Diagram Showing Deaths from Pulmonary Tuberculosis, by Ages, Year

600

Ending December, 1903.

400

400

800

The following table gives, for 1903, the deaths, the State, country and city rate by months of pulmonary tuberculosis, also the annual figures for the same points. Rates are per 100,000.

100

200

500

600

700

A study of the above table discloses the fact that the city rate is always higher than the country rate and always higher than the State rate a fact easy to account for, as consumption is a foul-air disease and the chances for pure outdoor air and sunshine are not so good in cities as in the country. If country people would learn to ventilate their bedrooms at night and their houses at all times, the country rate would diminish.

In 1903 pulmonary consumption destroyed 790 mothers and 425 fathers between the ages of 18 and 40-the prime of life. These left 2,515 orphans, and the question is, How many of these found their way into orphans' homes, and how many, being deprived of parental care and direction, found their way into the juvenile courts? Fourteen hundred and fifteen homes were broken up by consumption in 1903. The total annual cost to the people of Indiana to have this preventable disease is not less than $5,000,000.

SMALLPOX IN 1903.

RECORD BY MONTHS.

January. The number of cases reported in Indiana in January was 921, with 50 deaths, making it the worst month for smallpox since the disease entered the State. Compared with January of 1902 there is an increase in area of 80 per cent. an increase in cases of 98 per cent., and an increase in deaths of 900 per cent. Fifty-six counties were invaded, as follows: Adams, 16; Allen, 4; Blackford, 1; Carroll, 1; Cass, 38; Clark, 3; Clay, 1; Clinton, 1 case, 1 death; Daviess, 54; Dearborn, 6; Decatur, 1; Dekalb, 13; Delaware, 7; Dubois, 11; Elkhart, 8; Fayette, 11; Floyd, 1; Fulton, 5; Gibson, 11; Grant, 54; Hamilton, 5; Ian

cock, 4; Harrison, 3; Howard, 3 cases, 1 death; Jackson, 2; Jasper, 11; Jay, 15; Johnson, 1; Knox, 71; Kosciusko, 4; Lagrange, 16; Lake, 6; Lawrence, 10; Madison, 4; Marion, 268 cases, 34 deaths; Marshall, 4; Monroe, 75; Morgan, 6; Owen, 11 cases, 2 deaths; Pike, 9; Posey, 5; Pulaski, 2; Putnam, 7; Randolph, 22 cases, 7 deaths; Shelby, 9; Spencer, 7; Starke, 16; St. Joseph, 8; Tippecanoe, 2 cases, 1 death; Tipton, 6; Vanderburgh, 12 cases, 3 deaths; Vermillion, 48 cases, 1 death; Vigo, 25; Wabash, 15; Wayne, 2; Wells, 1.

It is of interest to note that of the thirty-four persons who died in January at Indianapolis, only three had ever been vaccinated. One of these was vaccinated in infancy, and the other two about fifteen years ago. One of the men who died had syphilis. This man died of hemorrhagic smallpox on the fourth day after the initial symptoms.

February. There were reported 889 cases of smallpox in fiftynine counties, with 50 deaths. As compared with the corresponding month last year this is an increase of 49 per cent. in number, in area of 19.5 per cent., and in deaths of 157 per cent. Compared with the preceding month, smallpox shows a decrease in cases of 3.5 per cent. The number of deaths are exactly the same for both months, and there is an increase in smallpox area of 5.3 per cent. The severe epidemic centers were Cass, Marion, Brown, Daviess, Fulton, Grant, Knox, Lawrence, Madison Martin, Monroe, Ripley, Vanderburgh and Vigo Counties. The distribution by counties in the month was as follows: Adams, 15; Benton, 2; Boone, 1; Brown, 50; Carroll, 1; Cass, 115 cases, 1 death; Clark, 11; Clay, 10; Clinton, 1; Daviess, 53; Dearborn, 7; Decatur, 13; Dekalb, 19; Delaware, 2; Dubois, 25; Elkhart, 2; Fayette, 2; Floyd, 1; Fulton, 38; Gibson, 4; Grant, 30; Hancock, 8; Howard, 10; Huntington, 1; Jackson, 1; Jasper, 1; Jefferson, 1; Johnson, 1; Knox, 21; Laporte, 2; Lawrence, 20; Madison, 27 cases, 2 deaths; Marion, 181 cases, 39 deaths; Marshall, 8; Martin, 40; Monroe, 69; Montgomery, 7; Morgan, 2; Noble, 2; Owen, 5; Parke, 2; Posey, 3; Pulaski, 8; Putnam, 2; Ripley, 20; Rush, 2; Shelby, 1; Spencer, 15 cases, 3 deaths; St. Joseph, 2; Sullivan, 5; Tippecanoe, 7; Tipton, 3; Vanderburgh, 22 cases, 1 death; Vermillion, 12; Vigo, 20; Warren, 6; Warrick, 5; Wayne, 3; White, 19.

