As I wrote you, when I called, I found one child dead, one just dying—was dead in three minutes after I reached the house-and three sick, and mother with "bastard" symtoms. On the tenth day of the disease two died; the girl lived until the fifteenth day of illness and died, the boys (two) recovered. I do not know as to the origin of the Cleveland case, but believe Katie carried the germs there. I do not know whether Katie had the disease in Cleveland after she went there or not. The family were not exposed before Katie's arrival. Sanitary condition was of the poorest, and was such as would breed diphtheria or kindred disease. Water in cellar-greenish, foul, thick with rubbish, and no outlet to convey water from cellar. The Meeks are careless to a degree. Everything was in fit condition to intensify and prolong disease when once started. There was no other case of contagious disease in that neighborhood that I know of, but am not positive. I believe Katie had a mild diphtheritic infection before she came home, and from what might have been a mild run of the disease, the sanitary condition was such it developed into a severe, fatal one. The house is small, and when all the family are at home, they are "huddled" somewhat, which fact would only help to intensify the more. I am, yours truly, B. R. LEROY. The following letter was received from Dr. P., of Lancaster: LANCASTER, O., August 26, 1889. C. O. Probst, M. D., Secretary State Board of Health, Columbus, Ohio: DEAR SIR: I take the liberty of writing you for the purpose of calling your attention to the fact that this town has no "board of health," (notwithstanding the law requires one, I believe,) and to the further fact that there is business here for such a board; but more especially do I wish to bring before you the facts regarding the nusiance that is being maintained by the Hotel Martin. When this hotel was built, owing to there being no sewer system here, a large vault was dug in the street adjoining it, and the pipe from the water-closets runs into it. This vault is now full to overflowing, and the filth from it is seeping through the earth and into the gutter where it runs alongside of the house, thus creating a stench that is a menace, not only to the health of the guests of the hotel, but of the whole neighborhood surrounding it. In addition to this, the water-closets themselves are in bad condition, owing to their not flushing properly. Complaint has been made to the owner of the building, Mr. John D. Martin, but he does nothing, and is now in Middle Bass, having a good time; also, to the proprietors of the hotel, M. E. Howell & Co., but they do nothing, saying it is Mr. Martin's place to remedy the matter; we have also called the Mayor's attention to it; he says it is the business of C. H. Towson, as councilman from this ward, to see to it; he, also, has been spoken to, but does nothing, and the nuisance remains unabated. Now, as a last resort, I appeal to you to know if there is not some way of compelling the authorities to act in the matter and abate the nuisance. I remain sir, very courteously yours, M. P. I addressed a letter to the Mayor and Council, calling attention to the complaint, and stating that it would surely not be to the interest of their city to have such disgraceful conditions made public. I asked them to take action at once, for the abatement of the nuisance, and urged the necessity of their having a board of health. Dr. P. writes in regard to the matter as follows: LANCASTER, O., August 27, 1889. C. O. Probst, M. D., Secretary State Board of Health, Columbus, Ohio: DEAR SIR: Your favor of 26th at hand and noted. Thanks for your kindness and promptness. Since the receipt of your letter, the Mayor has promised to have the nuisance abated, and also promised to bring the matter before the next meeting of the city council and try and have a board of health appointed. The only reason I can find for not having a board appointed before is, that it would cost the city some two or three hundred dollars per year for the health officer. The council thought by appointing a committee to look after the matters properly belonging to a board of health, that the expense of the board could be saved. In case the nuisance is not abated within a reasonable time, I will advise you of the fact. Trusting that may not be necessary, however, I remain, Very courteously yours, The following complaint comes from New Lisbon : State Board of Health, Columbus, O.: M. P. located at GENTLEMEN : I write you to-day in regard to one Dr. Geo. AO. He had a case of malignant scarlet-fever, and the patient died. The family consulted him as to there being any danger in holding the funeral in the church, and he told them there would be none; also, that there would be no risk in letting the child's companions act as pall-bearers. The result is, scarlet-fever has broken out in the school at — dices to prompt me to write to you, as the man is twelve miles from me. I am, very