Full text of "Annual report"

See other formats

This is a digital copy of a book that was preserved for generations on library shelves before it was carefully scanned by Google as part of a project
to make the world's books discoverable online.

It has survived long enough for the copyright to expire and the book to enter the public domain. A public domain book is one that was never subject
to copyright or whose legal copyright term has expired. Whether a book is in the public domain may vary country to country. Public domain books
are our gateways to the past, representing a wealth of history, culture and knowledge that's often difficult to discover.

Marks, notations and other marginalia present in the original volume will appear in this file - a reminder of this book's long journey from the
publisher to a library and finally to you.

Usage guidelines

Google is proud to partner with libraries to digitize public domain materials and make them widely accessible. Public domain books belong to the
public and we are merely their custodians. Nevertheless, this work is expensive, so in order to keep providing this resource, we have taken steps to
prevent abuse by commercial parties, including placing technical restrictions on automated querying.

We also ask that you:

+ Make non-commercial use of the files We designed Google Book Search for use by individuals, and we request that you use these files for
personal, non-commercial purposes.

+ Refrain from automated querying Do not send automated queries of any sort to Google's system: If you are conducting research on machine
translation, optical character recognition or other areas where access to a large amount of text is helpful, please contact us. We encourage the
use of public domain materials for these purposes and may be able to help.

+ Maintain attribution The Google "watermark" you see on each file is essential for informing people about this project and helping them find
additional materials through Google Book Search. Please do not remove it.

+ Keep it legal Whatever your use, remember that you are responsible for ensuring that what you are doing is legal. Do not assume that just
because we believe a book is in the public domain for users in the United States, that the work is also in the public domain for users in other
countries. Whether a book is still in copyright varies from country to country, and we can't offer guidance on whether any specific use of
any specific book is allowed. Please do not assume that a book's appearance in Google Book Search means it can be used in any manner
anywhere in the world. Copyright infringement liability can be quite severe.

About Google Book Search

Google's mission is to organize the world's information and to make it universally accessible and useful. Google Book Search helps readers
discover the world's books while helping authors and publishers reach new audiences. You can search through the full text of this book on the web

at|http : //books . google . com/

GENERAL LIBRARY of the
UNIVERSITY OF MICHIGAN

-PRESENTED BY-

n.^j. — oXv ^^J^^a

\mi. N'^t^^

Digitized by VjOOQIC

/.e-

Digitized by VjOOQIC

TWENTIETH ANNUAL REPORT

OP THE

STATE BOARD OF HEALTH

OF INDIANA

FOR THE

Fiscal Year Ending October 31, 1901, and the Statistical
Year Ending December 31, 1901.

TO THE GOVERNOR.

INDIANAPOLIS:

WM. B. BURFORD, CONTRACTOR FOR STATK PRINTING AND BINDING.
1908.

Google

Digitized by VnOOQ

STATE OF INDIANA,
Executive Depart ment,
IiiDLA.NAPOi.iB, December 10, 1902,

02. J

Received bj the Goveraor, examiaed and referred to the Auditor of State
for verification of the financial statement.

Office of Auditor of State, \

Indianapolis, December 10, 1902. j

The v^ithin report, so far as the same relates to moneys drawn from the State
Treasury, has been examined and foand correct.

W. H. HART,

Auditor of State.

December 10, 1902.
Returned^by the Auditor of State, with above certificate, and transmitted to
Secretary of State for publication; upon the order of the Board of Commissioners
of Public Printing and Binding.

CHA8. E. WILSON,

Private Secretary.

Filed in the office of the Secretary of State of the State of Indiana, December
10, 1902.

UNION B. HUNT,

Secretary of State.

Received the within report and delivered to the printer this 10th day of De-
cember 1902.

THOS. J. CARTER,

Clerk Printing Bureau.

<2)

Digitized by VjOOQIC

CONTENTS.

PAOB

Extract from Proceedings 6

Report of Special Meeting— 1901 15

Report of First Quarter— Minutes 16

Report of Second Quarter— Minutes 29

Report of Special Meeting 48

Report of Special Meeting 50

Report of Third Quarter— Minutes GO

Report of Fourth Quarter— Minutes 79

Reports of County Health Officers— 1901 239

Statistical Tables— 1901 125

Statistical Tables— 1902 608

Diagrams Showing Principal Causes of Death During Year 202

Conference of Indiana Health Officers 291

Report of Committee on State Medicine— 1901 222

Report on State Medicine— 1902 529

Report of First Quarter— 1902 405

Report of Special Meeting 421

Report of Second Quarter 431

Report of Special Meeting 443

Report of Special Meeting 445

Report of Third Quarter 446

Report of Fourth Quarter 513

Health Officers' Association 321

Digitized by VjOOQIC

MEMBERS OF THE BOARD-

J, H. FoRKEST, M. D., President Marion.

W. N. WiSHARD, M. D., Vice-President Indianapolis.

T. Henry Davis, M. D Richmond.

Clark Cook, M. D ; Fowler.

J. N. Hurty, M. D., Phar. D., Secretary Indianapolis.

(6^

Digitized by VjOOQIC

[Extract from Proceedings of the State Board of Health, in regular ses-
sion, October 10, 1902.]

Indianapolis, October 11, 1902.

The manuscript of the Annual Report for 1901 was reviewed
and discussed and finally approved and it was

Ordered, That the manuscript of the Twentieth Annual Report,
as amended and approved, be sent to the Printing Board.

J. X. ITURTY, Secretary.

(») Digitized by Google

REPORT OF STATE BOARD OF HEALTH.

Indianapolis, Ind., December 1, 1901.

Hox. W. T. DuRBix, Governor of Indiana:

The State Board of Health herewith respectfully submits its
Twentieth Annual Report. The fiscal report covers the twelve
months ending October 31, 1901, and the report of the transactions
of the Board, the detail account of the sanitary work done, and
the vital statistics of the State are for the calendar year 1901.

RfXJOMMENDATIONS.

The health hiw re(iuires the State Board of Health to make such
recommendations as may seoiii desirable in the line of health legis-
lation. In accordance with this command, we submit the following
suggestions. They are not new, all having been offered before,
and all of them have been proven wise economies in the experience
of other states and countries.

A STATE LABORATORY OF HYGIENE.

We recommend that a laboratory be established in the State
House at Indianapolis under the charge and direction of the
State Board of Health, to be called "The State Laboratory of
Hygiene." This laboratory would be used for making sanitary
analyses necessary in the work of tracing the cause and origin of
diseases, also for making examinations of diphtheria cultures, ex-
aminations of sputimi, blood, etc., for the purpose of settling diag-
noses, that cure and prevention may be promptly applied. A
third use of the laboratory would be to make analyses of foods
and drugs, which is the first step necessary in the enforcement of
the pure food and drug law. A laboratory devoted to the above

^'^ Digitized by Google

purpose should be located at Indianapolis under the charge of the
State Board of Health and be presided over by skilled men who
should give all of their time and energies to their work. All of
the states bounding Indiana have state laboratories, and like-
wise, almost all of the northern and a few of the southern states.
In this respect, therefore, Indiana is behind.

SANITARY SCHOOLHOUSES AND TEACHING HYGIENE IN THE
PUBLIC SCHOOLS.

We suggest a statute reqidring that all schoolhouses hereafter
built shall conform to natural sanitary laws; also that the act
should contain a clause requiring that hygiene be taught in the
public schools. Xot less than 10 per cent, of the school moneys
are now wasted on account of unsanitary schoolhouses. Massa-
chusetts, Michigan and other states have statutes of the character
we propose, and better health and progress among the school chil-
dren has thus been secured.

A STATE HOSPITAL FOR INDIGENT CONSUMPTIVES.

•

Massachusetts and Xew York have provided state hospitals for
consumptives, and Ohio, Maryland, Pennsylvania, Michigan and
other states are considering the matter. Both humanity and
economy demand such institutions in every state. At present,
fully 1,000 indigent consmnptives are being cared for at public
expense in Indiana, but in such a way as to spread the disease and
not restore to health a single patient. The proposition to estab-
lish a State Hospital for Indigent Consumptives is not one to
spend more money, but is clearly a measure to more wisely expend
the money now devoted to caring for these imf ortunates.

We believe that all of these recommendations are wise; and
would, if put into force by the State, save money to the people
and materially promote the public happiness.

Digitized by VjOOQIC

FIXAXCIAL STATEMENT.

RECEIPTS.
By appropriation $6,000 00

DISBURSEMENTS.

1900.

Nov. 28. Edward Smith, wrapping annual reports $5 00

Dec. 1. Maude Linn, clerical services 35 00

Dec. 1. , Maud Hoffman, clerical services 17 50

Dec. 1. Ona Grube, clerical services 35 00

Dec. 1. Eva D. Campbell, stenographer 35 00

Dec. 1. May Stuart, clerical services 35 00

Dec. 3. United Tyi)ewrlter Supply Co., typewriter 50 00

I>ec. 21. T. Henry Davis, expenses attending Board meeting 5 00

Dec. 21. J. H. Forrest, expenses, attending Board meeting 6 20

Dec. 21. E. D. Laughlin, expenses attending Board meeting 11 00

Dec. 21. Vincent Foster, postage stamps 25 00

Dec. 21. United States Express Company, expressage 1 tk)

Dec. 21. The Wooden Novelty Co., diphtheria outfits 16 39

Dec. 21. Wm. B. Burford, printing and stationery 581 51

Dec. 21. Wyckoff, Seamans & Benedict, repairing typewriter 35

Dec. 21. American Toilet Supply Co., laundry 2 25

Dec. 21. Jessie Boyd, clerical services : 16 00

Dec. 21. The New York Store, soap 90

Dec. 31. Maude Linn, clerical services 36 00

Dec. 31. Ona Grube, clerical services 35 00

Dec. 31. Maud Hoffman, clerical services 17 50

Dec. 31. Eva D. Campbell, stenographer 35 00

Dec. 31. May Stuart, clerical services 35 00

1901.

