at the Norris House. Nature of the disease was not recognized until 3 cases had developed. These and three more cases were treated in an annex to the Norris House, and the presence of the disease there was not made known to the Board of Health until another case developed in town, the result of contact with those at the Norris House. In the outbreak in the Holy Cross district 12 cases were treated at their homes, under strict quarantine.

The disease was brought to this county from Lexington and Louisville; it was not recognized until after all had been exposed. I estimate that 800 vaccinations have been done in the county since the first cases occurred, that 2,500 had been previously vaccinated, out of a total population of 16,290, leaving 13,790, or 85 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 $1,500. The estimated cost to the county in loss of trade and interference of business has been $2,500.

Our chief difficulty in stamping out the disease was: The presence of the disease having been kept a secret from the Board of Health, at the Norris House. All other cases were easily isolated at their homes, and we had the thorough co-operation of the town and county authorities.

Very respectfully,

R. C. MCCHORD, M. D., Secretary.

Marshall County Board of Health: Dr. V. A. Stilley, Dr. W. S. Stone, Dr. E. G. Thomas.

To the State Board of Health:

Benton, Ky., July 16, 1901.

Gentlemen: Within the last four years we have had 4 outbreaks of smallpox in this county, in the following districts or precincts: Sharpe in 1900 and 1901, Oak Level in 1901, and Benton in 1901, with a total of 65 cases and no deaths. One hospital or pest house was provided near Benton, and the following was our method of management: Isolation, and vaccination of all exposed, as far as we were permitted to carry these into effect.

The disease was brought to this county from Paducah, Ky., and Colorado State. It was recognized after 15 had been exposed in Oak Level district, and in Sharpe in 1900 there were ten exposures. It was promptly recognized in Benton and only one case occurred outside of the first family. I estimate that 500 vaccinations have been done in the county since the first cases occurred; that 3,500 had been previously vaccin

ated, out of a total population of 13,500, leaving 9,500, or 70 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 $800. The estimated cost to the county in loss of trade and interference of business has been very small.

Our chief difficulties in stamping out the disease were: Failure to be vaccinated, and the disease was not recognized in Oak Level and Sharpe as early as it should have been by the local physicians, owing to its mildness. Our county board and officials gave us cordial support. Very respectfully,

V. A. STILLEY, M. D., Secretary.

Martin County Board of Health: Dr. J. R. Fairchild, G. W. Estep, S. W. Newberry.

To the State Board of Health:

Inez, Ky., July 18, 1901.

Gentlemen: Within the last four years we have had 1 outbreak of smallpox in this county, in the Wolf Creek district, with a total of 4 cases and no deaths. A hospital or pest house was provided near mouth of Crooked, and the following was our method of management: The houses where the disease was were flagged, the cases isolated and all exposed persons vaccinated.

The disease was brought to this county from West Virginia; it was recognized after about 8 had been exposed. I estimate that 300 vaccinations have been done in the county since the first cases occurred; that 200 had been previously vaccinated, out of a total population of 7,580, leaving 7,000 now unprotected in the county.

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 $200. The estimated cost to the county in loss of trade and interference of business has been $3,000.

The peo

Our chief difficulties in stamping out the disease were: ple were hard to manage on account of not believing it was smallpox, because they did not die as soon as one would take it. Many of the people were not able to pay for vaccination and the county officials, or rather those in charge of the finances of the county, were not willing to pay for the same.

Very respectfully,

J. R. FAIRCHILD, M. D., Secretary.

Mason County Board of Health: Dr. H. K. Adamson, Dr. J. A. Reed, Dr. P. G. Smoot, Dr. W. H. Hord, Dr. M. H. Davis.

To the State Board of Health:

Maysville, Ky., July 23, 1901.

Gentlemen: Within the last four years we have had 3 outbreaks of smallpox in this county, in the following districts or precincts: Mayslick, Washington, Lewisburg and Maysville, with a total of 58 cases and no deaths. A hospital or pest house was provided near Maysville, and the following was our method of management: Rigid isolation of cases in hospital when this was possible, and general vaccination, beginning with those who had been exposed.

The disease was brought to this county from West Virginia and Ohio; it was recognized after a number had been exposed. I estimate that 2,500 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 20,446, leaving about 8,000 now unprotected in town and county.

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 $3,800. The estimated cost to the county in loss of trade and interference of business has not been great.

