We have no eruptive hospital. Our method of managing the disease was to carefully quarantine the patients at their homes, and after recovering to thoroughly fumigate and disinfect the premises.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $20. The estimated cost in loss of trade and interference with business has been nothing.

We had no difficulty in stamping out these outbreaks.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, fifty cases and thirty deaths; typhoid fever, 120 cases and nine deaths; diphtheria, seventeen cases and two deaths; scarlet fever, fourteen cases and one death; cholera infantum, fifteen cases and two deaths; dysentery, fifty-six cases and no deaths. The average cost to our people for managing and treating a case of any of these diseases, including medical attention, nursing, loss of time and incidental expenses, is estimated to be $30, making a total loss to the county for the two years from diseases which might be prevented of $8,160, as against $34,000 paid for State taxes. The county health officer is paid no salary, but an agreed fee for each service rendered.

The following additional facts will be of interest in connection with this report: There have also been three cases of cerebro-spinal meningitis in the county within the last year, all of whom died. The above report is approximate only, as I nave been unable to get all of our physicians to report their cases.

Very respectfully,

J. E. WILSON, M. D., Secretary.

Perry County Board of Health.

Hazard, Ky., August 31, 1905.

To the State Board of Health:

Since our last published report two years ago there has been one outbreak of smallpox in this county, in the town of Hazard, with a total of three cases and no deaths.

The first case came from Valley View, Ky., and two persons had been exposed to the disease before its character was recognized and reported so that we could take steps to bring it under control. Of those exposed, none had been properly vaccinated; of these, two contracted the disease and none died.

The population of this county is 8,276. At the time of our last report 250 had been vaccinated. Since that time it is estimated that

none have procured vaccination, leaving 972 per cent. still unprotected, after nearly eight years of smallpox almost constantly in some section of the State.

We have no eruptive hospital. Our method of managing the disease was to confine the patients in their house in the limits of town, which house was enclosed in strong paling fence, which had a strong gate which we securely locked, allowing no ingress or egress except the health officer, with the result that no further spread resulted.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $50. The estimated cost in loss of trade and interference with business has been $100.

The chief difficulties in stamping out the disease have been opposition to vaccination and opposition from one certain physician in inciting people's prejudices, and stating through his prejudices that vaccination was not a protection, and inducing them to not be vaccinated-that we could not enforce it.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, ten cases and four deaths; typhoid fever, twenty cases and two deaths; cholera infantum, twenty cases and four deaths; dysentery, five cases and one death. The average cost to our people for managing and treating a case of any of these diseases, including medical attention, nursing, loss of time and incidental expenses, is estimated to be $200, making a total loss to the county for the two years from diseases which might be prevented of $4,000. The county health officer is not paid a salary.

The following additional facts will be of interest in connection with this report: I am forced to state that your health officer had some differences with the present county attorney, in that he absolutely refused to deliver the key which secured said temporary smallpox premises to your health officer, stating that he would deliver same to that certain physician so prominently spoken of heretofore, but upon a challenge to do so, and upon the fearless assurance that he should suffer the severe penalties of the law, he took care not to do it, and with the staunch support of the county judge, be it said to his credit, the disease was as thoroughly in our grasp as though we had no opposition, and-mark the result-not a case of smallpox within the limits of the county.

Very respectfully,

E. KE LEY, M. D., Secretary.

Pike County Board of Health.

To the State Board of Health:

Pikeville, Ky., August 31, 1905.

Since our last published report two years ago there have been about three dozen outbreaks of smallpox in this county, in all parts

of the county, with a total of 175 cases and three deaths.

The first case came from Williamson, W. Va., and many persons had been exposed to the disease before its character was recognized and reported so that we could take steps to bring it under control. Of those exposed, a few had been properly vaccinated; of these, none contracted the disease. Of the many exposed who had not been vaccinated, most all took the disease and three died.

The population of this county is about 30,000. At the time of our last report 22,686 had not been vaccinated. Since that time it is estimated that 5 per cent. have procured vaccination, leaving 60 per cent. still unprotected, after nearly eight years of smallpox almost constantly in some section of the State.

We have an eruptive hospital, located 1% miles from Pikeville, with a capacity for twenty-four patients. Our method of managing the disease was: Placed some under strict guard; for some people who are responsible I did not have any guard, and got along equally as well.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $3,200. The estimated cost in loss of trade and interference with business has been practically nothing.