Jan. 18. May Loomls, clerical services 5 00

Feb. 1. May Stuart, clerical services 35 00

Feb. 1. Ona Grube, clerical services 35 00

Feb. 1. Maude Linn, clerical services 35 00

Feb. 1. Maud Hoffman, clerical services 17 50

Feb. 1. Eva D. Campbell, stenographer 35 00

Feb. 1. T. Henry Davis, expenses attending Board meeting 5 00

Feb. 1. E. D. Laughlin, expenses attending Board meeting 10 45

Feb. 1. Bowen-Merrlll Co., publication 2 85

Feb. 1. J. N. Hurty, Secretary, expenses 219 95

Feb. 1. The New York Store, soap 97

Feb. 1. Geo. F. McGinnis, stamps 50 00

Feb. 1. Western Union Telegraph Co., telegrams 10 15

Feb. 1. Central Union Telephone Co., rental and toll 31 20

Feb. 1. New Telephone Co., rental 10 00

Feb. 1. New Long Distance Telephone Co., tolls 4 50

Feb. 1. Art Metal Construction Co., special case 74 00

Feb. 1. United States Express Co., expressage 1 33

Digitized by VjOOQIC

DISBURSEMBNTS-Continued.
1901.
Feb. 1. Dr. J. A. Egan, dues, conference State and Provincial

Boards of Health $5 00

Feb. 1. P. Blakiston's Sons, publication 2 00

Feb. 1. Editor Sanitarian, subscription, five copies 20 00

Mar. 1. Eva D. Campbell, stenographer 40 00

Mar. 1. May Stuart, clerical services 40 00

At,ar. 1. Ona Grube, clerical services 35 00

Mar. 1. Maude Linn, clerical services 35 00

Mar. 1. Maud Hoflfman, clerical services 17 50

Mar. 13. Geo. F. McGinnis, stamps 50 00

Apr. 1. May Stuart, clerical services 40 00

Apr. 1. Eva D. Campbell, stenographer 40 00

Apr. 1. Maude Linn, clerical services 35 00

Apr. 1. Maud Hoffman, clerical services 17 50

Apr. 17. May Loomis, clerical services 20 00

Apr. 18. Wm. B. Burford, printing and stationery 808 58

Apr. 18. Bowen-MerrlU Co., publication 3 00

Apr. 18. Sander & Recker, desk anVi hall tree 16 00

Apr. 18. New Long Distance Telephone Co., tolls 3 65

Apr. 18. New Telephone Co., rental 10 00

Apr. 18. American Toilet Supply Co., laundry 2 25

Apr. 19. J. H. Forrest, attending Board meeting 14 10

Apr. 18. T. Henry Davis, attending Board meeting 15 00

Apr. 19. Western Union Telegraph Co., telegrams 7 99

Apr. 18. Joe A. Downy, postal guide 2 50

Apr. 18. Central Union Telephone Co., rental and toll 31 80

Apr. 18. Phil. Med. Pub. Co., publications 3 00

Apr. 18. Yawman & Erbe Mfg. Co., card cabinet and cards 95 00

Apr. 18. Baub; 'i & Lomb Optical Co., sub. journal 1 00

Apr. 18. H. K. Mulf ord & Co., culture media 5 97

Apr. 24. J. N. Hurty, Secretary, expenses 113 86

May 1. Maud Hoffman, clerical services 20 00

May 1. May Stuart, clerical services 40 00

May 1. Maude Linn, clerical services 40 00

May 1. Eva D. Campbell, stenographer 40 00

May 1. 'Marietta Thompson, clerical services 35 00

May 1. Geo. F. McGinnis, stamps 50 00

May 6. W. N. Wishard, attending Board meeting 10 00

May 6. T. Henry Davis, attending Board meeting 13 70

May 6. J. H. Forrest, attending Board meeting 14 95

May 6. Clark Cook, attending Board meeting 17 50

May 6. Bowen-Merrill Co., one desk 37 50

May 6. Bowen-Merrill Co., publications 6 25

May 18. Marietta Thompson, clerical services 22 50

May 28. T. Henry Davis, attending Board meeting 15 00

May 28. W. N. Wishard, attending Board meeting 10 00

May 28. J. H. Forrest, attending Board meeting 14 95

May 28. Clark Cook, attending Board meeting 18 00

June 1. Maude Linn, clerical services 40 00

Digitized by VjOOQIC

1.
1.
1.

1.
1.
1.
1.
1.
8.

1901.
Jnne 1.
June
June
June
June
July
July
July
July
July
July
July 12.
July 12.
July 12.
July 12.
July 12.
July 12.
July 12.
July 12.
July 12.
July 12.
July 12.
July 12.
July 12.
July 12.
July 12.
Aug. 1.
Aug.
Aug.
Aug.
Aug.
Aug.
Sept.
Sept.
Sept.
Sept
Sept.
Sept.
Oct.
Oct.

1.
11.
11.

Oct.
Oct.
Oct
Oct.
Oct 11.
Oct 11.
Oct 11.
Oct. 11.
Oct. 11.

DISBURSEMENTS— Continued.

May Stuart, clerical services $40 00

Dva D. Campbell, stenographer 40 00

Minnie Goeggel, clerical services 17 50

Maud Hoffman, clerical services 20 00

Geo. F. McGinnls, stamps 50 00

May Stuart, clerical services 40 00

Eva D, Campbell, stenographer 40 00

Minnie Goeggel, clerical services 40 00

Maud Hoffman, clerical services 20 00

Maude Linn, clerical services 40 00

Geo. F. McGinnls, stamps 50 00

Central Union Telephone Co., rental and tolls 35 20

Nev7 Yorl£ Store, soap 60

Western Union Telegraph Co., telegrams 6 84

American Toilet Supply Co., laundry 2 25

United States Express Co., expressage 71

New Telephone Co., rental '. 10 00

New Long Distance Telephone Co., tolls 4 60

Wm. B. Burford, printing and stationery 274 87

Bowen-Merrill Co., publications 4 00

J. H. Forrest, attending Board meeting 15 00

T. Henry Davis, attending Board meeting 15 00

W. N. Wishard, attending Board meeting 10 00

Clark Cool£, attending Board meeting 18 50

J. N. Hurty, Secretary, expenses 9 77

Mary Burlte East, reporting conference 25 00

Maude Linn, clerical services 40 00

Maud Hoffman, clerical services 20 00

Minnie Goeggel, clerical services 40 00

E)va D. Campbell, stenographer 40 00

May Stuart, clerical services 40 00

Geo. F. McGinnls, stamps 50 00

Minnie Goeggel, clerical services 40 00

Eiva D. Campbell, stenographer 40 00

Maude Linn, clerical services 40 00

Maud Hoffman, clerical services 20 00

May Stuart, clerical services 40 00

Geo. F. McGinnls, stamps 50 00

Maud Hoffman, clerical services 20 00

Maude Linn, clerical services 40 00

May Stuart, clerical services 40 00

Eva D. Campbell, stenographer 40 00

Central Union Telephone Co., rental and tolls 19 75

New I^ng Distance Telephone Co., tolls 45

New Telephone Co 10 00

American Med. Pub. Co., publications 4 00

H. Stems, soap 75

Cyrus A. Smith, culture tubes 2 50

United States Express Co., expressage 1 05

Digitized by VjOOQIC

DISBURSEMENTS— Continued.
1901.

Oct 11. Smith-Premier Typewriter Co., repairs on machine $0 75

Oct 11. American Toilet Supply Co., laundry 2 25

Oct 11. Badger Furniture Co., awning 4 00

Oct. 11. Wm. B. Burford, printing and stationery 229 18

Oct 11. Western Union Telegraph Co., telegrams 6 77

Oct 11. Jas. L. Anderson, chief clerk, expenses 2 85

Oct 11. J. N. Hurty, Secretary, ezpensee 21 85

Oct. 11. J. N. Hurty, Secretary, water analyses 30 00

Oct 11. J. N. Hurty, Secretary, expenses 106 24

Oct 11. Clark Cook, attending Board meeting 18 00

Oct 11. T. Henry Davis, attending Board meeting 15 00

Oct. 11. J. H. Forrest, attending Board meeting 14 85

Oct. 16. Geo. F. McGlnnis, stamps 50 00

Oct. 24. W. N. Wlshard. attending Board meeting, American

Pub. Health Association and expenses to Clay City . . 48 20

Oct 24. Claik Cook, attending Board meeting 18 50

Oct 24. J. H. Forrest, attending Board meeting 18 05

Oct. 24. T. Henry Davis, attending Board meeting 15 00

Oct 24. Smith-Premier Typewriter Co., typewriter 90 00

Oct 24. Sanbom-Marsh Electric Co., desk lamp 2 20

Oct 24. Sanbom-Marsh Electric Co., electric buzzer 4 78

Oct. 29. J. H. Forrest, attending Board meeting 17 00

Oct. 29. T. Henry Davis, attending Board meeting 14 00

Oct 29. Clark Cook, attending Board meeting 18 00

Oct. 29. W. N. Wlshard, attending Board meeting 10 00

Oct. 31. May Stuart clerical services 45 00

Oct 31. Maude Linn, clerical services 45 00

Oct 31. Eva D. Campbell, stenographer 46 00

Oct. 31. Maud Hoffman, clerical services 25 "00

Oct 31. J. N. Hurty, Secretary, expenses 18 15

Oct. 31. Balance reverted to general fund 39

Total $6,000 00

SUMMARY.

Total receipts for year $9,300 00

Secretary's salary for one year $2,400 00

Clerk's salary for one year 900 00

Office appropriation 6,000 00

Total $9,300 00

J. II. FOEREST,

President,
WM. N. WISHAED,

Vice-President,
CLARK COOK,
T. HENRY DAVIS,
J. N. HURTY, Secretary.

Digitized by VjOOQIC

MINUTES AND TRANSACTIONS

INDIANA STATE BOARD OF HEALTH

THE FISCAL YEAR ENDING SEPTEMBER 30, 1901.

Digitized by VjOOQIC

SPECIAL MEETING.

Office Indiana State Board of Health,

Indianapolis, Ind., December 21, 1901.

Called to consider what legislation the Board would suggest
to the Sixty-second Assembly, also to consider the charges against
Dr. W. H. Fuller, Health Officer of North Vernon, Ind.

Called to order at 3 p. m.

Present : Drs. Davis, Forrest, Laughlin, Wishard and Hurty.

President Davis in the chair.

The proposed bill establishing a laboratory was considered line
by line. The bill was then approved as a whole.

Ordered, A card case, two units, with cards, shall be pur-
chased, and that the death records shall be indexed by names.

Ordered, That the Secretary of the North Vernon Board of
Health, Dr. W. H. Fuller, be summoned to appear for trial at
the next regular meeting in January, 1901.

Adjourned.

(15)

Digitized by VjOOQIC

FIRST QAURTER.

November and December^ 1900, and January, i90t.

Office Indiana State Board of Health,
Indianapolis, Ind., December 21, 1901.

Regular quarterly meeting for quarter ending January 31,
1901.

Present: Drs. Laughlin, Wishard and Hurty.

Minutes of last meeting read and approved.

Minutes of special meeting held December 21, 1900, read and
approved.

REPORT OF SECRETARY FOR THE QUARTER.

