessness and procrastination rather than to prejudice. It is true that a great many persons object to having vaccination forced upon them, but the objection is to interference with individual liberty rather than to the vacoination. In spite of the difficulties through the patient and often self-sacrificing labors of our local boards of health the disease has been stamped out in county after county until it is now under control, except in Covington and the contiguous territory. Here such serious conditions still prevail as will demand your special attention unless we are to repeat the Henderson experience of last year, where the obstinacy and mismanagement of the fiscal authorities was the means of causing the disease to be spread over that entire end of the State. The disease has existed in Covington for nearly two years and, while the widespread epidemics in Louisville and Cincinnati were promptly stamped out by systematic vaccination and isolation, here our able and faithful health officer has never had more than a half-hearted support from the fiscal authorities, has been constantly hindered and crippled by restraining orders and injunctions from the courts and, in marked contrast with other sections, the newspapers have constantly antagonized and misrepresented his efforts. As a natural result of all these things, the work is demoralized, and all that part of the State is in danger of a serious and expensive epidemic. The disease has already been carried from there to a number of other counties, and my advice since last visit there is that the gravity of the situation is slowly but constantly increasing. As you are aware, the Board has been entirely without funds for several months. At the beginning of the year we were in debt nearly $1,500, and, owing to the unfortunate situation at Frankfort, we (have not been able to draw our appropriation since. The outlook is now more promising, and I think we may soon hope to enter upon a new era. With an increased appropriation, with provision for our printing outside of this, and with the powers of the local boards defined and confirmed by recent decisions of the Court of Appeals, our hands are so strengthened as should greatly extend our usefulness. As to how these responsibilities should best be met and utilized may well demand your most serious consideration.

I suggest that popular health conventions for the laity be organized and held month after month until every county In the State has been covered, for the discussion of the best known practical methods for preventing sickness, such as typhoid fever, diphtheria, scarlet fever, consumption and other preventable diseases. I also advise that you arrange for the publication and wide distribution of monthly leaflets upon popular health topics, or, preferably, for tne publication of such notes regularly in the newspapers of the State. Newspaper men advise me that the latter plan is feasible, and that accurate, crisp paragraphs adapted for popular reading would be acceptable to both them and the public.

I also suggest that you establish, preferably in connection with the State College, if such an arrangement can be made, a bacteriological and analytical laboratory, and thus put within the reach of all our local boards and physicians and the laity, free or at a nominal cost, expert assistance in investigating causes and sources of sickness of all kind. With the rapid growth of population, most of our streams, large and small, upon which this and future generations must depend for a water supply, are being rapidly converted into open sewers by the drainage into them of the refuse of our cities, towns and country districts. Unless there is to be repeated here the disastrous experiences of the Old World, and even of the older States of this Union, the time has arrived for both investigation and action upon this important branch of preventive medicine. The epidemics of typhoid fever in our camps during the recent war with Spain caused by using water from streams polluted by their own offal was no more than has gone on in a small way year after year in town and country districts all over Kentucky.

Finally, and in my judgment of more far-reaching importance than these methods, I suggest that the Board begin earnest and persistent efforts to have the plain laws of health taught to every school child in Kentucky. Mainly through our efforts this was provided for in the school laws several years ago, but so far little more has been attempted than to teach them a smattering of anatomy and physiology. I believe that the best methods for preventing the occurrence and spread of disease may be made both easy and interest

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