has been $500. The estimated cost in loss of trade and interference with business has been $5,000.

The chief difficulty in stamping out the disease has been want of vaccination, notwithstanding I have warned them from time to time.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the year as follows: Consumption, thirty cases and twenty-five deaths; typhoid fever, thirty-five cases and fifteen deaths; diphtheria, forty cases and eight deaths; scarlet fever, fifty cases and ten deaths; cholera infantum, twenty cases and six deaths; dysentery, ten 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 $50, making a total loss to the county for the year from diseases which might be prevented of $20,000, as against $60,000 paid for county, and $50,000 for State taxes. The county health officer is paid a salary of $300, and all of the other members serve gratuitously.

The following additional facts will be of interest in connection with this report: I have been health officer for one year only, therefore this report only covers that period. I feel assured, however, by taking the proper precautions to prevent infectious and contagious diseases I have saved the county of Madison thousands of dollars this year.

Very respectfully,

J. W. HARRIS. M. D., Secretary.

Magoffin County Board of Health.

Salyersville, 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 Salyersville, with a total of five cases and no deaths.

The first case came from St. Louis, Mo., and twenty-five 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, twenty had been properly vaccinated; of these, none contracted the disease. Of the five exposed who had not been vaccinated, four took the disease and none died.

The population of this county is 15,000. At the time of our last report, 1,200 had been vaccinated. Since that time it is estimated that twenty-five have procured vaccination, leaving 90 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 quarantine each case in their own home and employ sufficient guards and nurses to stop ingress and egress, except those carrying food, medicines, etc., and all cases giving strict orders under the penalties of the quarantine law. The above cases were selfsupporting, as they paid their own doctor bills, nurses and guards; no cost to the county.

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 nothing.

The chief difficulty in stamping out the disease has been lack of co-operation from the public.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, twenty cases and eighteen deaths; typhoid fever, sixteen cases and six deaths; diphtheria, one case and one death; scarlet fever, one case and no death; cholera infantum, fifty cases and ten 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 $40, making a total loss to the county for the two years from diseases which might be prevented of $3,000, as against $9,013.82 paid for county, and $6,013.82 for State taxes for 1904, and $9,207.73 paid for county, and $6,207.73 for State taxes for the year 1905. The county health officer is paid no salary.

The following additional facts will be of interest in connection with this report: The undersigned has been secretary of the Board of Health for this county since 1894. In round numbers, during all that time he has received about $50 from the fiscal court for his services, to say nothing of the "bouquets" thrown at him in the form of "non-Sunday-school talk, brimstone," etc., from the quack "medicine men," midwives, ignorant and superstitious, every time this board has attempted to have the law enforced. Can't the Legislature make a more strenuous law for the protection of its citizens?

Very respectfully,

M. C. KASH, M. D., Secretary.

Marion County Board of Health.

Lebanon, 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 city of Lebanon, with a total of twenty cases and no deaths.

The first case came from Indiana, and twenty or more 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, no one, so far as I can determine, contracted the disease who had been properly vaccinated.

We have one eruptive hospital, located one and one-fourth miles from Lebanon, with a capacity for eight patients. Our method of managing the disease was isolation at home, and those who could not be isolated at home were moved to the hospital. The character of the disease was not discovered until possibly twelve had recovered without treatment. The first case was diagnosed chicken-pox, and was of such a mild character that those exposed paid very little attention to it, and when they did have the disease did not call a physician.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $300. The estimated cost in loss of trade and interference with business has been $500.

The chief difficulty in stamping out the disease has been mistake in diagnosis. As soon as its true nature was determined, we had no difficulty in stamping it out.

The county health officer is paid no salary.

The following additional fact will be of interest in connection with this report: Before the nature of the disease was discovered, one of the convalescent cases went to Springfield, and thus started the epidemic there.

Very respectfully,

R. C. MCCHORD, M. D., Secretary.

Marshall County Board of Health.

Benton, Ky., August 31, 1905.

To the State Board of Health:

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

The population of this county is 13,500. At the time of our last

report 3,700 had been vaccinated. Since that time it is estimated that none have procured vaccination, leaving 73 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, fifteen cases and seven deaths; typhoid fever, seventy-five cases and eight deaths; cholera infantum, three cases and one death; dysentery, 250 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 $50, making a total loss to the county for the two years from diseases which might be prevented of $19,000, as against $20,000 paid for county, and $20,000 for State taxes. The county health officer is paid no salary.

All of this is estimated. I referred this to the other members of the board and they think that it is substantially correct.

Very respectfully,

V. A. STILLEY, M. D., Secretary.

Martin County Board of Health.

Inez, 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 Second and Third precincts, with a total of fifteen cases and no deaths.

The first case came from West Virginia, and fifteen 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 fifteen exposed who had not been vaccinated, fifteen took the disease and none died.

The population of this county is 6,000. At the time of our last report, 1 per cent. had been vaccinated. Since that time it is estimated that none have procured vaccination, leaving 99 per cent. still unprotected, after nearly eight years of smallpox almost constantly in some section of the State.

We have no eruptive hospital.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine,