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were hunted down, vaccinated and kept under observation. The cases, were all in mild form and needed nothing but attention to general health and isolation.

The disease was brought to this county from Greenup county; Portsmouth, O., and a traveling show; it was very promptly recognized, after 20 or 30 had been exposed. I estimate that 2,000 vaccinations have been done in the county since the first cases occurred; that 5,000 had been previously vaccinated, out of a total population of 17,000, leaving 10,000 now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $2,500. The estimated cost to the county in loss of trade and interference of business has been $25,000 or $30,000.

Our chief difficulties in stamping out the disease were: An unmanageable negro population, recklessness and want of care among some whites, and opposition of some physicians, who persisted in denying the truth of the diagnosis of the disease.

Very respectfully,

LUCIEN McDOWELL, M. D., Secretary.

Franklin County and Frankfort City Boards of Health: Dr." U. V. Williams, Dr. G. W. Chinn, Dr. J. E. Hume.

Frankfort, Ky., July 17, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 3 outbreaks of smallpox in this county, in the following districts or precincts: City, Cedar Run, Bald Knob, Feak's Mill, with a total of 149 oases and 2 deaths. A hospital camp was provided near Frankfort, and the following was our method of management: Isolated all suspects in suspect camp. Confined all cases in camp hospital for treatment; surgeon on the ground day and night, assistant in city, who made visits to all suspects and passed upon them and diagnosed cases. Cooks, corps of nurses and commissary, vaccinated all suspects. Ordered a general vaccination; was well prosecuted and executed; not perfect in the county, but reasonably well done in the city.

The disease was brought to this county from the soldiers' camp; it was not recognized until many had been exposed. I estimate that 5,000 vaccinations have been done in the county since the first cases occurred; that 2,500 or 3,000 had been previously vaccinated, out of a total of 20,000, leaving 12,000 now unprotected in city and county (estimated).

The total cost of management to the county, including hospital,

physicians, vaccinations, guards, nurses, food, etc., for all f!ie cases which have occurred in the time named has been $11,000. The estimated cost to the county in loss of trade and interference of business has been from $50,000 to $75,000.

Our chief difficulties in stamping out the disease were: Want of co-operation of city council and fiscal court ,an unreasonable objection to vaccination and the flooding of the city and county with anti-vaccination literature, and on the part of quite a number of local physicians pronouncing the disease not to be smallpox, but "Cu-jan or elephant itch."

Very respectfully,

U. V. WILLIAMS, M. D. .Chairman.

Fulton County Board of Health: Dr. A. B. Whayne, Dr. J. M. Alexander, Dr. J. W. Naylor, Dr. A. A. Faris.

Fulton, Ky., September 27, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had several outbreaks of smallpox in this county, in the following districts or precincts: Fulton, Cayce and Hickman, with an estimated total of 300 to 350 cases and about 20 to 25 deaths. A pest house was provided near Fulton and one near Hickman, and the following was our method of management: Vaccination of exposures; isolation of cases; fumigation of infected houses and household goods. Little treatment was used or required.

The disease was brought to this county from several places, Cairo, 11l., Tennessee, etc.; it was usually not promptly recognized until others had been exposed. I estimate that 2,000 vaccinations have been done in the county since the first cases occurred, that some had been previously vaccinated, out of a total population of 11,500, leaving a large per cent, now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been about $3,000. The estimated cost to the county in loss of trade and interference of business has been .

Our chief difficulties in stamping out the disease were: Non-belief on part of laity of existence of smallpox.

Very respectfully,

J. M. ALEXANDER, M. D., Secretary.

Garrard County Board of Health: Dr. James B. Kinnaird, Dr. Isaiahs. S. Wesley, Dr. Hugh M. Grant.

Lancaster, Ky., July 17, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have nad, at three different occasions, sporadic oases of smallpox in this county, in the following districts or precincts: Lancaster, Cartersville, Pruitt and Hiattsville, with a total of 18 cases and 1 death. A hospital or pest house was provided on Poor House Farm, and the following was ourmethod of management: All oases, suspects and those exposed tothe contagion were vaccinated and quarantined. All living in the vicinity of the contagion were ordered vaccinated, and the most complied. Clothes, beds, etc., burned and houses fumigated.

The disease was brought to this county from Pulaski county in. last cases, and from Madison in the first cases; it was very promptly recognized, after they had been exposed. I estimate that 800 to 1,000vaccinations have been done in the county since the first cases occurred, that many had been previously vaccinated, out of a total population of" 12,000, leaving 4,000 now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the caseswhich have occurred in the time named has been $1,000. The estimated cost to the county in loss of trade and interference of business has been in reality nothing, with prompt measures, and not allowing the facts to be widely published.

