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The report for the preceding quarter showed a marked decrease in the number of cases of smallpox and a decided increase in its mortality, as compared with the corresponding period in the year 1902. For this quarter a decrease in cases, but an increase in death rate, appears, as compared with the same period last year.

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By this comparison the decrease in cases was 68.9 per cent., the decrease in deaths 15 per cent., and the decrease in area invaded 46.9 per cent.; but it will be observed that while the cases and deaths were fewer in number, the rate of deaths per cases is greatly increased, the death rate being in the third quarter, 1902, one in 48.3 cases and in this quarter one in 17.7, or a death rate increase of 63.3 per cent.

TYPHOID FEVER.

The third quarter of every year shows an increase in typhoid fever over preceding quarters. This year, as compared with the corresponding quarter in the preceding year, a decrease is to be recorded. The following table shows the status for the third quarter of 1900, 1901, 1902 and 1903:

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It seems not unreasonable to believe that this steady decrease in this filth disease is due, at least in some degree, to the work of the State Board in sending preventive circulars to all of the afflicted families and in teaching prevention at farmers' institutes

and teachers' meetings. The decrease in typhoid in the three years since 1900 in the third quarter has been 22.3 per cent.

VISITS AND INSPECTIONS.

July 15th. I visited Laporte on account of telephone message from the health officer, who represented that several cases of mild smallpox existed, and he was unable to convince his board that it was smallpox. He argued that the time to prevent the disease was in the beginning, when the cases were mild and few, and desired greatly to have the aid of the State Board that he might secure the support of his board in any necessary work of disease prevention. Upon arrival at Laporte I visited four cases of eruptive disorder. One of them was certainly an eruption which was obscure in its character, but was not smallpox. This diagnosis agreed with that of the attending physician. The other cases were found to be mild smallpox. After seeing them I waited upon the Mayor and the Chairman of the Health Committee of the City Council. These gentlemen were very much inclined to make light of the situation, and it could be easily seen that they desired not to have smallpox in their midst, and it was this desire which led them to deny its existence. Finally they were convinced and promised the fullest support and aid to their health officer in enforcing the rules and laws for the suppression of disease.

July 16th. The day following my visit to Laporte I went to Plymouth and there had an experience almost identical with that at Laporte. It perhaps was a little more difficult to convince the authorities at Plymouth than it was at Laporte. Finally, however, proper conditions were secured and promises made that quarantine and vaccination would be enforced.

July 24th.-Carmel is a small town in the southern part of Hamilton County. I visited this place because Dr. Hershey, local health officer, desired very much to have the advice of the State Board in regard to a creamery and a slaughter house, both unsanitary institutions, existing in his town. He desired the visit more to secure support in what he already knew than for any other purpose. Arriving at Carmel, I met Dr. Hershey and we visited. the "unsanitary creamery." I found that Dr. Hershey had properly characterized this creamery as unsanitary. It was in a dilapi

dated dwelling house. It was frame, built flat upon the ground, and all the drainage from the creamery, such as rinsing of milk cans, churns, troughs and the like, simply went through the floor on to the ground beneath. At several places the boards which composed the foundation were torn away, and it was easy to see that beneath the house was an awful condition. The stenches which arose were very pronounced. Every condition existed which should not at a creamery. I learned that people in that neighborhood refused to purchase the butter and other products of the creamery because of the stench which surrounded the place, and I learned further that all of the products found a ready sale at Indianapolis. Dr. Hershey had already recommended the abolition of this nuisauce, and it simply remained for me to call upon the town authorities and confirm Dr. Hershey's condemnation and recommendations. It was promised that the place would be immediately abolished.

This being done, a visit was made to the village slaughter house. The man owning this institution fed the blood and other offal of the slaughtered animals to hogs. The sights and smells at this place were indescribable. Hogs could be seen in mud and filth which was reeking with maggots, eating animal offal. The owner of the place was called upon, and after some conversation and arguments he promised to cease feeding animal offal to hogs, and that lime and gravel would be hauled into the hog lot until the existing conditions were entirely abolished. It is of interest to note that the owner of this slaughter house confessed that he would not slaughter hogs fed upon animal offal, because he "did not believe that their flesh was fit for human food." When asked what he did with the hogs he said he sold them. It seems quite appropriate in this connection to say that the more I see of the preparation of animal food, the more I believe the same is hardly fit to eat.

