but is perhaps also the best informed county at all times as to her general sanitary condition. The health officer of Cecil County has no such aids. He has, however, a Board of County Commissioners who meet once a month as a Board of Health, and give honest consideration to the reports of their executive officer. There are no town boards of health in Cecil, and no district health officers of any sort, so that the information conveyed in the report from that county owes little to any other influence than the vigilance and energy of one man. The report from Frederick contains nothing to indicate that any real organization of the County Commissioners as a Board of Health has been effected. The chief towns, Frederick City and Brunswick, have their own local boards, so that the county officer is chiefly concerned with rural hygiene, and apparently he is permitted to prosecute his work quite unaided. Under such circumstances it is impossible that his report should contain the circumstantial evidence of continuous effort which appears in the reports from Cecil and Washington Counties. In Kent and in Queen Anne's the County Boards of Health are in effect the executive officers. There is no town board of health in either of these counties, and no means of systematic communication concerning prevailing sickness exists in either. These counties, therefore, owe whatever distinction they obtain in a sanitary way to the personal power and influence of their health officers, rather than to official qualifications or organization. In all five of these counties the reports indicate an amount of work which is not adequately paid for, but the five health officers are not equally underpaid. Arranged in accordance with the money spent on sanitary work Washington stands first, Frederick next, then Cecil, and Kent and Queen Anne are equal. These considerations perhaps show that an effective organization of a local board of health under the present law on the subject requires first the selection of a superior medical man as executive officer, and next, on the part of the commissioners, sufficient intelligence to appreciate the suggestions of their medical adviser, and independence enough to put them into practice. So long as county commissioners are chosen by the people without the slightest consideration of their fitness to regulate the sanitary affairs of the county, it must be pure good luck if any county has a board of health which deserves to be called good. List of County Health Officers. Names. Dr. Charles H. Brace, Cumberland..... Dr. H. Burton Stevenson, Rider P. O... Dr. Chas. R. Foutz, Westminster.. Dr. Howard Bratton, Elkton... Dr. Martin W. Goldsborough, Princess Anne.... Dr. T. A. Councell, Easton...... Counties. Allegany. Anne Arundel. ..Calvert. .Caroline. Carroll. Charles. Garrett. Howard. Kent. Montgomery. Prince George's. Queen Anne's. .Somerset. St. Mary's. Talbot. Washington. Wicomico. .... Worcester. Aberdeen. ...... Annapolis. .Brunswick. .Cambridge. Catonsville. Crisfield. ...Cumberland. Frederick. Havre de Grace. NOTIFICATION OF INFECTIOUS DISEASE. The law upon this subject has been fairly well operated in some of the counties of Maryland, and in all the counties it has been about as well administered as are the other laws of public health. Some of the town boards of health have the full and hearty co-operation of practising physicians, and prompt information is obtained of every appearance of the notifiable diseases. The boards of health in Frederick, Brunswick, Lonaconing and Hagerstown are probably as fully informed at all times concerning the presence of infectious disease as is the Health Department of Baltimore City. The newly organized Health Board of the City of Hagerstown regularly returns to the State Board of Health all the notices of infectious disease which are received in the course of each month. These notices contain the address of all infected houses, with the names of the householders. Information of this sort can be turned to great practical account by the State Board of Health, and it is very desirable that all local boards of health should make the similar returns. Throughout Washington County the notification act is well observed in respect to diphtheria, scarlet fever and measles, the common diseases which are best restricted by easy means. A CONVICTION FOR FAILURE TO NOTIFY SMALL-POX. On the morning of the eleventh of May information was received that two cases of supposed small-pox had been sent from Sparrow's Point, in Baltimore County, to the Baltimore City Quarantine Hospital as private patients, paid for by the Maryland Steel Company. Inquiring at the City Health Department, it was learned that a report from the Quarantine Hospital gave the name of the last patient as Egbert Thrower, admitted May 8th, and it was stated that the physician to the Maryland Steel Company informed the quarantine officer that the case had been reported to the health authorities. No notification of this case having reached the office of the State Board of Health, written inquiries were at once sent to the local officers in Baltimore County, and they were also interrogated by telephone. But one officer was reached by telephone, Dr. C. L. Mattfeldt, who was on that date the acting health officer for Baltimore County, who replied that he was ignorant of the existence of any infectious disease at Sparrow's Point, having received no notification of any sort from any physician at that