Board of Health of Maryland, and Report on the Public Charities of the same State, from C. W. Chancellor, M. D., Secretary; 4th Biennial Report of the California State Board of Health, from F. W. Hatch, M. D., Secretary; and the Transactions of the Wisconsin State Medical Society for 1877, from the Secretary.

This office is also regularly receiving the weekly and monthly reports of the Boards of Health of various cities.

The following books have been purchased for the library during the year:

Volume 3, and subscription for volume 4 of Public Health Papers; Walling's Atlas of the State of Wisconsin; Heredity, by T. Ribot; Village Improvements, by G. E. Waring; Nurse and Patient, and Camp Cure, by S. W. Mitchell, M. D.; The Detection of Criminal Abortion, by E. Van de Warker, M. D.; The Jukes, by R. L. Dugdale; Lectures on State Medicine, by F. S. B. F. de Chaumont, M. D.; On Personal Care of Health, by É. A. Parkes, M. D.; Water, Air and Disinfectants, by W. N. Hartley; 2 volumes Popular Science Monthly, and 1 volume Popular Science Supplement; Sex in Education, and The Building of a Brain, by E. H. Clarke, M. D.; Illustrated Homes, by E. C. Gardner; Mothers and Daughters, by T. S. Verdi, A. M., M. D.; Sanitary Engineering, by Baldwin Latham; Nutrition in Health and Disease, by J. H. Bennett, M. D.; Sanitary Engineering, by J. Bailey Denton, M. D.; Public Health, by E. A. Parkes, M. D.; Health in the House, by C. M. Buckton; also, subscriptions to the Sanitarian, the Sanitary Journal of Scotland, and the Public Health Journal of London.

EXPENSES.

The following is a summary of the expenses of the board during the year, as shown by the vouchers which have received your approval, numbered from 38 to 95 inclusive, and upon file in this

From this amount there should be deducted the sum of $382.18,

the same being for the cost of printing and distributing 3,000 extra copies of the first annual report of the board, an expense properly belonging to the year 1876, leaving the actual expenses of the year 1877 at $2,366.18.

Very respectfully,

J. T. REEVE, M. D.,
Secretary.

SCARLET FEVER;

ITS NATURE AND MEANS OF PREVENTION.

BY E. L. GRIFFIN, M. D., OF FOND DU LAC.

President of The State Board of Health.

A recent writer remarks, "that if science can point out practical conditions by which great maladies may be averted, society is, in the highest degree not only unwise, but blameworthy, if these conditions are not realized." I

With propriety this responsibility may be thoughtfully considered in relation to scarlet fever, which has come to be one of the most destructive agents of human life on this continent. While with reference to yellow fever, cholera and small pox, the profession and the public may have been fully alive as to the necessity of prevention and limitation, it is equally true that scarlet fever has not commanded such general and well directed efforts for its limitation as its prominence, as a preventable disease, demands. This fact may be accounted for, in part, when we consider the lack of well defined views concerning its nature, and the laws that govern its spread.

There is no disease that causes greater anxiety and suffering. It penetrates the private dwelling and the public institution. It is in the city, the village, and the remotest country home; in the cottage of the poor and the mansion of the rich, gathering its fearful harvest of young life.

It is within the province of boards of health, both local and state, to instruct the people, so far as they can, in the use of such measures as give promise that the disease may be greatly curtailed, and many of its fearful ravages averted. Hence it becomes desirable that all parties, and especially those who are entrusted with the

personal care of those sick with the disease, should be able to recognize its early invasion and know best how to neutralize its contagious element, both for their own protection and that of those who may be exposed.

HISTORY.

Scarlet fever is a disease of Asiatic origin. The first authentic history to be found of it was given in 1550. In 1565 it was epidemic in Paris. In 1580 it appeared in Spain, and in 1680 in Italy. It the latter part of the 17th century it prevailed as an epidemic in London. It is comparatively a new disease in the United States. So rare was the disease, that Dr. Benjamin Rush is said to have remarked sixty years ago that a physician would not be likely to see it more than once in his life time. The first authentic record of scarlet fever in this country is an account of an epidemic in Kingston, Massachusetts, 1737, by Dr. Douglass. From this place it spread slowly but with great fatality throughout the New England Colonies.

In some localities in this country it receives but little attention even at the present day. In the mild and genial climate of the gulf states it generally appears in its benign form, and we are informed that until quite a recent date, it was not recognized upon the Pacific slope. There are yet some localities where it is unknown. It has never been recognized in Japan, and is not much known throughout India.

ITS FATALITY.

It ranks among the most fatal of diseases. In Boston the deaths from scarlet fever for the ten years preceding 1820, were only 30. For the ten years preceding 1849, there were 1,468. For the year 1876, 642. The whole number of deaths from this cause in the state of Massachusetts for twenty years ending with 1875, was 23,829.

The deaths from this cause in Wisconsin, according to the last census, for the ten years ending June 1, 1870, were 1,016, and it is quite likely that the number largely exceeded these figures.

Owing to the very incomplete mortuary returns by the physicians of this state, no accurate statement can be given of the number of deaths during the past year from this one cause, but reliable returns from a few townships and cities show a large aggregate mortality.

In New York city there were only 67 deaths from scarlet fever during the ten years preceding 1828, while during the four years preceding 1870, there were 5,271, and the mortality from this cause has been very large during the consecutive years up to the present time.

In Chicago, scarlet fever is credited with 1,177 deaths during the twelve months ending August 1, 1877. Milwaukee, for the same time, reports 205 deaths from the same cause. Nor is this fearful mortality confined to the large cities and populous towns. In Wisconsin, many inland villages and rural districts have been the theater of an extensive and very fatal form of this disease during the past year.

These facts in the history of scarlet fever are introduced to show the manifestly increasing aggregate mortality from this cause, with the hope that the attention of all parties may be directed to the duty and the necessity of observing such methods and means as may give promise of checking its spread wherever and whenever it may manifest itself.

Vital statisticians have come to regard scarlet fever as the most constant epidemic which afflicts the community. A moment's reflection upon the great army of little ones that annually melt away before this pestilence ought to awaken the deepest solicitude on the part of all, and commend to universal approval and hearty support all measures looking towards the limitation of this great evil. It is certainly our duty to search out, by every possible means, the causes, however deeply hidden they may be, which contribute to the spread and fatality of this disease, and to devise means whereby it may be rendered less prevalent and fatal.

NATURE OF THE DISEASE.

Scarlet fever is a highly contagious and infectious disease of the zymotic class, and may be acquired through contact with the skin, through emanations from the lungs, from the excretions of the body, and through the exfoliations of the skin which are characteristic of this disease. Usually, in some part of its course, it is accompanied with a scarlet blush or rash, and is generally attended with sore throat, frequently mild, often very severe.

As a disease, it is in essence one, having one common nature and origin, wherever it occurs and whatever its type. Whether it be

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