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Our chief difficulty in stamping out the disease was: Its mild form. Some of the physicians who first saw them failed to diagnose the cases until there had been several exposures and 4 or 5 cases at Edmonton, and about 3 cases at Knob Lick. It was diagnosed as chicken pox by the first physician that saw the cases, or treated them, at Edmonton, at least, but was recognized promptly at Knob Lick.

Very respectfully,

J. A. YATES, M. D., Secretary.

Monroe County Board of Health: A. H. Chism, Esq., Dr. H. B. Ray, Dr. R. F. Duncan, Dr. Geo. W. Bushong.

Tompkinsville, Ky., July 31, 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: East Tompkinsville, Martinsburg and Gamaliel, with a total of 29 cases and no deaths. No hospital or pest house was provided, and the following was our method of management: First made diagnosis, then isolated those infected and vaccinated those known to have been exposed, and put both the infected and the suspects in quarantine for 21 days, at the expiration of which time we disinfected the premises and raised the quarantine.

The disease was brought to this county from Louisville, Ky., and Nashville, Tenn.; it was promptly recognized after 150 or 200 had been exposed. I estimate that 300 vaccinations have been done in the county since the first cases occurred, that 600 had been previously vaccinated, out of a total population of 13,000, leaving 12,000, or 92 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 $410. The estimated cost to the county in loss of trade and interference of business has been $4,000.

Our chief difficulty in stamping out the disease was: There had been no smallpox in this county since the Civil War, and the people had come to think smallpox was a disease confined to cities and more densely populated sections; a disease to be read about in the newspapers, and not for country people to be afflicted with, so that when a diagnosis of smallpox was made, the best citizens raised their voices against it and denounced any man who had pronounced smallpox in their midst to be unmitigated liars, and used all their influence against reason.

Very respectfully,

GEO. W. BUSHONG, M. D., Secretary.

Montgomery County Board of Health: Dr. J. A. Shirley, Dr. W. R. Thompson, Dr. W. T. Willis.

Mt. Sterling, Ky., July 31, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 3 outbreaks of smallpox in the county, in the following districts or precincts: Levee, Aaron's Run, Harts, Smithville, and this city, with a total of 78 cases and no deaths. A hospital or pest house was provided near Mt. Sterling, Ky., and the following was our method of management: At first cases were treated and quarantined at home, but as expense was so great, a pest house was established, as stated above and all cases were removed to same as fast as they appeared. Those exposed were quarantined at home under guard until period of incubation had passed.

The disease was brought to this county from West Virginia; it was recognized after about 150 had been exposed. I estimate that 3,500 vaccinations have been done in the county since the first cases occurred; that 6,000 had been previously vaccinated, out of a total population of 12,500, leaving 3,000, or about 24 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 $5,313. The estimated cost to the county in loss of trade and interference of business has been very little.

Our chief difficulties in stamping out the disease were: Neglect of vaccination and opposition to any measure to stamp out the disease, claiming there was no smallpox. Strange to say the most of this opposition came from the educated and better class of our citizens. But the county judge and his committee from county court stood by the board and gave us their most hearty support notwithstanding opposition. Very respectfully,

W. R. THOMPSON, M. D., Secretary.

Moryan County Board of Health: Dr. B. F. Carter, Dr. B. F. McClure, Dr. J. D. Whittaker.

West Liberty, Ky., Oct. 25, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 1 outbreak of smallpox in this county, in the following districts or precincts: Coney and vicinity, with a total of 150 cases and 2 deaths. No hospital or pest house was provided, and the following was our method of management: A strict quarantine was established, and guards placed on all roads; general vaccination.

The disease was brought to this county from Tennessee; it was not promptly recognized, or until 300 had been exposed. I estimate that 300 vaccinations have been done in the county since the first cases occurred, that 100 had been previously vaccinated, out of a total population of 13,000, leaving 12,500 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 $1,200. The estimated cost to the county in loss of trade and interference of business has been slight; can not estimate.

Our chief difficulty in stamping out the disease was: It was brought here by about thirty negroes (railroad hands) in a very mild form, and there were many exposures before it was recognized. The negroes worked, danced and hunted while they had it. There were so many exposures that the county did not attempt to provide pest houses and they were quarantined in their homes. Principally the county officials were backward about co-operating.