place. Later, letters were received from all three of the local officers stating that no notification had been sent. The eleventh of May happened to be the date of the regular monthly meeting of the State Board of Health. The above facts were reported to the Board, and the Secretary was instructed to investigate, and if the facts showed that a case of small-pox occurring at Sparrow's Point had been recognized by the attending physician and had not been reported to the health authorities of the county or State, to cause the arrest and punishment of the physician so delinquent. Late in the afternoon of May 11th the Commissioner of Health of Baltimore City informed the Secretary of the State Board of Health that Dr. E. G. Welch had sent a notification to the Department that a colored man, one Jackson, an employee of the Maryland Steel Company, had just been at his office for medical advice, having then small-pox in the stage of eruption; that said Jackson had returned to Sparrow's Point, and would, on the following morning, be in Baltimore again. The Secretary of the State Board of Health went to Sparrow's Point on the first morning train for the purpose of finding and isolating this patient, and to discover, if possible, the existence of other cases. The physician of the company was seen, and he expressed great surprise that the presence of small-pox in that community, if true, should be known in Baltimore before it was discovered by himself. By consulting the pay-roll we were enabled to locate the man Jackson. He was found in a compartment of a series of barracks occupied by the lowest class of labor employed by the company. There were three other colored men occupying the same room.. Jackson was sent to Quarantine Hospital. This part of the shanty was ordered shut up until it could be disinfected. The other three colored men were to be isolated and kept under observation until the period of incubation of the disease had passed. Mr. Wood, superintendent of the Company, gave a ready assent to every suggestion for the prevention of further spread of the disease, and from that time forward co-operated with and assisted the health authorities in the work of suppressing the disease. On the following day the Secretary of the State Board of Health revisited Sparrow's Point in company with Dr. Stevenson, Health Officer for Baltimore County, to arrange for general vaccination. While there it was discovered that the room from which the man Jackson had been removed had not been shut up, nor the exposed persons in any way isolated. One of them was sick, the eruption just appearing. We were informed there was a suspicious case, probably small-pox, in that part of the town known as "The Island." This case was visited by Dr. Stevenson. On Sunday, the 13th, while vaccinating from house to house, three cases of small-pox came under the observation of the Secretary, one of whom was dropping the crusts and must, therefore, have been more or less sick for about three weeks. This patient claimed to have been visited by the company's physician and to have been treated for eczema. The other facts concerning this outbreak of small-pox may be found in the report of the Health Officer for Baltimore County, Dr. Stevenson. These circumstances are mentioned here in connection with the prosecution of the company's physician for failure to report the case of Egbert Thrower, who was sent to Quarantine Hospital on May 8th. A warrant was sworn out against the physician for violating Section 34B, of Article 43, of the Code of Public General Laws, before Justice Wm. Leyshon. The preliminary hearing before the magistrate was waived, and bond was given to await the action of the grand jury. The grand jury of Baltimore County, at the October term, found an indictment. The defense elected to be tried by the court. The physician was found guilty, and the lowest fine of fifty dollars was inflicted. This case was an important and interesting one. It tested the ability of the State Board of Health to obtain both an indictment and conviction, notwithstanding the absence of intent to violate the law, and without the introduction of evidence to prove gross neglect of ordinary precautions. The evidence offered before the grand jury was only so much as was believed necessary to secure an indictment. At the trial the State admitted the 'defendant's plea of ignorance of the law. The defense made large claims of great activity and effectiveness on the part of the company's physician in the suppression of small-pox both before and after the intervention of the health authorities, and the State did not challenge these claims. The defense was conducted by able and industrious counsel, who employed every available expedient. The outcome would seem to indicate that the local, health authorities in this State can enforce the notification of infectious diseases. THE BACTERIOLOGICAL LABORATORY. The report of the bacteriologist to the State Board of Health will show part of the useful work done by that officer. While the work of that department is growing, and while its results in the short period of its operation have been worth more than their cost to the State, there are some directions in which the advantages of bacteriological examinations have not been demanded at all. Thus in determining the period at which a child recovered from diphtheria may safely be allowed to return to school, a bacteriological examination of a culture from the throat is the |