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Reader, will you not have yourself and every one for whom you are responsible vaccinated at three places on the arm to-day?

Copies of this circular for free distribution may be obtained by writing to the board at Bowling Green. By order of the board:

J. M. MATHEWS, M. D., President. J. N. McCORMACK, M. D., Secretary.

Those especially interested in health work in Kentucky will find much of interest in the history of the present epidemic which has been imported and re-imported into the State time after time since 1898. In its war against the disease, the board found that its author. ity to place in quarantine counties and towns whose authorities failed or refused to adopt proper precautions against the disease an indispensable weapon. This authority was exercised sparingly, but the knowledge that it would be used when necessary, when this was fully understood, had a most salutary effect on that large class of county officials, especially, who constantly hampered the work of their health officials by refusing timely appropriations necessary for feeding, housing and nursing the indigent sick, and using this pretense of economy as a vote-making device for popularity and re-election to the then held or some higher office. This authority was resorted to at Lebanon Junction after every other remedy had failed, as will be shown by the following:

Early in March, 1899, a railroad employe, whose run was between Lebanon Junction and Corbin, contracted smallpox, probably in Louisville, where it had existed for months, and came down with it at his father's home in Williamsburg, his father being an undergraduate physician, practicing under the time limit and examination clause of the medical law. The disease was not recognized as smallpox, and, as soon as he was able to travel, after communicating the disease to his family, he returned to his brother's at Lebanon Junction, covered with scabs, bringing the disease to them, as well as to several of his fellowemployes.

As has been the case throughout the epidemic, most of the cases were mild, patients being quite ill usually until the eruption appeared, and then in a few days feeling well enough to walk about, having little if any secondary fever, many of the cases not even sending for a phy. sician. Quite a number of cases occurred and the disease had been carried from this point to Horse Cave, Corbin and into Nelson county before this board received information that anything suspicious was there.

One of our most experienced inspectors was sent at once, but he was unable to induce either the town or the county authorities to take any interest in the matter, although he found a number of cases well marked, in the contagious stage, on the street and lounging about the depot platform. As Lebanon Junction is the end of the Knoxville Division of the L. & N. Railroad, where many of the employes get their lay-off, and as the principal boarding-houses were within 30 feet of the stopping place for many of the passenger trains, it is an important town from a smallpox standpoint. The executive officer went to the place in person, upon the failure of the inspector to interest the authorities or people, and he was equally unsuccessful, although he had learned in the meantime that the disease had already been carried from this point to Horse Cave, Corbin and into Nelson. He met one man on the street starting off with a fishing party, who was covered with scabs, and found that others had been going about in the same manner, and that a majority of the people and officials could not be induced to adopt any efficient measures either to stamp out the disease in the town or for the protection of the traveling public, which was more or less constantly exposed while trains stood at the depot for the transfer of passengers.

Believing that the conditions existing there so seriously endangered a large portion of the State as to demand immediate action, this officer took the first train for Louisville, calling a meeting by wire, and the following was at once issued:

“Proclamation by the State Board of Health.

"Bowling Green, Ky., April 17, 1899. "Whereas, It has come to the knowledge of this board that smallpox is epidemic at Lebanon Junction, Bullitt county, Kentucky, that practically all the inhabitants and railroad employes at that place have been exposed to said disease, and that very many of them are not only unprotected by vaccination, but appear not to appreciate the importance of this and the other recognized precautions to be used against this disease; and,

"Whereas, The conditions and railroad connections of this place are such as to endanger the health and business interests of a large portion of the State;

"Now, therefore, be it known, That the State Board of Health, in the exercise of the authority vested in it by law, hereby declares the town and suburbs of Lebanon Junction, and each of the inhabitants thereof, temporary and permanent, to be in quarantine, and, under the

Figure 10-A Case of moderate severity. Might have been contracted from a case like Figure 9.


Figure 4—A case from Robertson County. Mild.

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