The mortality statistics were collected, tabulated and analyzed
for each month, as appears in the Monthly Bulletin, which were
promptly printed each month for the quarter. The correspond-
ence increased over the preceding quarter. Xine visits were
made, as follows :

November 1. Crawfordsville, on account of Invitation from the local
Health Officer, Dr. J. N. Taylor, and the Town Council, to advise in re-
gSLvd to ]nunicipal management of slaughterhouses.

November 12. Danvillo, on account of inspection of school children,
as schools had been closed for two weeks because of diphtheria. A visit
was made at the request of the School Board.

November 26. Fowler, on account of request of County Health Officer,
to help inspect school, Jail and courthouse and give advice.

December 1. North Vernon, on account of invitation of County Super-
intendent, to address the County Teachers' Institute on "School Sani-
tation."

December 5. Columbus, Ind., on account of invitation of School Board
and local Health Officer, to inspect schoolhouses and make sanitary recom-
mendations, and to attend the monthly meeting of the Bartholomew
County Medical Society and read a paper upon "Typhoid Fever."

December 11. Richmond, on account of Invitation of local Health
Officer, Dr. T. Henry Davis, to make diagnosis in ease of suspected
smallpox.

(16)

Digitized by VjOOQIC

December 12. Greensburg, on account of invitation from School Board
to make tests of tiie ventilation and heating of the new schoolhouse.

December 18. Vincennes, on account of summons from grand jury to
give evidence in the case of the pollution of the Wabash River.

December 27. Michigan City, on account of appearance of eruptive
disease among the prisoners at the Indiana State Prison.

Herewith I give in detail what was accomplished by these visits.

CRAWFORDSVILLB.

November 1. Arriving at Crawfordsville, I found the Health
Officer ready to take me upon a tour of inspection of the slaughter-
houses of the city. We first visited the Keller slaughterhouse.
It was dilapidated, timbers were rotten and the ground upon
which it stood was filthy and sodden to a very great degree.
The drainage of the blood and oflFal was simply onto the open
ground adjoining the building. Water for washing the meat
was from a well situated in the slaughterhouse, from which the
local Health Officer told me dead rats could be taken at any time.
The odors around the slaughterhouse were very repulsive and re-
pellent. My advice was that such a slaughterhouse was a nuisance
and should be suppressed.

The next slaughterhouse visited was called the Wiel slaughter-
house. The building was badly dilapidated and vile odors were
perceptible every^vhere. The drainage was simply onto the sur-
face of the back yard. Entrails and other offal were strung
around promiscuously. The timbers of the building were saturated
with filth. The well was beneath the floor and was badly polluted
undoubtedly. It was my recommendation that the Weil slaugh-
terhouse be condemned as a nuisance.

Fink's slaughterhouse was next visited. It was found to be
dilapidated. Timbers were sodden with rottenness. Back yard
was loathsome. Water was taken from a dug well, which was
situated in the sodden and awful back yard.

Stout slaughterhouse. This was found to be a new house, with
cement floor ; water was supplied from a spring in the hillsida A
back yard adjoining the building received all the offal. Putridity
was everywhere discoverable in this hogyard. At all of these
slaughterhouses hogs were fed on putrid offal. Returning from
the inspection, I was called to meet a special session of the Council.

2-Bd. of Healtli.

Digitized by VjOOQIC

The above description was given to the Council of the various
slaughterhouses, and I recommended that they all be condemned
as nuisances, and that a special ordinance be passed, stating spe-
cifieallv how all meat which was sold in Cra\i^ordsville should be
slaughtered and cared for. I have since learned that the Council
has taken appropriate action and that no difficulty is being met
vnih in securing a proper sanitary meat supply.

DANVILLD.

November 12. Diphtheria broke out in the Danville public
schools the last week in October. Some fifteen cases were dis-
covered, all at first being taken for tonsilitis. Three deaths, how-
ever, called the attention of the people and physicians to the
situation. Cultures were made and it was shown that diphtheria
was the disease they had to deal with. The schools were dismissed.
On Xovember 9 the President of the School Board called at the
office of the State Board of Health and asked a visit from the State
Health Officer, to inspect the school children, who would be
called to school again on J^ovember 12. I arrived at Danville at
8:20, and was promptly at the schoolhouse, in the primary room,
at 8:45. Dr. Hoadley, County Health Officer, and Dr. Parker,
City Health Officer, met me and aided in the inspection of the
school children. Twenty-three children out of thirty-three regis-
tered in the primary room, appeared to attend school. The tem-
perature of each child was taken and a thorough examination made.
Of this number thirteen were sent home. Three were found to
have diphtheria, as was proven by direct microscopical examina-
tion of the throat exudate. The three were, of course, immediately
sent home with notes to their parents, telling of their condition
and directing what should be done. Afterward the local Health
Officer imposed quarantine. The ten other children were found
with from one to two degrees abnormal temperature and, may be
said to have severe colds. Being obviously unfit to remain at
school, they were sent home with kind notes to their parents, sug-
gesting that medical attention be given the children. I returned
on the afterno(m train, leaving instructions with the Health Offi-
cers, named above, to inspect all the other rooms, which they did
on the two following days. Dr. Hoadley reported by letter that a

Digitized by VjOOQIC

better condition was found among tlie older children, but three
were discovered who were ill, and who were, of course, sent home.
The President of the School Board said it should be his endeavor
hereafter to have medical inspection made of all school children
at various times.

FOWLER.

Xovember 26. Arriving at Fowler, Dr. J. S. Mavity, Health
Officer of Benton County, met me at the station. We immediately
went to inspect the jail. It is a stone and brick building, built
some eighteen years ago. It is unsanitary in every respect. The
ventilation is imperfect, the closets out of order, and the odors
issuing from the prisoners' department were very offensive. There
were four prisoners in the jail at the time. All of them seemed
quite well. One was insane, but not perceptibly ill. I joined Dr.
Mavity in recommending to the Commissioners that early action
be taken to relieve the unsanitary conditions found. We next
inspected the schoolhouse. It was built in 1894. It is constructed
of brick and stone and has ten rooms. It is supplied with Smead
dry closets and is heated by furnaces. Two of the rooms were
found to be unsanitary inasmuch as the ventilation was obviously
imperfect. Upon entrance to these rooms, a very perceptible odor
was distinguishable. The odor was that which is always found
where bad ventilation exists. The dry closets were perfect.

Benton County is distinguished by the fact that not a single
death occurred from typhoid fever within its borders during the
statistical year ending September 30. But one case of typhoid
fever was- known and the patient in that instance had been to
Chicago for a few days and within two weeks after his return was
taken down. In inspection of this, it was discovered that the in-
habitants of Benton County use nothing but driven or bored wells.
With Dr. Mavity, I walked the town over, trying to discover a dug
well, but such a thing could not be found. I think this is a splen-
did illustration of the advantages to be derived from driven wells
and is confirmatory of the well-known contention of sanitary sci-
ence, that typhoid is a water-borne disease.

Google

Digitized by VnOOQ

NORTH VERNON.

December 1. At North Vernon, I was met by Dr. Mitchell,
County Health Officer, and went immediately to the church where
the County Teachers' Institute was in session, as the object of my
visit was to address said institute upon "Schoolhouse Sanitation/'
In my address I endeavored to cover pretty thoroughly the whole
ground, for ample time was accorded for that purpose. What I
had to present was received with favor, for a special vote of thanks
was given me.

In the afternoon, together with three members of the School
Board, I visited the public school building. This is an old brick
building and not up to the sanitary standards of the present day.
The rooms are insufficiently lighted. The building is warmed by a
furnace and the ventilation is through ducts in the wall. The
heating and ventilating apparatus was supplied by a Cincinnati
firm. School was not in session and the furnace was not in opera-
tion, and I therefore could not determine as to the sufficiency of
the apparatus. I made verbal recommendations to the authorities
as to various improvements which might be made.

COLUMBUS.

December 5. Arriving at Columbus, I was met at the station
by Dr. Kirkpatrick, local Health Officer. We immediately started
upon a tour of inspection of the various schoolhouses.

Maple Grove Schoolhouse, six rooms, was new, built of brick
and stone, favorably located. It was warmed and ventilated by
modern, approved sanitary methods. The apparatus was supplied
by an Indianapolis firm. The only complaint that the teachers
made was that in very cold weather the rooms were not warm
enough, and it l>ecame necessary, imder sucTi circumstances, to
dismiss the school. An inspection resulted in facts which lead to
the opinion that the apparatus was not sufficiently large to do the
work demanded of it.

North Schoolhouse was a new building of six rooms. It was
intended to be sanitary in every respect, but evidently the ven-
tilating apparatus does not work, for the odor which is perceptible
in badly ventilated rooms was plainly apparent in every room
which was visited.

Digitized by VjOOQIC

North Schoolhouse was an old building of eight rooms. Base-
ment had been constructed underneath part of the building very
lately and the furnace put in. The furnace very thoroughly
warmed the building with fresh, warm air, but the rooms were
unsupplied with ventilating ducts.

South Schoolhouse. This building was ventilated by windows
and doors and heated by common stoves. It was unsanitary for
this reason.

Central School Building. This is a very old building and was
warmed by stoves and ventilated by windows and doors.

High School Building. This was a comparatively new structure,
^ warmed and ventilated by furnaces and ventilating ducts. The
apparatus was working well in all of the rooms. The only criti-
cism to be made was that this building was overcrowded, the regu-
lation amount of space not being accorded to each student. Ap-
propriate written recommendations were made upon the spot con-
cerning the situation, and addressed to the local School Com-
missioners.

RICHMOND.

December 11. Upon telephone from Dr. T. Henry Davis, Sec-
retary of the Richmond City Board of Health, I went to Rich-
mond to investigate a case of eruptive disease which was supposed
to be smallpox. Arriving at the station, I was met by Dr. Davis
and immediately taken in his carriage to the house which contained
the patient. Very brief examination disclosed that said patient
was not suffering from smallpox. The quarantine was therefore
raised.

GRBBNSBURG.

December 12. Upon invitation from the School Board and the
principal of the schools at Greensburg, I visited the town, taking
along our anemometer, also the polymeter, and an apparatus for
testing the purity of the air. These three instruments were left
vnth the Superintendent, after instruction in how to use them.
There were few of the rooms in this new schoolhouse which were
found to be properly ventilated. Humidity also was not correct.
No report has as yet been received from the Superintendent of
Schools as to his final results.

^ Digitized by VjOOQIC

VINCENNBS.