Our chief difficulties in stamping out the disease were: The disregard of the colored population of the disease, and the attempt of a newspaper to make a little cheap notoriety by questioning the diagnosis.

Very respectfully,

H. K. ADAMSON, M. D., Secretary.

Meade County Board of Health: Dr. D. C. Pusey, Dr. J. D. Shacklette, Dr. R. P. Walker.

To the State Board of Health:

Brandenburg, Ky., Sept. 25, 1901.

Gentlemen: Within the last four years we have had 1 outbreak of smallpox in this county, in the Garnettsville district, with a total of 6 cases and no deaths. A hospital or pest house was provided near Grahamton, and the following was our method of management: The cases were isolated, consisting of husband, wife and four children. The man, having been vaccinated, had varioloid mildly, and was able to nurse other patients. They ran a regular course of smallpox, nothing unusual occurring in the cases.

The disease was brought to this county from an unknown source; it was recognized after the one family had been exposed. I estimate that 100 vaccinations have been done in the county since the first

cases occurred; that 2,000 had been previously vaccinated, out of a total population of 10,553, leaving 8,453 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 $275. The estimated cost to the county in loss of trade and interference of business has been nominal.

There were no difficulties in circumscribing the disease; vaccinations were pretty general, though I could not give the per cent. Very respectfully,

D. C. PUSEY, M. D., Chairman.

Menifee County Board of Health: Dr. R. B. Kash, Dr. W. O. B. Remy, Dr. E. B. Northcott.

To the State Board of Health:

Frenchburg, Ky., July 17, 1901.

Gentlemen: Within the last three years we have had 1 outbreak of smallpox in this county, in the district near Rothwell, Ky., with a total of 5 cases and no deaths. No hospital or pest house was provided, and the following was our method of management: Each family was rigidly quarantined and no spread occurred.

The disease was brought to this county from West Virginia; it was promptly recognized. I estimate that very few vaccinations have been done in the county since the first cases occurred; that very few had been previously vaccinated, out of the total population, leaving over 6,000 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 $20. The estimated cost to the county in loss of trade and interference of business has been comparatively nothing.

The disease was very promptly quarantined and only existed in two families, which we had guarded and thereby prevented the spread of the disease, which was of a very light form, and not highly infectious. Very respectfully,

R. B. KASH, M. D., Secretary.

Mercer County Board of Health: Dr. A. D. Price, Dr. M. L. Forsythe, Dr. W. D. Powell.

To the State Board of Health:

Harrodsburg, Ky., July 17, 1901.

Gentlemen: Within the last four years we have had 1 outbreak of smallpox in this county, in the following districts or precincts: Harrodsburg, Salvisa and Duncan, with a total of 72 cases and no

deaths. No hospital or pest house was provided, and the following was our method of management: Vaccination, isolation and subse-

quent disinfection.

The disease was brought to this county from Tennessee; it was recognized after a number had been exposed. I estimate that 2,000 vaccinations have been done in the county since the first cases occurred, that one-third had been previously vaccinated out of a total population of 15,000, leaving 8,000 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 $626.39. The esti-mated cost to the county in loss of trade and interference of business. has been small, as we had little excitemnet.

No special difficulties in stamping out the disease, as we have an intelligent people and had the full support of our city and county authorities. Very respectfully,

A. D. PRICE, M. D., Chairman.

Metcalfe County Board of Health: Dr. H. C. Reid, Dr. J. A. Yates, Dr. H. R. Vanzant.

To the State Board of Health:

Edmonton, Ky., July 24, 1901.

Gentlemen: Within the last four years we have had 2 outbreaks of smallpox in this county, in the following districts or precincts: Edmonton and Knob Lick, with a total of 14 cases and no deaths. No hospital or pest house was provided, and the following was our method of management: The houses where the outbreak occurred, together with all of its occupants, were quarantined, and all outside exposures were isolated and held in quarantine for 16 days, and vaccinated.. The clothing and bedding were burned and the house and all fixtures were thoroughly fumigated after the last case was dismissed. All patients and occupants were given a carbolized bath before dismissal.

The disease was brought to this county from Green county to Knob Lick, Edmonton not known; it was recognized after 20 had been exposed. I estimate that 2,500 vaccinations have been done in the county since the first cases occurred, that 2,500 had been previously vaccinated, out of a total population of 10,000, leaving 5,000, or 50 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 $700. The estimated cost to the county in loss of trade and interference of business has been $1,500 to $2,000.