truly, yours, I have no preju M. I at once wrote the doctor, informing him of the charges, and requesting his statement in regard to the matter. He answered as follows: C. O. Probst, M. D., Sec'y State Board Health: DEAR SIR: I was greatly surprised on receipt of your letter to hear of the information you had. Surprised, on account of its being so directly contrary to facts. Please let me state the matter just as it was, and what I say I can substantiate by sworn testimony by our citizens. We had a funeral of a child who had the scarlet-fever-but was over that part of it—but “took cold" in convalescence, and died of pneumonia. They did take the corpse into the church, for which I was not responsible. I inquired before the funeral, and was told that the child would be buried and afterward there would be public service in the church. This I thought was the intention, till they had her in the church. I was not at the funeral myself. The other children, or two of them, were down with scarlatina at the time of the funeral. Had I not been informed that it was the intention to bury first, I should have objected to their going to the church. Regarding the pall-bearers, I will give their names and ages, near as I would judge. They were Joseph Crawford, aged about 60; Joseph Dickey, aged about 50; John White, aged about 45, and T. B. Crook, aged 45 or 50. So you see they were not children at all, and I cannot see why any one should report such blank untruth. It was spoken of once, and a man came to me about it, but I put a stop to it. Now, I will tell you the precaution I took in the whole matter. I stopped the school in order to prevent any spread of it. It was the intention to have what they call a children's day service in the church last Sunday. I stopped that. I advised people not to call at the house where disease was. I used disinfectants and prophylactics. I have one case only of scarlatina now, and that one is convalescing. I had eleven cases in all. Three of them were of a mild form, and at the town next to ours. All my cases made good recoveries excepting the one that died. Now, if you would like the testimony of our citizens here as to what precaution I took, and as to what I had to do with the public service, I will willingly send you such. I think I can send you a sworn statement from all our citizens here, as I cautioned all, and incurred for awhile the displeasure of the family by advising people to stay away. I do not see how I could have done any different from what I did. I had thought of reporting the sickness to you once, but it did not assume an epidemic form, and I did not. Yours truly, Dr. A. I notified Mr. M. that he must furnish proof of his statements, or withdraw his charges. I also requested Dr. ments. to furnish evidence in support of his state The latter responded as follows: C. O. Probst, M. D.: DEAR SIR: I send herewith the testimony of the pall-bearers and of the parents of the deceased child. I thought of sending a lot more names as to what course I took, and to substantiate all I wrote in my other letter, but thought this was all you wished. I can, however, if you wish, send testimony as to all I wrote. There have been no new cases since I wrote you, and the case I had is nearly well, The school is still closed, however. I shall send in reports regularly, and will report anything of interest to the Board. I hope this will be sufficient to show my innocence regarding the report you had. Yours, etc., DR. A. This certifies that Dr. A. had nothing whatever to do with the funeral of our little child, Elsie G. It was our own doing and he was not informed, and as far as we know he was not aware that a public service was to be held at the church. The funeral was held July 30. The child died from relapse of scarlet-fever. This is to certify that we, the undersigned citizens of at the funeral of Elsie G., deceased. LEVI DICKEY, aged 45. T. B. CROOK, aged 46. The following letter was received from Mr. M., since which time nothing further has been heard of the matter, and I have written Dr. exonerating him from all blame. C. O. Probst, M. D., Columbus, Ohio : T DEAR SIR: Your communication to hand and contents noted. It was one of the trustees of the church who requested me to write you in regard to the matter. I have notified him of your request for proof, and he has promised to furnish affidavits. There has been three additional cases of the same fever in the immediate neighborhood, and he informed me that the school had been closed on account of it. So far as exonerating him before the public is concerned, I would just say that no one but yourself, the party who requested me to write, and myself, know anything about this matter. If the trustee is not forthcoming with the affidavits this week, I will give you his name, and you can ask him why he does not furnish the information that you request. I am, very truly, J. S. M. INVESTIGATION OF DIPHTHERIA AT MOSCOW. August 17, our correspondent at