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pains and penalties of law, forbids any person to enter or leave said place, or to approach near any railroad train or depot ground, or the reception or discharge at this place by any train of any passenger or employe, without a special permit from this board, and forbids any person afflicted with this disease to go upon or near any street, alley or other public road or way. This quarantine to be in force from this date until raised.

"By order of the board:

"J. M. MATHEWS, M. D., President.

"J. N. McCORMACK, M. D., Secretary.”

The authorities at once inaugurated proper measures for combating the disease and it was at once brought under control and the quarantine raised on May 3d following.

During the past two years the board is happy to state that owing to the larger experience of the local boards and the growing harmony between them and the fiscal courts, a much smaller number of cases of smallpox occurred. We note with special pleasure from the subjoined reports that the number of cases from each original focus is much smaller, indicating that diagnoses were made earlier and that local health authorities were much more prompt in vaccinating and re-vaccinating those exposed to the disease.

In nearly one-third of the counties our suggestion to put the county health officers upon an annual salary has been adopted with great satisfaction to all concerned. It has not only prevented misunderstandings about fees and greatly increased the efficiency of the county boards, but has greatly lessened the expenses of management as a consequence. In such counties upon the appearance of the first case the responsibility is upon the health office alone, as it should be, and having nobody to consult, and no occasion or excuse for delay, the disease can usually be confined to the first case or family, and at only a nominal expense. In other counties where different ideas have prevailed, the health officer was hindered and embarrassed for funds for meeting actual expenses for food, nurses and guards, and by the knowledge that he would have trouble in receiving compensation for his time and labor, and often so dreaded the contention and abuse incident and to follow the efficient discharge of his duties that they were avoided or neglected until the disease had gained a strong foothold, and an expensive and entirely avoidable epidemic had to be faced.

In this connection a summary of the facts contained in the reports from the county and municipal boards will be of interest. Within the two years there has been a total of 3,410 cases of smallpox and 96 deaths reported in the State as against 10,180 cases and 116 deaths in 1902-1903, and 11,279 cases and 184 deaths in 1900-1901. The total expense of management in the past two years was $80,939.69 or $23.73 per case, as against $308,271, or $27.30 per case in 1900-1901. Much interesting and valuable data is developed in the reports which are appended.

[graphic]

Figure 14-A common form, mild. From Jefferson County.

[graphic]

Figure 9.-The mildest form.

Very common and most dangerous to the public, as it might be easily overlooked or mistaken for something else.

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