From Carmel I rode to Nora, which is a little hamlet having a postoffice and a few houses. Here diphtheria had prevailed, which had been called tonsilitis. One death resulted, and because of the mistaken diagnosis the disease was spread to two other families. The situation was carefully reviewed with the people concerned, proper advice given and circulars left with them.

July 27th, Anderson.-On July 26th a telephone message was received stating that White River, below Anderson, was clogged with dead fish and that tons of them were in sight. On the 27th I

visited Anderson to inspect the conditions reported. Upon arrival I met Dr. Conrad, who took me to Moss Island dam, about two miles below the city. There I beheld a sight which was most extraordinary. Lodged against the dam was an immense body of dead fish, commencing to decay. It was guessed by bystanders that not less than five tons were in sight, but it was my judgment this figure is too high. Without doubt, however, three tons of fish were putrefying in the water. I made careful examination by walking along the dam, also at the sides of the stream, and with a long pole pushed the fish apart and discovered that they were almost entirely carp and suckers. No bass were found, although bystanders reported that some bass had appeared and were picked out by boys and men. The conditions were such as to demand immediate action, and so Dr. Conrad was urged to employ men to take the fish out of the stream and bury them. He finally succeeded in finding a man who owned a fertilizer factory near by. He promised to remove the fish the following day, and I have since learned that this was satisfactorily done. The fish were disposed of by the tanking process and they were all rendered into fertilizer. Mr. John Nipp, who owns the dam and the adjacent mill, said that dead fish first appeared Saturday evening, July 25th, and the water was markedly changed in its character. It had a slick feeling and an unusual sinell. He stated it was his positive opinion that strawboard refuse had been discharged into the stream in large quantities from the ponds of the strawboard company at Yorktown. Charles Stiffler, who lived near by, said the dead fish first appeared at Moss Island dam at 5 p. m. Saturday, July 25th. He said the water was greatly changed in color, the color being darker than usual. He made a vivid description of masses of struggling fish with noses projected above water, sucking the air. He said that at the mill the race was a rolling mass of life. Daniel Stewart, another nearby dweller, said Saturday, at 9 a. m., July 25th, he was about one mile east of Anderson, at Meyers' ford. He was engaged in cutting oats. There he saw bovs picking fish out of the water with their hands. All kinds of fish were to be seen-bass, catfish, carp and white suckers. He first noticed the fish were coming to the bank and the water was dark colored. He had seen these conditions once before, and knew the color was due to strawboard refuse; at least it was like the strawboard seen eight or nine

years ago. He estimated that ten tons of fish had passed the dam and lodged at the mill between Saturday, at 5 p. m., and Monday of the same hour.

From this inspection I went immediately to Yorktown by trolley car. There I carefully surveyed the refuse ponds of the strawboard mill. I could not find any cut in the banks and the sluiceway had a marked appearance of disuse. It was dusty, contained some boulders, and considerable earth had fallen in over the side. It had no appearance of recently having had water passing over it. The banks of the ponds had no marks upon them showing that the water had been lowered. In a word, all the appearances sustained the claim of the superintendent and the men at the mills, who said that "not a drop of liquor had run out of the ponds since last winter." From Yorktown I went to Muncie and called upon Dr. Spickerman and requested that he would, on the following day, make a thorough inspection of the strawboard ponds of the Consumers' Company, which are situated on White River, about one mile below the city. Dr. Spickerman, on the evening of the following day, made report by telephone that he was firmly convinced no strawboard refuse had been discharged into the river from the ponds he inspected since last winter. He reported there were no marks on the banks indicating that the water had been drawn off; there were no breaks in the banks, and further, the sluiceways had every appearance of disuse and neglect. Dr. Spickerman further reported that the manager and the men at the Consumers' strawboard plant all declared that "not a drop of liquor had passed into the stream." The evidence secured was all given to the Prosecutor of the district, who promised that he would look into the matter further, and if there was sufficient evidence he would bring the subject before the grand jury. The question as to what killed the fish can not be satisfactorily answered. The witnesses reviewed at Moss Island dam all were positive it was strawboard refuse, yet no one interviewed had seen the refuse in the stream. They all, however, testified that the water was darker than usual and had a smell. This might have been accounted for upon the supposition that the movement of the fish had stirred up the water and made it darker and also produced an odor. No one was found to swear that the water was of a yellow color, which would have been the case had quantities of strawboard refuse been discharged into it,

6-Bd. of Health.

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