The chief difficulties in stamping out the disease have been backbiting, tale tellers, busy bodies, etc. We have had very little difficulty in the past year, and expenses will be only about 50 per cent. of previous years.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, twenty-three cases and nineteen deaths; typhoid fever, fifty-one cases and seven deaths; diphtheria, seven cases and one death; cholera infantum, fifteen cases and no deaths; dysentery, 200 cases and nine deaths. The average cost to our people for managing and treating a case of any of these diseases, including medical attention, nursing, loss of time and incidental expenses, is estimated to be $27.50, making a total loss to the county for the two years from diseases which might be prevented of $8,140, as against $34,000 paid for State taxes. The county health officer is paid a salary of $250, and all of the other members serve gratuitously.

Very respectfully,

W. J. WALTERS, M. D., Secretary.

Powell County Board of Health.

To the State Board of Health:

Stanton, Ky., August 31, 1905.

Since our last published report two year ago there has been no outbreak of smallpox in this county.

The estimated population of this county is 2,800 or 3,000. At the time of our last report 30 per cent. had been vaccinated. Since that time it is estimated that 50 per cent. have procured vaccination, leaving 20 per cent. still unprotected, after nearly eight years of smallpox almost constantly in some section of the State.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, sixty cases and fifteen deaths; typhoid fever, forty-eight cases and ten deaths; diphtheria, two cases and one death; scarlet fever, five cases and one death; cholera infantum, twelve cases and three deaths; dysentery, twenty-five cases and five deaths. The average cost to our people for managing and treating a case of any of these diseases, including medical attention, nursing, loss of time and incidental expenses, is estimated to be $65, making a total loss to the county for the two years from diseases which might be prevented of $7,775, as against $7,200 paid for State taxes. The county health officer is paid no salary. Very respectfully,

CASSIUS D. MANSFIELD, M. D., Secretary.

Pulaski County Board of Health.

Somerset, Ky., August 31, 1905.

To the State Board of Health:

We have not had any cases of smallpox for two years. Regarding the other preventable diseases, no records at all are kept, and there is no way of obtaining any idea of these diseases.

Very respectfully,

A. W. CAIN, M. D., Secretary.

Robertson County Board of Health.

To the State Board of Health:

Mt. Olivet, Ky., August 31, 1905.

Since our last published report two years ago there has been no outbreak of smallpox in this county.

The population of this county is 5,450. At the time of our last report 25 per cent. had been vaccinated. Since that time it is esti

mated that none have procured vaccination, leaving 75 per cent. still unprotected, after nearly eight years of smallpox almost constantly in some section of the State.

We have no eruptive hospital.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, twenty-five cases and ten deaths; typhoid fever, 285 cases and twenty deaths; cholera infantum, twenty cases and ten deaths; dysentery, 125 cases and eight deaths. The average cost to our people for managing and treating a case of any of these diseases, including medical attention, nursing, loss of time and incidental expenses, is estimated to be $25, making a total loss to the county for the two years from diseases which might be prevented of $11,375, as against $9,000 paid for State taxes.

There is no appropriation made by our fiscal court to remunerate the profession for any services rendered, hence there is but little interest manifested. When the people become sufficiently interested and educated, may we hope to arrest many outbreaks of various dis

eases.

J. B. WOOD, M. D., Secretary.

Rockcastle County Board of Health.

Mt. Vernon, Ky., August 31, 1905.

To the State Board of Health:

Since our last published report two years ago there have been two outbreaks of smallpox in this county, in the First and Second districts, with a total of forty-three cases and no deaths.

The first case came from Jellico, and many persons had been exposed to the disease before its character was recognized and reported so that we could take steps to bring it under control. Of the many exposed who had not been vaccinated, 30 per cent. took the disease and none died.

The population of this county is 8,000. At the time of our last. report 500 had been vaccinated. Since that time it is estimated that 200 have procured vaccination, leaving 87 per cent. still unprotected, after nearly eight years of smallpox almost constantly in some section of the State.

We have no eruptive hospital. Our method of managing the disease was to treat the patients in their own homes, all of whom aided us in every way possible in the enforcement of the law.

The total cost of managing the disease for the two years, including