Moscow, Dr. T. C. McKibben, reported thirty-two new cases of diphtheria in that village, with eight cases reported the previous week still under treatment. I wrote at once for further particulars, and sent a package of diphtheria circulars for distribution. On the 21st, a letter was received from Dr. McKibben, who stated that the disease had become epidemic; that while the people were panicstricken, but few precautions were being taken to control the disease. A local board of health had not been established, and an urgent request was made for aid from the State Board. I left on the first train for Cincinnati, and reached Moscow by steamer at 3 A. M. the following day-August 22d. Early that morning I met Dr. McKibben, who informed me that they had had three deaths from diphtheria within the last thirty-six hours, and that the bodies were not yet buried. The corpse of one child was to be taken to Felicity, a neighboring village, where arrangements had been made for a public funeral. I at once visited the undertaker who had charge of the three funerals, and directed that the funerals should be held with the strictest privacy. I also gave them a recipe for a bi-chloride solution, with instructions to envelop the bodies in sheets wet with the solution, and to coffin them at once, and bury them as soon as possible. They agreed to strictly follow these instructions. I then visited the family which had arranged for a public funeral at Felicity, at 3 P. M., and succeeded in arranging for the funeral to take place at 10 A. M., services to be held at the grave with none but the adult relatives present. The mother of this child was suffering with sore throat, which, under the circumstances, was suspicioned to be diphtheria, and I requested her not to attend the funeral, to which she consented. I then called on the Mayor, Mr. Wiley, who agreed to call a special meeting of Council at 1 P. M to consider the formation of a board of health. Dr. McKibben then took me in charge and showed me all the cases he had under treatment, about thirty in all. He also showed me over the village, that I might form some idea of its sanitary condition. I next called on Dr. McGill, who showed me six or eight of the worst cases in his practice. He also gave me a list and a brief history of all the cases he had treated up to that date. Subsequently, Dr. McKibben and Dr. Montjor furnished each a list and history of all cases of which they had professional knowledge. Dr. Montjor, an eclectic, also gave me a history of three cases which Dr. Jones, also an eclectic, but then absent, had treated. From information thus received, and from personal observation, the following facts were learned: Moscow is a village of about 600 inhabitants, with a school enumeration of 214, which includes half a dozen families outside the corporation. The town is located on the Ohio river, in Clermont county, twentyeight miles above Cincinnati. The site of the town is a rolling plain, the hills being some distance from the river, with the surface drainage from above down the river, and both toward and from the river, the central part of town being slightly depressed. The soil is wet and clayey, and there are no cellars after leaving the front or river street, that are not wet, unless deeply drained. The streets are of fairly good width, but the gutters were, most of them, obstructed with vegetation. The houses, generally, are neat and comfortable; the inhabitants are mostly native born, and there is not a negro or pauper in the place. The water supply is almost exclusively from cisterns, which are usually built under ground and cemented. Privies are constructed with vaults, uncemented, and required by ordinance to be eighteen feet. The ordinance is not usually enforced, however. These privies are never emptied, but when full are covered over, a new vault being dug. Their condition, as far as seen, was no worse than is usually found in small villages. A slaughter-house, just beyond the corporate limits, is an occasional source of complaint to those living near it, but on the whole the town was found to be in as good sanitary condition as the great majority of small places. The first case of diphtheria known to have occurred in Moscow for some years, was that of Miss Hirling, who returned sick from New Richmond, a neighboring village, where she attended a teachers' institute. Diphtheria was prevailing in New Richmond at that time. Dr. McGill was called to see this case November 13, 1888. There were five children in this family. Dr. McGill forbade them to attend school, which was then in session, and no other cases occurred at that time. No special pains were taken to isolate the patient. The second case occurred in the Kensell family, two or three children having the disease. No direct connection between the first and second cases could be traced, but the first family have a grocery, and it is not unlikely that there was communication in this way. No other cases occurred until about April 1, |