December 18. Some months ago, as appeared in my reports to
this Board, I was called to Vincennes by the County Health OflS-
cer and the city authorities to consult in regard to the pollution
of the Wabash Kiver, by a large distillery, situated just above the
waterworks, which supplied the city with water. At that time,
report was made that the distillery was polluting the stream very
materially, which undoubtedly had considerable effect upon the
health of the citizens. Complaint of the situation was made to the
grand jury and it was upon summons of the grand jury of Knox
County that I visited Vincennes. My testimony was given before
the grand jury, but I have had no report or information concerning*
what action was taken.

MICHIGAN CITY.

December 27. On account of the appearance of a suspicious
eruptive disease in two inmates of the Indiana Prison at Michigan
City, I left Indianapolis to visit the prison on December 27. At-
riving in Chicago on December 28, after becoming chilled in the
sleeping car, I was taken sick and compelled to go to the hotel and
go to bed. I suffered severely during the day and passed a very
miserable night. On Saturday morning, December 29, physicians
were summoned and my trouble was diagnosed as appendicitis.
Dr. Arthur Reynolds, Health Commissioner of Chicago, showed
me every attention, and Dr. Herman Spalding, attached to the
Health Department of Chicago, had me taken to St. Luke's Hos-
pital. There I was very ill for a period of seven days, finally re-
covering sufficiently to return home, where I was confined to my
bed for two weeks more. The trip, therefore, to Michigan City
was abandoned and nothing was accomplished.

The following circular was sent to all County Health Officers at
the beginning of the new statistical year:

October 9, 1900.

Dear Doctor— The new health law of 1899 has been in force now for a
year. The second year commenced October 1. The work of the first year
has been well done, but of course, we must all strive to do better. The
salaries of County Health Officers were increased and fixed by the last
Legislature, under the promise that the county officers would do more and
better health work. You are the superior Health Officer in your county.

Digitized by VjOOQIC

and it is your duty to see to it that the health law and the rules of the
State Board of Health are enforced thoroughly and completely in your
county. Your subordinates should be visited at least twice a year, their
books inspected, and inquiries and inspections made. In "a word, you
are to be diligent in the health cause, instructing the people in hygiene
and protecting them according to the law, against epidemics and unneces-
sary diseases.

Mortality statistics are now well reported, but we are not getting quite
all of the deaths, and they must b€» secured. To* this end, you ar^ to visit
your subordinates as frequently as you conveniently can, watch the news-
papers for deaths and see to it that they are reported by making inquiries.
Do the same, also, in regard to births and disease statistics, the diseases
being enumerated in Rule 1. Our birth and disease statistics must be im-
proved. It is your duty to see that this is done in your county. Our
Monthly Bulletin has touched upon this several times, and forms of affi-
davits have been given for making complaints against offenders. Respect
is always accorded officers who fearlessly and impartially execute the law,
and disrespect is accorded those who do not.

The trimming, hesitating officer, he who does not inform himself of
his duties and then honestly perform them, is, of course, a deficient. Do
not fall this year, commencing October 1, to make quarterly report to
your County Board of Health of all work done, and transmit a copy to
the State Board. Be sure also to arouse an Interest in the members of
your Board in public health affairs. Public health is public wealth. To
let preventable diseases go unprevented, is for the Board to fail to obey
the State law, to fail in a common, christian duty; to fail in promoting the
public happiness and welfare. Not a few doctors need to have their atten-
tion drawn to the duties they owe to the State and their neighbors. Health
work must obviously be. done with tact, and the first step is to inform
yourself fully in regard to the law and the rules. Every officer should own
a good work on hygiene and study it well. The law says that "all officers
shall inform themselves in hygiene according to the requirements of the
State Board of Health." No requirements have yet been formulated, but
will be ere long. Rohe's Hygiene is a good work upon the subject. Be
sure to read and file the Monthly Bulletin.

This Is a circular letter sent to every County Health Officer in the State

and we are sure that it will be received in the spirit in which it is sent.

Very truly yours.

Secretary.

By order of the State Board of Health.

A NUISANCE AT COLUMBUS.

On account of the rather extra extraordinary circumstances, I
make this report of a slaughterhouse nuisance at Columbus, Ind.
In East Columbus, a suburb or part of Columbus, Bartholomew
County, are two slaughterhouses, one owned by Wolf Brothers, and
the other by John Dahns. Both of these slaughterhouses must be
foul and very unsanitary and also conducted in an unsanitary way,

Digitized by VjOOQIC

for citizens in the neighborhood made strong petitions, requesting
the health authorities to abate them. These petitions complained
of foul and offensive odors and of repulsive sights. The petitioners
were advised to appeal to Dr. J. S. Arwine, Health Officer of
Bartholomew County, in the matter. It seems they understood
that Dr. Arwine had full power to abate nuisances, and on account
of the failure of the Board of Health to act upon the report and
recommendations of Dr. Arwine, the petitioners considered Dr.
Arwine to blame and made a second petition to the County Board
of Health, requesting that the salary of their Secretary be with-
held for that quarter on account of inefficiency. This petition, a
copy of which is appended, was referred by the County Board of
Health of Bartholomew County to the State Board of Health.
The letter was formal and was issued by the Auditor. Said letter is
also appended hereto. As Secretary of the State Board of Health,
I returned the petition with the following letter addressed to the
Auditor:

November 10, 1900.
Hon. Samuel W. Fitch. Auditor Bartholomew County, Columbus, Ind.:

Dear Sir— The State Board of Health has submitted the document sub-
mitted to it by the honorable Board of Health of Bartholomew County,
and I have full directions for reply.

County Health Officers derive their power entirely from the State
Board of Health and from their own County Board of Health, The State
Board of Health issues rules, a copy of which is enclosed, which direct
all Health Officers in the worl£ of disease prevention. It is left for local
Boards of Health to issue such rules as local conditions may demand. In
the matter of any nuisance occurring in Bartholomew County, it is the
duty of the County Health Officer to make full report concerning the same,
with recommendations to his Board of Health. Said Board, under the law,
should then take such action as in its judgment seems proper. Dr. Arwine
has not the power to abolish a nuisance, but the County Board of Health
of Bartholomew County has almost absolute power so to do. If, therefore,
Dr. Arwine made his report to the County Board of Health with recom-
mendations, either verbal or written, he Is relieved of all further responsi-
bility, except the execution of any orders which his Board might issue. We
hope the Bartholomew County Board of Health will find it possible to
take proper action in suppressing the nuisance complained of at an early
date. The State Board of Health can not, with the meager evidence at
hand, offer an opinion in regard to the faithfulness or unfaithfulae^s of
Dr. Arwine.

Very truly yours,

Secretary.

Digitized by VjOOQIC

state of Iiidiiina, Bartholomew County, ss.:

In Commissioners* Court, November Term, 1900.

In the matter of complaint of slaughter nuisance in Eiast Columbus.

Come now D. Ogden and others and file and present petition to the
Board to abate nuisance of slaughtei'house in Kast Columbus, which peti-
tion is in words as follows, to wit:

And the Board, after a careful examination of said petition, and being
sufficiently advised in the matter, order that said petition be sent to the
Secretary of the State Board of Health for proper action, and the Auditor
is hereby dfrected to transmit to said Secretary a certified copy of this
order.

I, Samuel W. Fitch, Auditor within and for said county and State,
do hereby certify that the foregoing is a true and complete transcript
of the proceedings of the Board of Commissioners of said county in said
matter, as appears of record in my office.

In testimony whereof I herewith subscribe my name and affix the
seal of the Board of Commissioners, at the city of Columbus,
this 7th day of November, 1900.

SAMUEL W. FITCH,
Auditor of Bartholomew County.

Columbus. Ind., October 4, 1900.

State of Indiana:

In Commissioners' Court, October term.

In the matter of the quarterly allowance of Dr. .T. S. Arwlne, for services
as Secretary of Bartholomew County Board of Health.

We, the undersigned citizens and taxpayers of said county, hereby
protest against the allowance to be made to the said Secretary of the
County Board of Health for the following reasons, for gi-ossly neglecting
his duties as such officer in the following instances, to wit:

For some months past there has been existing in East Columbus a
slaughterhouse nuisance from AVolf Brothers' and John Dahns' slaughter-
houses. The smell has been so bad from these places, especially at night
when the wind was from the northwest, that we were unable to sleep, and
sickness has been caused by failure on his part to abate same.

On September 10. Dr. J. S. Arwine, Secretary of the County Board of
Health, was notified, in writing, of the existing nuisance and asked to
have same abated at once in order to preserve the health of the citizens
of Bast Columbus. There has been no relief and the nuisance still exists,
and no effort on his part has been made to abate the same. We are still
suffering from the effects of the slaughterhouse nuisance without relief
and no promise of any.

At this date the smell is so great from these slaughterpens that we are
unable to sleep at night, and sickness is on the increase, caused, we be-
lieve, solely from the smell from these disease-breeding slaughterhouses.

Signed: D. Ogden; J. H. Cook; D. W. McCliire; Amos Dark; John A.
Waggen; .T. O. Wagner; R. Elzea; Samuel Gooden; John B. Camp-

/ Google

Digitized by VnOOQ I

bell; John J. Tiiell; M. J. Swartwood; D. D. Swartwood; Eli Laz-
zell; Marlon Disney; Arthur Monroe; Walker Tusser; Scott Har-
rison: John Gibley; Albert Rush; A. M. Moreton; Ed. Graffa; L.
F. Brooks; George Bearnhart; Jas. Hendricks; Henry Graffa;
Henry A. Hulse; A. H. Wilson; Josh Nail; Leonard Lay.

And the Board, after a careful examination of said petition,
and being sufficiently advised in the matter, order that said peti-
tion be sent to the Secretary of the State Board of Health for
proper action, and the Auditor is hereby directed to transmit to
said Secretary a certified copy of this order.

I, Samuel W. Fitch, Auditor within and for said County and State,
do hereby certify that the foregoing is a true and complete transcript of
the proceedings of the Board of Commissioners of said county in said
matter as appears of record in my office.

In testimony whereof, I hereunto subscribe my name and affix the
seal of the Board of Commissioners at the City of Columbus,
this 7th day of November, 1900.

SAMUEL W. PITCH.
Auditor Bartholomew County.

REPORT OF NUISANCE AT CKOTIIERSVILLE.

Tlic »T., M. & I. Railroad maintains a stock pen in the very
center of the town of ( 'rothersville, Jackson County. This stock
pen has been an offense to the people of Crothersville for a long
time and many efforts have been made to have it removed. At
last an ai)peal was made to the State Board of Health, the petition
being signed by 120 residents. The following is the text of the
petition:

Crothersville, Ind., August 20, 1900.
To the Honorable Indiana State Board of Health of Indianapolis:

We, the undersigned, residents of said town, hereby petition your
honorable body to abate and remove a nuisance which exists within said
town, described as follows, to wit: A stock pen located on the west
side of the P., C. C. & St. L. R. R. switch, northwest of the railroad
depot, within said town and maintained by said railroad company.