Our chief difficulties in stamping out the disease, if we had any, were the seeming indifference of the county court and the carelessness of the populace, and their great desire to go to see sick people. A great many also did not want to be vaccinated.

Very respectfully,

HUGH M. GRANT, M. D., Secretary.

Grant County Board of Health: Dr. N. S. Matthews, Dr. C. D. O'Hara, Dr. W. A. Scroggin.

Williamstown, Ky., July 17, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 2 outbreaks of smallpox in this county in the following districts or precincts: First, Cordova, 1900; second, Oak Ridge; 3d, Corinth, 1901, with a total of 11 cases and 1 death. No hospital or pest house was provided, and the following was our method of management: Quarantined each case and suspect within his own home; maintained a guard to prevent further exposures; caused universal vaccination.

The disease was brought to this county first, from Covington; second, from Kenton county; third, from Sadieville; it was always

promptly recognized after a few had been exposed. I estimate that 1,000 vaccinations have been done in the county since the first cases occurred, that 10,000 had been previously vaccinated, out of a total population of 15,000, leaving 4,000, or 26 2-3 per cent, now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $225. The estimated cost to the county in loss of trade and interference of business has been light.

Our chief difficulties in stamping out the disease were: Some physicians denied the disease was smallpox.

Very respectfully,

N. S. MATTHEWS, M. D., Chairman.

Graves County Board of Health: J. L. Dismukes, Jr., M. D. , J. J. Shell, M. D. (Health Officer), B. F. Morris, M. D., H. H. Hunt, M. D.

Mayfield, Ky., July 19, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 14 outbreaks of smallpox in this county, in the following districts or precincts: Various parts of city and county, with a total of 151 cases and 5 deaths. No hospital or pest house was provided, and the following was our method of management: Guarded and treated at residence; those without homes in tent provided by city and county.

The disease was brought to this county from Evansville, Ind., Cairo, 11l., and Jackson, Tenn.; it was very promptly recognized, after few had been exposed. I estimate that 1,500 vaccinations have been done in the county since the first cases occurred, that 4,000 had been previously vaccinated, out of a total population of 40,000, leaving 34,500, or 87 per cent, now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $8,500. The estimated cost to the county in loss of trade and interference of business has been $2,000.

Our chief difficulties in stamping out the disease were: Failure of county and city officials to furnish suitable buildings for pest hbuse or hospital. The objection of the people to vaccination; the mild form of the disease caused the populace to doubt that it was smallpox.

Very respectfully,

GEO. T. FULLER, M. D.,

Member State Board of Health.

Mayfteld City Board of Health: Dr. G. T. Fuller, Dr. Woolley, Dr. J. D. Landrum, Dr. H. H. Hunt.

Mayfield, Ky., July 18, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 5 outbreaks of smallpox in this city, in the following districts or precincts: Two in Ward No. 1, 2 in Second and 1 in the Third, with a total of 28 cases and no deaths. No hospital or pest house was provided, and the following was our method of management For want of pest house, used tents in 4 cases, the tents being out of city limits; 24 cases was kept at their homes, isolated, disinfected and fumigated by a gas mode of Piatt's Chlorides, chloride of lime, bichloride of mercury, carbolic acid, etc., etc. Carbolized vaseline used externally.'

The disease was brought to this city from Evansville, Ind., in April, 1899, Tennessee and Missouri; it was only recognized after many had been exposed. I estimate that 300 vaccinations have been done in the city since the first cases occurred, that about 1,500 had been previously vaccinated, out of a total population of about 7,000, leaving nearly 5.000, now unprotected.

The total cost of management to the city, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been about $1,800. The estimated cost to the city in loss of trade and interference of business has been nothing—so estimated by a number of merchants and other business men.

Our chief difficulties in stamping out the disease were: A want of vaccination, there being strong opposition and prejudice against it. the city council refusing to pass an ordinance to enforce it"; and a strong disposition on the part of many to not co-operate with the health officer, believing it was not smallpox—the reason of that belief because there were no deaths. All the physicians sustained the health officer. The opposition has about passed away.

Very respectfully,
J. D. LANDRUM, M. D., City Health Officer.

Grayson County Board of Health: T. M. Barnett, T. M. Nemmo, Ambrose Ames, O. F. Stuteville, W. S. Clarke.

Leitchfield, Ky., July 29, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 3 outbreaks of smallpox in this county, in the following districts or precincts: Big Clifty, N. Leitchfield and Horntown, with a total of 60 or 70 cases and 2 deaths. One hospital or pest house was provided near Big Clifty, and the following was our method of management. The majority of

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