At Indianapolis the greatest fatality is to be noted, where there were 39 deaths on account of smallpox, with 181 cases, making a death rate of 21.4 per cent. Vaccination in Marion County and in Cass County has been very general, and it is now believed that not less than 85 per cent. of the population has been vaccinated. It is now about time for the disease to disappear, and it certainly will do so on account of this general vaccination.

March. There were reported 873 cases of smallpox in fifty-four counties, with 28 deaths. In the corresponding month of last year there were 832 cases in eighteen counties, with 4 deaths. In the preceding month there were 889 cases in fifty-nine counties, with 50 deaths. The normal comparison is with the corresponding month of the preceding year, and this shows an increase of 4.9 per cent. in cases, 200 per cent. in area invaded, and 600 per cent. in deaths. The distribution of smallpox by counties in the month was as follows: Bartholomew, 1; Benton, 3; Boone, 2; Brown, 21; Carroll, 2; Cass, 66; Clark, 10; Clay, 2; Clinton, 3; Daviess, 27; Decatur, 22; Dekalb, 12; Delaware, 2; Elkhart, 4; Fayette, 1; Floyd, 4; Fountain, 5; Franklin, 5; Fulton, 7; Gibson, 2; Grant, 16; Hamilton, 22; Harrison, 2; Howard, 4; Huntington, 1; Jasper, 8; Jefferson, 3; Jennings, 1; Knox, 7; Kosciusko, 2; Lake, 4; Laporte, 38; Lawrence, 63; Madison, 62; Marion, 78; Martin, 30; Monroe, 24; Montgomery, 2; Morgan, 1; Noble, 6; Owen, 4; Pike, 1; Posey, 2; Pulaski, 13; Putnam, 3; Ripley, 28; Sullivan, 10; Tippecanoe, 54; Tipton, 1; Vanderburgh, 13; Vermillion, 16; Vigo, 93; Warren, 12; White, 29; Whitley,16.

At Indianapolis the greatest fatality is to be noted, where there were 19 deaths on account of smallpox, with 78 cases. Vaccination has not been pushed in the last month in this district—indeed, there is a marked falling off reported on every hand. There undoubtedly yet remain many unvaccinated people, who are a menace to the community. The sudden death of Senator Gibson with black smallpox is a matter of moment. The death was put down as "hemorrhage (thoracic)" on the death report. Senator Gibson had been feeling badly for several days, and on Wednesday morning, March 4th, on "account of severe grippe svmptoms," failed to get up. He was a very sick man from this time on. Sunday, the 8th of March, at about 10:30, he suddenly died. Dr. J. B. Bennett, of Cannelton, was the first to suspect smallpox was the cause

of death. His conclusion was reached from the appearance of the corpse, and because the two children, Oscar and Cora, who saw their father's corpse at Indianapolis, promptly came down with smallpox. Further confirmation was furnished in that Senator Newhouse, who had viewed the body with the children, was also promptly attacked. Furthermore, the report of the embalmer was confirmatory of the same conclusion. The question is now finally settled by Dr. Nelson Brayton, a well-known smallpox expert, who disinterred the body, with the help of Harry Elliott, a medical student, and made an examination. Dr. Brayton reports he is positive the death was caused by black smallpox. A brother of Senator Gibson, and two children, Oscar and Stella, have since died of smallpox at the Senator's home, and all of the family, save the mother, who was well vaccinated, were attacked. Only one person at the hotel where the death occurred contracted smallpox, and she was unvaccinated. The hotel, called the Circle Park, is conducted by a German, the force is almost wholly German, and as is well known, all Germans are always successfully vaccinated. This fully accounts for the failure to spread among the hotel people. The embalmer is entitled to much credit, for, on account of the eruptions upon the body, he did his work with extra care, and this most probably was the reason that smallpox was not contracted by some of those who viewed the corpse.

April. There were reported 590 cases of smallpox, with 21 deaths, in fifty-six counties. In March there were reported 873 cases, with 28 deaths, in fifty-four counties. In April last year there were reported 878 cases, with 6 deaths, in fifty-five counties. Comparing these two Aprils, which is the normal comparison, there is to be noted a decrease in cases of 14.8 per cent., an increase in deaths of 250 per cent., and an increase in area of 1.8 per cent. The cases and deaths occurred in the following counties: Allen, 4; Bartholomew, 4; Boone, 2, 1 death; Brown, 1; Carroll, 1; Cass, 69; Clark, 8; Clay, 12; Daviess, 27, 5 deaths; Decatur, 13; Dekalb, 10; Delaware, 3; Dubois, 4; Elkhart, 1; Fayette, 12; Floyd, 2; Franklin, 33, 4 deaths; Fulton, 11; Gibson, 1; Grant, 12; Greene. 3; Hamilton, 4; Harrison, 3; Howard, 2; Huntington, 1; Jackson, 3; Jefferson, 1; Jennings, 4; Johnson, 1; Knox, 10; Lake, 5: Laporte, 16; Lawrence, 15; Madison, 39; Marion, 17, 7 deaths; Martin, 20; Miami, 13; Monroe, 39;