That the same is offensive, physically, to the senses, and thereby
makes life uncomfortable to the people residing in its locality and also
to passersl)y by its stench, unsightliness, and also is noisome, and that
the same is dangerous to the public health.

Signed by 120 Residents of Said Town.

Fpon receipt of this petition the petitioners^ were recommended
to api)eal to their own Board of Health, which had ample powers

Digitized by VjOOQIC

in the premises. The appeal was accordingly made and the fol-
lowing order was passed under the advice of the attorney of the
Town Board:

State of Indiana, Jackson County, ss.:

Office of the Board of Health of the Town of Crothersvllle, Ind.,

October 10, 1900.

To the Pittsburg, Cincinnati, Chicago & St. Louis Railway Co.:

You are hereby notified that on the tenth (10th) day of October, A.
D. 1900, the Board of Health of said town adopted the following resolu-
tion:

Resolved, That in the opinion of the Board of Health of the town
of Crothersville there exists upon the following premises (the parcel of
land lying immediately west of the P., C, C. & St. L. Ry. switch in the
town of Crothersville, northwest of the P., C, C. & St. L. depot), a public
nuisance, dangerous to life and health, consisting of a stock pen used
for the purpose of loading cars for shipment, and within said pen and
around the same there exists continually filthy and unhealthful deposits
by the stock confined within said pen, and the agent, owner, occupant or
tenant of said premises is hereby ordered to abate the same on or before
the first (1st) day of December, A, D. 1900, by removing the said stock pen,
together with the filthy deposits in and about the same, outside of the
corporate limits of the town of Crothersville, or the same will be done
at the expense of the corporation and the costs and expenses thereof
assessed upon said property and the penalties prescribed by law for the
disobedience of this order. will be enforced and the clerk of this Board is
hereby directed to serve a copy of this resolution upon the agent, owner,
occupant or tenant of said premises.

You will comply with said resolution within the time therein speci-
fied or be subjected to the penalties of the law.

By Order of the Board of Health of the Town of Crothersville, Ind.

CHARLES W. WARD,
Clerk.

I hereby certify that the above is a true copy of the resolution passed
by the Town Board of this town on the 10th day of October, A, D. 1900.

CHARLES B. WARD,
Town Clerk of the Town of Crothersville.

There is a clause in the said law to the effect that subordinate
Boards of Health shall abate nuisances according to the approval
or commands of the State Board of Health.

The attorney, Alfred Cox, of Crothersville, thought it best to
secure the approval of the Board and then serve notices under the
order, upon the railroad company. This action is deemed worthy
of special report by the -Secretary because the State Board has

Digitized by VjOOQIC

for several years been trying to arouse the citizens of Crothersville
to abate the many unsanitary conditions which exist in that town.
It is most proper, therefore, to commend this forward step.

TYPHUS FEVER.

Dr. R. S. Wilson, of Scott, Ohio, in a professional visit at
Berne, Indiana, reported two deaths from typhus fever. This was
considered of enough importance for special inquiry. Accord-
ingly, Dr. Costello, Health Officer of Adams County, was written
to on the subject, and directed to investigate. Dr. Costello re-
ported:

"Dr. Schenk, Health Oflacer of Berne, says: *Dr. Calderwood, of
Ohio, first treated the Smithlej children, and diagnosed their disease
dysentery. Dr. Wilson was called just in time to give death certificate.
I am satisfied there has been no typhus fever in this neighborhood.' "

Ordered, That the Secretary notify Dr. Fuller, of North Ver-
non, to appear before the next regular meeting for trial under the
charges heretofore made and recorded. Dr. Fuller to be in-
formed that failure to appear will be considered cause for removal.
Those making charges shall also be informed.

Digitized by VjOOQIC

SECOND QUARTER.

February, March and April, 1901*

Office Indiana State Board of Health, '

Indianapolis, Ind., April 19, 1901.

Present: Drs. Davis, Forrest, Hurty.

President Davis called the Board to order, and ruled that it pro-
ceed immediately to organize and elect President and Vice-Presi-
dent.

President Davis nominated Dr. Forrest to serve as President
from March 1, 1901, for two years. Seconded by Dr. Hurty.
Motion carried unanimously.

Dr. Forrest nominated Dr. Wishard for Vice-President.

President Forrest then took the chair.

Minutes of the last meeting read and approved.

Moved by Dr. Davis that the order issued at last meeting re-
garding Dr. Fuller, of North Vernon, be suspended. Seconded
by Dr. Hurty. Carried.

Secretary's report for the quarter was read, accepted and or-
dered spread of record.

SECRETARY'S REPORT FOR QUARTER ENDING
APRIL 1, 1901.

The second year for the collection of vital statistics commenced
with January. The various tables of statistics for publication in
the annual report are not yet ready to send to the printer, but will
be in a few weeks. Said tables are eleven in number :

No. 1. Deaths by months, counties and sex.

No. 2. Deaths by ages, counties and sex.

No. 3. Deaths statistically classified from all causes, with rates per
100,000.

No. 4. Deaths by counties, geographical sections.

<*^ - ,Goo5le

Digitized by VnOOQ I

No.

10.

No.

11.

Deaths from important causes.

Deaths from important ages.

Deaths by grouped classifications.

Deaths by months and ages.

Deaths by counties for all causes, and sex.

Births.

Marriages.

During. the quarter the following analytical and microscopical
examinations were made at the Secretary's expense:

Diphtheria, 5; 3 positive, 2 negative.
Sputum, 12; 1 positive, 2 negative.
Waters, 12; 3 good, 9 bad.
Vinegar, 1; 1 bad.

Four visits were made by the Secretary during the quarter :

March 7. Winchester— Account smallpox.

March 19. Lynn— Account schoolhouse.

March 27. Terre Haute— Account normal school.

March 29. Aurora and Rising Sun— Account smallpox.

Full report of three visits, together with report of a typhoid
epidemic at Irvington and a report of smallpox at East Chicago,
are given herewith.

WINCHESTER.
March 7 —

I visited Winchester for the purpose of settling diagnosis of an
eruptive disease sup]X)sed to be smallpox. Upon arrival the house
was visited and the patient was found to be suffering from a case
of eczema.

LYNN.
March 19--

I visited the town of Lynn, Randolph Countv, at the invitation
of Dr. Cox, Health Officer. He had been instructed by the Town
Board to invite the inspection by the State Board of Health of
their schoolhouse. Said schooUiouse was found to be an old
and dilapidated two-story brick structure. It had four rooms and
no basement. Foundation was of stone and the site fair. The
steps for gaining access to the second story were steep and wind-
ing; ventilated by windows and doors; heated by stoves; slate
blackboards in all rooms.

Digitized by VjOOQIC

High-School Room. The room was 31x21x12 feet, and con-
tained 25 students. This leaves ample space. The attendance
was 95 per cent, of the enrollment, but the teacher said that
coughs, colds, sore throat and headaches were complained of all
the time. The room was lighted from two sides.

Grammar Room. This room was 40x28x12 feet and had 52
enrolled sudents. Average attendance was 45. The seats were
only passable, some of them being old. Teachers said the children
complained of coughs, colds, headaches and eyeaches. Windows
on three sides.

Intermediate Room. This room was 46x28x12 feet. The en-
rollment was 55 ; average attendance, 95 per cent. Seats not
modern. Windows on three sides. Teacher reported that coughs,
colds, headaches, eyeaches, and sleepiness were complained of.
Xo diphtheria or scarlet fever during the year.

Primary Room. This room was 31x21x12 feet with an enroll-
ment of 64. xYverage attendance, 90 per cent. Floor in bad
repair. Teacher reported the students had coughs, colds, eyeaches
and headaches. Seats were modern and light entered from two
Sides. Xo contagious diseases during the year. The outhouses
were passable ; paths leading to the same were quite good. Water
is supplied to the students by placing a bucketful on a box in the
hall, and was supplied by two or three tin cups. The following
letter was written by Dr. Cox, after his return:

Dr. C. E. Ck)x, Health Officer, Lynn, Ind.:

Dear Doctor— As State Health Officer I wish to make some recom-
mendations in regard to your schoolhouse. Please present these recom-
• mendations to your School Trustees, and. if practicable, make them known
to the citizens of Lynn. My object in this matter is to better the condi-
tion, if possible, that the children of Lynn may have a sanitary en-
vironment and will thus be aided in their health and also in their book
progress.

First, permit me to present a detailed account of the exact condition
of the present schoolhouse. It is a two-story brick, four rooms, no base-
ment, stone foundation, walls are cracked and the building is probably
dangerous. The building site is fair. There are steep winding stairs to
the second story. These steep stairs are undoubtedly a cause of injury
to a percentage of the children. Stairs should be broad and easy to
ascend, and there should be a landing half way up. Your schoolhouse is
ventilated by windows and doors, is heated by stoves and the rooms are
lighted generally from three sides. All of this is wrong. It has been
absolutely proven that it is Impossible to ventilate schoolrooms properly

Digitized by VjOOQIC

by windows and doors without draughts. As draughts are injurious, and
as children must have pure air and plenty of it in order to be surrounded
by the best conditions of health, it is plain that this method of ventila-
tion is insufficient and all wrong.

The rooms are heated by stoves. This is a great mistake, for it is
impossible to evenly warm schoolrooms with stoves. In this instance
your stoves are supplied with natural ga«, and there is no disturbance
due to firing "in the room. Ordinarily, however, this disturbance is a
factor of considerable moment. You, of course, are aware that the chil-
dren whor sit near the stoves are sure to be rendered uncomfortable by
the excessive heat. The pores are open, perspiration is induced, the
child becomes restless and uncomfortable and for these reasons can not
study and progress as it should. In addition, on account of open pores,
and undue perspiration, the child is most liable to congestion when it
goes out of doors. The children removed from the stoves are, of course,
frequently chilled, their feet cold and their pores are tightly closed. They,
too, suffer and these conditions prevent them from studying and pro-
gressing as they should. An unevenly warmed room, therefore, produces
discomfort and sometimes brings illness, and these conditions prevent
progress. This simply means a waste of school money. It is not wise
and economical to surround our children with conditions productive of
discomfort and illness and which prevent application to boolis and to the
work in hand.