Very respectfully,

B. F. CARTER, M. D., Chairman.

Muhlenberg County Board of Health: Dr. M. P. Creel, Dr. Augustus Lewis, Dr. J. T. Woodburn, Dr. H. C. Kennedy, Dr. T. G. Farnet.

Central City, Ky., July 26, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 4 outbreaks of smallpox in this county, in the following districts or precincts: Bevier, Central City, Greenville and South Carrollton, with a total of 117 cases and 1 death. Hospitals or pest houses were provided near Greenville and Central City, and the following was our method of management: Strict isolation of all cases and general vaccination as far as this protective measure could be enforced.

The disease was brought to this county from Paducah, Ky.; it was recognized after many had been exposed. I estimate that 700 vaccinations have been done in the county since the first cases oo« -curred; that 200 had been previously vaccinated, out of a total population of 20,700, leaving nearly 20,000 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 $1,700. The estimated cost to the county in loss of trade and interference of business has been from $10,000 to $15,000.

Our chief difficulty in stamping out the disease was: The idiots -claiming that it was not smallpox. Some of the physicians were the worst people we had to contend with, but fortunately some of then* contracted the disease and scattered it in their families and patrons who fought the health officers and boards the hardest. The opposition subsided in a measure after the disease was better understood. Very respectfully,

M. P. CREEL, M. D., Secretary.

Nelson County Board of Health: Dr. A. G. Blincoe, J. L. Pope, B. E. Gore.

Bardstown, Ky., July 17, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 1 outbreak of smallpox in this county, in the Bardstown precinct, with a total of 7 cases and no deaths. A pest house was provided in Bardstown, and the following was our method of management: The cases were isolated and flagged and all exposed persons were vaccinated.

The disease was brought to this county from Lebanon Junction; it was promptly recognized after very few had been exposed. I estimate that 1,500 vaccinations have been done in the county since the first cases occurred, that 9,000 had been previously vaccinated, out of a total population of 18,000, leaving 7,500, or 40 per cent., now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., Tor 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 $200.

Our chief difficulties in stamping out the disease were: The opposition of some business men, a few private citizens and some physicians. Our county authorities gave us their support .

Very respectfully,

A. G. BLINCOE, M. D. , Chairman.

Nicholas Cotinty Board of Health: Dr. M. Dills, Dr. B. F. Reynolds, Dr. W. H. Martin.

Carlisle, Ky., July 15, 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: Carlisle, and lower part of county, and Stony Creek, with a total of 150 cases and no deaths. No hospital or pest house was provided, and the following was our method of management: Owing to the great idea of keeping down expense the county court failed to provide a pest house until last epidemic was about over. We simply quarantined cases and placed guards to see that no exposure from cases occurred. After all was vaccinated and after twelve days from last case houses were disinfected and inmates released.

The disease was brought to this county from some unknown source; it was not promptly recognized, and many had been exposed. I estimate that 4,000 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 12,000, leaving 6,000, 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 $1,200. The estimated cost to the county in loss of trade and interference of business has been $20,000.

Our chief difficulties in stamping out the disease were: Co-operation of physicians, who at first were slow to report cases; the county court in refusing to stand by the county board; a few people who always seem to think their duty is to object to everything; false reports from outside newspapers.

Very respectfully,

M. DILLS, M. D., Secretary.

Ohio County Board of Health: Dr. S. J. Wedding, Dr. E. W. Ford, Dr. J. S. Smith, Dr. S. D. Taylor. .

Beaver Dam, Ky., July 18, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 6 outbreaks of smallpox in this county, in the following districts or precincts: Near Horton, at McHenry, Taylor Mines, Hartford, Buford, and Arnold, this county, with a total of 200 cases and 2 deaths. One hospital or pest house was provided near Taylor Mines, and the following was our method of management: Strict quarantine and vaccination. As soon as a case was diagnosed it was placed in hospital under care of physician and nurses, where strict enforcement of sanitary regulations were enforced.

The disease was brought to this county from Louisville, Ky.; it was not recognized until after many had been exposed. I estimate that 2,000 vaccinations have been done in the county since the first cases occurred, that 300 had been previously vaccinated, out of a total population of 35,000, leaving 33,000 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 $3,000. The esti

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