I note that the high school attendance is about 95 per cent. That is
to say, that 5 per cent, of the pupils are perpetually absent on account of
minor illness, such as coughs, colds, catarrh, sore throat, headaches, eye-
aches, etc. The average attendance of the grammar room is 90 per cent.
The older pupils are better able to withstand the evil conditions, for
they have already been hardened, to a degree, to unsanitary surroundings
The attendance in t^je intermediate room and also in the primary room
is about 90 per cent. Undoubtedly the attendance Avould be much better
if the surroundings were not of such a character as to produce illness.

The lighting of schoolrooms is a matter of very great importance.
People who have not studied this subject are apt to think that any kind
of lights coming from any direction is all that is required. Investigation
and study have shown that the eye-strain and with it nervousness, indi-
gestion, headaches, etc.. are all very freciuently due to improper lighting
of schoolrooms. The best possible light is skylight. Where skylights are
used they should be made tight as to always exclude rain. Ordinarily it
would be impossible to light schoolrooms by skylight. The next best way
is to permit the light to come in from one side only and so aiTange the
desks as to permit the light to fall over the left shoulders of the pupils.
When this is done the windows should reach clear to the ceiling of the
room, and their area should e(iual one-sixth of the area of the floor. With
a flood of light entering from one side of the room, falling upon the
books and filling the upper portion, no eye-strain would result. As said
above, eye-strain induces nervousness, indigestion, sleeplessness and is
sometimes very serious in it final effects.

I^ynn, unquestionably, needs a new schoolhouse. The town can not
afford longer to continue to present an old, dilapidated, dangerous, un-
sanitary building. In the present schoolhouse children are having their

/Google

Digitized by VnOOQ I

health injured daily. They can not make the progress they should, and
the progress they would make under first-class sanitary conditions. Money
is being thrown away at Lynn, which should be saved. Happiness is
also being wasted, for one case of sickness in a family which might be
produced by unsanitary surroundings at school is a source of unhappi-
ness.

The State Board of Health most earnestly urges the people of Lynn to
proceed without delay to take those steps which are necessary to supply
the town with a new schoolhouse, perfectly sanitary in every respect and
which would be a credit. It is by our works that we are known, and
if the town of Lynn wishes to be known as progressive and up-to-date
and wishes at the same time to bring great benefit to the people, a mod-
ern sanitary schoolhouse will certainly be constructed. The State Board
of Health unhesitatingly condemns the present building. This does not
mean that an order has been issued commanding the same to be aban-
doned. We simply mean that said Board gives warning of the unsani-
tary conditions which now exist with theh" unquestioned attendant ill-
ness and their threat of future ill health.

If our recommendations are accepted and a new school building is
determined upon, we hope your authorities will call upon the State Board
of Health for any help we can render. The plans for the new building
should be submitted to this Board for examination and approval in so far •
as sanitary points are concerned. We will gladly give you our opinion
and advice and hope you will be pleased to command us.

Secretary State Board of Health.

TERRE HAUTE.

March 27—

I went to Terre Haute on account of request of management to
consult in regard to addition to be made to the building which was
allowed by the last Legislature and also to consider certain sanitary
features of the building. Upon arrival I was received by Prof.
Rettger. Plans were reviewed and found very excellent, and op-
portunity offered but one reconmiendation which was adopted.

RISING SUN.
March 29 —

I visited Rising Sun on account of written invitation of town
authorities and merchants. The invitation was extended because
of smallpox existing in Ohio and Switzerland counties. I found
that smallpox had prevailed quite extensively for at least one
month prior to my visit in country districts. As usual, some phy-
sicians pronounced it chickenpox ; and such were very loud in their
denial that it was smallpox. The Health Officers, in their intel-
ligence, had pronounced the eruptive disease smallpox and had

3-Bd. of Health. f^ r^r\n]o

Digitized by VnOOQ IC

proceeded accordingly, but the moral support of the people was
not offered.' There had been, since the outbreak, and up to the
time of the visit, at the lowest estimate, 450 cases, but no deaths.
There had been no cases at Risdng Sun. At West Enterprise and
vicinity there had been probably 200 cases, at Florence and
neighborhood probably fifty cases. The officers were instructed to
continue quarantine and to urge vaccination. The positive diag-
nosis of the eruptive disease was made as smallpox, and those phy-
sicians who contended otherwise were commanded to so consider
it. The town authorities of Rising Sun and Patriot were met, the
subject discussed and they resolved, upon recommendation, to urge
vaccination upon the people and to furnish free virus to the poor.

SMALLPOX AT EAST CHIOAGO.

On March 4 a letter was received from Dr. Scheicker, Health
Officer of East Chicago, telling of smallpox at that place, and re-
lating that trouble was experienced in establishing quarantine and
managing the disease. He was replied to, directing how he should
proceed, and was furnished with plenty of smallpox circulars.
It seems there were many citizens who still would not believe the
disease to be smallpox and the State Board of Health was appealed
to by the city authorities in a telegram as follows :

I am direc'ted by the City Council to urge you to send some one here
by first train to investigate supposed cases of smallpox, with authority
to act if necessary. W. F. HALE,

Mayor.

Accordingly, Dr. A. W. Bray ton was commissioned a Deputy
Health Officer to go to East Chicago, make investigation and give
such directions, under the law, as in his judgment seemed best.

Herewith is Dr. Bray ton's rei)ort of his visit:

With the authority vested in nie by the State Board of Health as
deputy, I visited Hammond and East Chicago Saturday, March 9, with
my son. Dr. X. D. Brayton, and studied the smallpox situation there. I
will say that Dr. H. Spaulding, of Chicago, was in E3iist Chicago i:he
Friday preceding and found the same conditions, and that as far as I
could learn, his conclusions agree with mine.

Smallpox appeared in East Chicago in late January, or early February.
Two cases were in the detention house for a time, were cured, discharged
and the detention house closed.

In January Dr. Spear had smallpox, which both he. Dr. Rose, Drs.
Davis and Swan, of South Cliicago, regarded as vaccinia. Later his

Digitized by VjOOQIC

baby hnd smallpox, which was regarded as scarlatina. His wife es-
caped, having been vaccinated. These two cases are now well and are
dlscnarged.

I found a woman quarantined with smallpox. She was living with
her two children, nine months and three years old. The house is quaran-
tined and guarded. They live on the second floor over the premises of.
Dr. Spear. They are shut off from other occupants of the building. Ac-
cess is only by the back stairs.

Another domicile has a case of smallpox in a boy of fourteen years
of age. The family, eight or ten, has been vaccinated and a guard lives
In a tent in the street. In the four cases seen the disease is very mild.

I recommended that the schools be kept closed until next Monday,
and In the meantime that all children not vaccinated be vaccinated and
allowed to enter school only on physicians' certificates.

I had the Mayor, the two local editors, the Health Oflicer and Dr.
Scheicker, 'also Dr. Clark, of Hammond, a very capable man, assembled
and discussed the entire situation amicably, and smoothed over all points
of friction.

I found the authorities alert and the cases well quarantined. I or-
dered that they get other and better vaccine, as that they had been
using was inert and In no instance did I see a good "take." .

Very respectfully,

A. W. BRAYTON.

TYPHOID EPIDEMIC AT IRVINGTON.

Irvington is a town of about 1,800 inhabitants, in Marion
County, about four miles east of Indianapolis. Butler University
is situated there. Dr. H. W. Ridpath, Tlealth Officer of the county,
presented the following report of a typhoid epidemic at Irvington
as follows:

Indianapolis, Ind.. February 8, 1901.
To the State Board of Health:

On January 23, 1001, I received a request from Mr. J. P. Finley, of
Irvington, to investigate a number of cases of illness at 110 Butler
Avenue. The following day I visited Irvington and found a most serious
condition existing. The property known as 110 Butler Avenue is owned
by Mr. Finley and conducted by Mrs. Allen as a boarding house. Some
forty or forty-five students from Butler College have been taking their
meals at this clubhouse, and a number of them also roomed there. I
found that some twelve or thirteen of these students had been stricken
with fever— typhoid in character— within the ten days previous. Dr.
Thompson, of Irvington, was called on January 14 to see Walter Roe. and
on reaching his patient found several suffering from similar conditions,
which, in a few days, developed into genuine typhoid.

Immediately following these first cases others were stricken and
within a few days twenty-one students were confined to their beds.

The house occupied by the infected students is new and the sanitary
conditions surrounding appeared to be good, but, upon investigation, I

/Google

Digitized by VnOOQ I

found that a private drain, built with the consent of the Town Board of
Irvington, passed within a few feet of the house and discharged its
contents within forty feet of the rear door of the same. This sewer, as
I learned, is made of soft, porous tile, 8 or 10 inches in diameter, and
extends from Downey Avenue westward, crossing Dillon and Butler Ave-
nues. There is also a shorter drain connecting near Dillon Avenue with
the main drain. Some ten or fifteen houses are connected with this drain.
Water closet connections were forbidden, but I have it from reliable
sources that water closet matter has been discharged at the mouth of the
drain. In my examination of the boarding house I found a sink in the
kitchen connected with this drain by straight pipe without any trap <»on-
nections, thus allowing the house to be continually filled with pollution
gases. Believing that the cause of this epidemic was due to infection
from this drain, I immediately notified Mr. Finley and asked him to
bring the matter to the attention of the local Health Officer, Dr. J. B.
Terrell, and through him to the Town Board. A few days later the
alarm became greater. A number of the students had been transferred
to their homes. Two deaths had occurred— Walter Roe, of Boggstown,
and Morton Green, of Brownsburg. The citizens were thoroughly
alarmed; the boarding house was practically abandoned and the college
considerably harmed. I found that previous to the time of this epidemic
these students had been drinking water from other wells than the one
on the premises and these waters are now being collected for analysis.
I made a second visit to the town and made a thorough investigation of
nearly all the houses supposed to be connected with the drain, but was
unable to find any such connections.

I send you this communication to acquaint you of the serious condi-
tion in our suburb, with a request that you take whatever action seems
in your Judgment wise. The accompanying chart will help you to more
fully understand the situation. The crosses indicate residences con-
nected with the sewer and the small circles the location of wells from
which water was used. The line drawn from the church to the square
indicating the boarding house, will show you the course of the sewer.

Any assistance I may be able to render you will be cheerfully given
in this matter. Respectfully yours,

H. W. RIDPATH,

Secretary.

Upon re<»eipt of this letter, four samples of water were collected
from the fc^llowing places, and analyzed at the Secretary's expense:
Xas. 68 Dillon Avenue, 110 Butler Avenue, 154 Butler Avenue,
131 Butler Avenue, being the houses visited by the disease. All
four samples, u]x>n analysis, proved to l)e polluted, there being
abundant chemical and bacteriologic evidence supporting such con-
clusion. The following letter was then written to the Town Board
of Irvingtvon, to which no reply was received:

Digitized by VjOOQIC

Indianapolis, Ind., February 26, 1901.
To the Town Board of Irvlngton, Irvlngton, Ind.:

Gentlemen—Under the laws of the State of Indiana you constitute
ex officio a Board of Health, and it is as such Board that we address
you. The law says:

**The Trustees of each town shall constitute a Board of Health, ex
officio, whose dutj' it shall be to protect the public health by removal of
causes of disease when known, and in all cases to take prompt action
to arrest the spread of contagipus and infectious diseases, to abate and
remove nuisances dangerous to the public health, as directed or approved
by the State Board of Health, and perform such other duties as may from
time to time be required of them by the people."

With this understanding you will readily see that the recent outbreak
of typhoid fever at Irvington is a matter which directly concerns the
State Board of Health and of which it is our duty to take cognizance.
CJonceming this epidemic of typhoid, we have a report from Dr. H. W.
Ridpath, who is the County Health Officer. In this report he simply
gives a record of the persons who were attacked by the disease and of
those who died and gives his opinion that all of this sickness and these
deaths would have been prevented had not certain welJs become polluted
from a certain draJn which now carries sewage and which was never
intend-ed for such purpose. It is sad indeed to think that valuable lives
have been lost and sickness has been endured which was entirely unnec-
essary. We say it is not necessary, for, of course, you know that typhoid
fever is a filth disease and, like sin, is a reproach to any community. This
outbreak severely reflects upon Irvington, for it simply means that you
have filth conditions in your town which are not a credit to you.

The law reposes in the Town Board all the power that is required, and
makes it its duty to see to it that conditions do not exist which will
permit such destruction to health and life as has occurred in your midst.
You, of course, will not for one moment think that it is economy for you
not to take proper action in regard to this matter. On the contrary,
you will undoubtedly agree with us that to permit the condition to exist
which might again cause sickness and death, will simply be an exhibition
of extravagance and wrong doing.

Recommendations.— We respectfully recommend as a measure for the
benefit of Irvington, that, as early as possible you employ an engineer to
lay off the whole town in a comprehensive system of sewerage. You, of
course, w^iU not be able to construct this system at once, but it can be
done gradually. The engineer w^ill tell you where the main trunk sewer
should run, and this should be constructed at the vei*y earliest moment
possible. The laterals can be put in as money and time will allow. Now,
having the sewers, the next thing is to pass an ordinance compelling all
houses to connect with the same. When this is done the next step is to
pass an ordinance abolishing all privy vaults and sinks and all condi-
tions which are calculated to pollute the ground in any way. In this
manner the well can be kept pure, but so sure as you permit the present
conditions to continue, the ground will gradually become more and more
polluted by seepage from your present imperfect sewer-drain and from
the vaults and sink-holes. '

Digitized by VjOOQIC

Irvington can not grow and its real estate can not become valuable
on account of disease and death. A great mistake will therefore be made
if efforts are not put forth to banish these filth conditions, which, as
said above, are a reproach to any community.

It is impossible to make a better investment than to build sewers
and carry out of your town that filth which causes sickness and death.

We recommend further, that this be done as soon as possible, and rec-
ognize that it will take time and a considerable expenditure of money to
accomplish the ends we have recommended, but we confidently predict
that if Irvington will accomplish these reforms there will be an appre-
ciation of property and a fuller measure of happiness for her people. On
the contrary, If nothing is done, we can predict a depreciation in property
and a lessening of public happiness.

We feel confident you will accept these recommendations in the spirit
In which they are offered, and j-ou will recognize that it is our legal duty
and power to make said recommendations.

A brief history of the legislation recommended by the State
Board seems appropriate. A bill establishing a Laboratory of
Hygiiene was offered as follows :

A BILL for an act Entitled "An act to protect all streams, ponds, lakes
and open bodies of water from pollution; to control and to con-
serve, as far as stream, lake and pond pollution and the public health
are concerned, all industries and corporations which place offal, sew-
age or waste matter into streams, lakes or ponds; providing methods
whereby both streams and industries may be preserved to the State;
establishing a State Laboratory of Hygiene under the control and di-
rection of the State Board of Health, wherein analysis ajid exi)eri-
m€nts for the sanitary disposal of wastes may be conducted, and
wherein all kinds of sanitary studies and investigations may be made;
providing, also, that the Laboratory of Hygiene shall be used for mak-
ing food and drug analysis to make possible the enforcement of the
pure food and drug statutes; prescribing fines and penalties for the vio-
lation of this act; defining the duties and powers of the courts, Attor-
ney-General, Prosecuting Attorneys and tlie State Board of Health, in
relation to this act; fixing an appropriation, prescribing penalties and
repealing acts in conflict tlierewith."

Section 1. Be it enacted by the General Assembly of Indiana, That
it shall be the duty of the State Board of Health to make sanitary sur-
veys and inspections of streams, ponds, lakes, factories, mills, works, in-
dustrial establishments and cities and towns, in order to ol)tain sanitary
facts and data and samples of material for analysis and study. The
State Board of Health and all Boards of Health and their oflicers shall
have the right and power to enter into and upon all premises, buildings
and properties for the purposes al»ove named. It shall be the duty of
the State Board of Health to early endeavor to make practical use of all
sanitary data collected as herein provided, and to discover, invent or
apply proper methods for the constrnction and conduction of a plant for
the sanitary disposal of polluting wastes, hereinafter called a Sanitary

Digitized by VjOOQIC

Purification Plant. When, at any time, the State Board of Health shall
have decided that a practical and practicable sanitary method of waste,
sewage or refuse disposal has been discovered, invented or Is otherwise
known, it shall be its duty to place the knowledge of such method by
information before any court of general jurisdiction in the county wherein
Is situated any industry or corporation whose refuse, waste or sewage
is in question, and it shall then l>e the duty of such court to cause the
owners, managers, trustees or proper officials, or any person in charge
of the premises of said industry or corporation, to be summoned to appear
before the court at a time fixed by the court, and at the time fixed by
such notice, the court shall proceed to determine the sufficiency of such
method, and if, in the opinion of the court, It is shown and appears that
such disposal method is sanitary and both practical and practicable, then
the court shall order, by formal mandate, the adoption of the same within
a proper time, and shall also order its construction and maintenance of
a sanitary purification plant, and the sanitary purification plant so or-
dered shall be installed and conducted according to the approval and
rules of the State Board of Health. In case of refusal or neglect of any
industry or corporation to obey the court's order, as herein provided, then
the responsible parties shall be punished as for a contempt of court:
Provided, That in the case of a corporation, municipal or private, its
officers, or any of them, may be punished by a fine of $500 or by impris-
onment not exceeding three months, or by both, or the corporation may be
punished by a fine of not more than $500.

Sec. 2. A laboratorj^ is hereby provided for, which shall be desig-
nated as the State I-aboratory of Hygiene; it shall be located in the State
House at Indianapolis, and basement room No. 10 is set aside for the
said laboratory. The State Laboratory of Hygiene shall be connected
with and be under the control and direction of the State Board of Health,
and said Board shall have power to pass rules in accordance with this
act, and for the enforcement thereof. The said Laboratory of Hygiene
shall be used for making analysis of foods and drugs for the purpose of
enforcing the pure food and drug law, for making analysis, examinations
and studies for the purpose of enforcing tlie health statutes; for making
analysis, investigations and studies concerning the pollution of strean^s,
the composition of polluting matters of all kinds, and to discover, invent
or apply processes for tlie sanitary disposal of sewage and factory wastes
and for no other purpose. The Secretary of the State Board of Health
shall be the Director of the State Ivaboralory of Hygiene and with a con-
sent of a majority of all members of the State Board'*of Health, shall
have power to appoint all employes necessary for the conduct of said
laboratory, and said Secretary shall have the power to suspend, at any
time, any employe of the said Board, and during such suspension no wages
shall be paid, and the suspension shall be a final discharge, when approved
by a majority of all the members of the State Board of Health: Provided,
That all the skilled, scientific employes of the State Laboratory of Hy-
giene shall be appointed from an eligil)le list furnished by the authorities
of Purdue University; and said authorities shall secure such list by exam-
ination of all applicants at the University at such time, or times, as may
be agreed upon by the State Board of Health and the authorities of said
University. The salaries of the head chemist and also the head bac-

Digitized by VjOOQIC

teriologist shall not exceed $1,500 per annum, and all salaries shall be paid
quarterly by certificates from the State Board of Health, and on presenta-
tion of such certificates the Auditor of State shall draw his warrant on
the State Treasurer for the amount certified.

Sec. 3. It shall be the duty of the Attorney-General, either individ-
ually, by deputy or through Prosecuting Attorneys, to bring immediate
suit under this act, in the proper courts, whenever information of food
or drug adulteration, information of dangerous unsanitary conditions
threatening the public health; information of streams, lake or pond pol-
lution and of the discovery of methods of sefwerage or waste disposal may
be furnished to him, in writing, by the State Board of Health.

Sec. 4. Five thousand dollars or as much thereof as is found neces-
sary, are hereby appropriated for equipping the State Laboratory of
Hygiene with all necessary apparatus, books and appliances, the same to
be paid out by certificates from the State Board of Health, and on
presentation of such certificates the Auditor of State shall draw his war-
rant on the State Treasurer for the amount certified; and all certificates
shall have attached itemized bills for their face amount, and any unex-
pended portion of this appropriation shall revert to the general fund
within two years from the going into force of this act. For salaries of
the employes, maintenance of the laboratory, purchasing of food and drug
samples, transportation and hotel expenses of those necessary to conduct
investigations and attend prosecutions, and for the necessary incidentai
expenses, $10,000 per annum are appropriated.

Sec. 5. Any person or persons who, as oflicers of any corporation,
who shall violate any of the provisions of this act, shall be deemed guilty
of a misdemeanor, and, upon conviction thereof, shall be fined in any
sum not less than ten nor more than $100T

Sec. C. All statutes and parts of statutes in conflict with the pro-
visions of this statute are hereby repealed.

This bill passed the Senate and passed the House to third read-
ing, reaching the House the last week of the session. The last day
for legislation was Friday, March 8. The bill was received into
the House Tuesday, March 5. The Si)eaker steadily refused to
"hand down" the bill f(»r tinal action bv the House. Several peti-
tions were sent to the Speaker and numerous members called upon
him urging that the Legislature be allowed to act upon the bill as
tJie constitution re<|uired, but, as already said, it was not handed
down, and thus the measure was defeated.

Other health legislation with which this Board had nothing to
do, but the bill for which the Secretary wrote and which had the
supj)ort of the State Superintendent of Public Instruction, was
House Bill Xo. 455, which had for its object the regulating of
sanitary features of all schoolhouses hereafter built in Indiana.
The bill failed on final passage in the House, only nine affirmative

Digitized by VjOOQIC

votes being given. Itis to he deeply regretted this bill did not be-
come a law, for it certainly was in accord with sanitary science
and simply required that school children should be surrounded
with conditions necessary to preserve their health and to enable
them to prepress as they should.

Another bill of sanitary interest was Senate Bill IJfo. 405. It
was entitled "A Bill for an act prohibiting the sale of, or having
in one's possession for the purpose of sale, any article of food or
food products, or used or intended to be used, as an ingredient of
any food or food products, containing formaldehyde or other anti-
septics or poisons, fixing a penalty for the violation of its pro;
visions and providing a method for its collection and declaring an
emergency."

This bill was projected for the puri>ose of attacking the Royal
baking powder and all baking powder containing crea.m of tartar,
as an examination of the bill will show. The bill passed and be-
came a law, but when found in the office of the Secretary of State
the four words or "bitartrate of potassium" which w^as included
among the illegal substances to be used, were erased by a scratch
knife.

The last bill of sanitary interest and which became a law, w^as
Senate Bill Xo. 267, entitled "A Bill for an act prohibiting the
discharge of waste water and refuse of manufacturing establish-
ments into streams or water, conferring certain powers upon the
State Board of Health in such cases, providing penalties for the
violation thereof, and declaring an emergency."

This law confers powers upon the State Bqard of Health to
grant licenses at its option to manufacturers to discharge waste
water and refuse liquors into streams.

BULLETIN AND STATISTICS.

The statistics for each month of the quarter have been collected,
tabulated and published in the Bulletin, as usual. The Bulletin
also contains for each month an account of sickness and a special
account of smallpox.

Applications according to the law were presented for permits
to discharge factory waste into streams by:

American Strawboai-d Co., Kokomo.
West Mnncie Strnwbonrd Co.. YorktowD.

Digitized by VjOOQIC

American Tin Plate Co., for Its works at Elwood, Gas City, An-
derson and Atlanta.
The Albany Paper Co., Albany.
Muncle Pulp Co., Muncie.
Consumers Paper Co., Muncie.

; The petitions and the law in regard to the matter were fully
considered, and Dr. Davis then introduced the following resolu-
tion:

Whereas, The statutes provide that permits may be issued by the
State Board of Health, at its discretion, allowing waste matters
from factories in the State to be deposited into streams, and,

Whereas, No pro\asion was made for expenses incident to visits
and investigations which are commanded by the law before permits
may be given, therefore, be it

Resolved, That no visits or investigations shall be made, unless
the necessary expenses of said visits and investigations are pro-
vided by the petitioners.

Unanimously carried.

Moved by Dr. Davis: Whenever the necessary expenses inci-
dent to visiting factories and making investigations required in the
matter of granting permits to deposit waste matter into streams
are provided by the interested parties, the members of the State
Board of Health, at such time as may be mutually agreed upon,
will visit the localities and factories from which petitions have been
received and personally inspect the streams, taking note of the
volume of water, speed of current, physical and climatic character
and amount of waste which it is desired to deposit or let pass into
streams, and report the results of their observations with recom-
mendations at the next regular meeting of the State Board of
Health.

Unanimously carried.

The following petition concerning the matter of granting per-
mits to factories to deposit waste into streams were received and
ordered spread of record :

Kokomo, Ind., April 18, 1001.
Dr. J. N. Hurty, Indianapolis:

Dear Doctor— Some of the citizens asked me to ascertain if the State
Board of Health has taken any action iu)on the application of the straw-
t)oard mill at Kokomo. If yoia have not, to postpone it a few days until
an Investigation can be made. Yours very truly,

EDGAR COX,

City Health<Offlcer. t

Digitized by VjOOQIC

Kokomo, Ind., April 18, 1901.
To the State Board of Health, Indianapolis, Ind.:

In yesterday's paper we noticed for the first time that the American
Strawboard Co. had made application to your Honorable Board for per-
mit to turn its refuse into Wild Cat Creek. We have not seen the statute
under which this proceeding is had, and there is not now time to exam-
ine the proceedings and make a formal resistance to the application.
Those who are most affected do not know that the matter is before you.
therefore they have had no chance to protest. But we represent that
there are many people here who can give, and we believe if given a
chance, will give your Board strong reasons why this permit should be
refused.

We show to your Board that Wild Cat Creek is small, it being, at
low water, hardly sufficient to wash away the sewage from Kokomo.
When the strawboard plant was in operation here before it discharged
vast quantities of refuse into the stream. As this floated down the slug-
gish current through the hot slm, at times standing in the deep places, the
foreign particles in the water decomposed, making the water not simply
unsightly, but absolutely offensive. AH the fish were killed. After this
refuse had floated for a long time down the stream, exposing the refuse
to the sun, this odor became far more offensive than when first discharged
into the stream, the odor there becoming so strong and offensive that
people living three-quarters of a mijp away often had to close the doors
to shut out its smell. Some families living near had much sickness while
this condition lasted, but noticed that they were not sick after this plant
stopped. This odor could be smelled much over a mile away. During
freshets, when the stream was full, and when the plant was stopped these
conditions did not exist, but they did exist during the greater part of the
year.

We apprehend that the applicants, in presenting their side, will claim
that certain preparations of lime and certain acids contained In this refuse
are fine disinfectants, and that the odor is not offensive. But all the lime
and acids which they use In this work can not disinfect the large quanti-
ties of other matter discharged with the refuse. The past has proven this
beyond question. All this lime and acid can no more make this putrid
matter sweet than a few drops of carbolic acid can make spoiled eggs
palatable or the odor of a polecat sweet perfume. It can easily be under-
stood how a strawboard man would not think the odor so bad. Being in
It constantly at the mill, before it has become putrid, he becomes used to
it, just like the laborers in fertilizer factories become so accustomed to
the odor of old dead animals, that they can eat at the factory in the midst
of odors so offensive that an ordinary person could not endure it at all.
Moreover, a bad smell that fills the purse of a man, is far more pleasant
to him than to a man whose home is made unpleasant by it.

We can further show that if this plant Is permitted to operate as a
strawboard plant and discharge its refuse into this stream, the conditions
which we describe will affect at least thirty-five square miles of farm
land In this country, all of which it will render extremely undesirable for
homes, and the value of which will be greatly decreased thereby.

Digitized by VjOOQIC

We hope these statements of facts will cause your Honorable Board
to carefully investigate both sides of this matter before granting a permit
which will result in sq much harm to property and fiomes.

Respectfully submitted,

W. C. OVE7RTON,

L. F. WILSON,

G. T. AND W. J. CAITCHLOW,

J. F. DIMITT,

D. H. JACKSON,

J. M. WILSON,

W. C. DIMITT.

Moved by Dr. Davis, that the Secretary be ordered to prepare
a blank form of application for permission to factories to deposit
waste into streams, and submit same for approval of the Attorney-
General, said blank permit to be supplied to all persons who wish
to make application for said purpose.

The Secretary presented the following concerning Senate Act
No. 291:

EXHIBIT ''A."
Enrolled Act No. 291— Senate.

An Act to define veterinary medicine, etc.

Section 7. Upon filing evidence of fitness, the Clerk of the county shall
issue to such applicant a certiflcater to practice in accordance with the
provisions of this act, in any county of the State of Indiana, such blank
certificate to be furnished by the State Board of Health.

Moved by Dr. Davis that Secretary shall prepare a proper form
of certificate, as provided in the veterinary law, and deliver to the
State Printing Board.

Petition of Max Ilerlich presented as follows:

New Palestine, Ind., April 17, 1901.
State Board of Health:

I would like to have permission of your Honorable Board to remove
two bodies, dead about thirty years ago of cholera; said bodies are buried
at their farm and should be removed to a public cemetery about two miles
from farm. I will see that graves are well disinfected and everything
done according to law. Please send me blanks so I can have the family
make them out and send them to you for removal blanks.

Hoping to hear from you, MAX HERLICH.

Moved by Dr. Davis that petition be granted.
Carried.

Digitized by VjOOQIC

Ordered, That the annual May conference shall be held May
27 and 28, and the Secretary shall prepare program and send out
call for meeting.

Ordered, The Secretary shall prepare a book for Health Offi-
cers which shall contain laws, by-laws, rules, instructions and other
information as may seem desirable, the same to be approved by
the President before publication ; 2,000 copies to be printed.

Moved by Dr. Davis: Whereas, "An act concerning the educa-
tion of children" was amended by the Sixty-second General As-
sembly to read : "Section 1. Provided, further. That no child in
good mental and physical condition shall, for any cause, any rule
or law to the contrary, be precluded from attending school when
such school is in session ;" and.

Whereas, Public health, life and safety are fundamental laws
of society, therefore, the State Board of Health

Orders, That all Health Boards and Health Officers in the State
of Indiana shall institute and maintain rigid quarantine of all con-
tagious and infectious diseases as directed by the rules of the State
Board of Health ; and it is especially ordered that no child be al-
lowed to attend school from any house that is under quarantine.

Unanimously carried.

A bill for twenty-five dollars ($25.00) was presented by Dr.
Herman Spaulding, of Chicago, for visiting, upon telegraphic re-
quest of the Secretary, Valparaiso and East Chicago, on account
of smallpox.

The bill was allowed.

CLAY CITY SCHOOLHOUSE.

.J
The following petition and correspondence was presented:

To the Stftte Board of Health, IndianapoUs, Ind. :

Gentleman— We, the undersigned, believe it to be our duty to call the
attention of your Honorable Board to the condition of the public school
building in Clay City. While the building is of brick, it shakes in every
wind; the walls of the exterior, also those of the interior of the building
are badly cracked, owing to a poor and insufficient foundation, and the
building is unsafe and dangerous.

No provisions are made for the proper ventilation or heating of the
building and It is therefore very unsanitary and unhealthy, and not fit for
school purposes.

It also happens to be insufficient in capacity to accommodate the num-
ber of school children of school age that should go to It and it is therefore
overcrowded, thus aggravating the unsanitary conditions. r^^^^T^

Digitized by VnOOQ IC

It is not provided with sanitaries; the priviefl are poorly built and of
insufficient size to accommodate the children, and ore too filthy for de-
scription.

We respectfully submit the above facts for your consideration at the
request of patrons of the schools, and ask for whatever measure or relief
you can give us. The building should be condemned.

Signed by Seventeen Citizens.

On account of the petition the Secretary sent a form of sanitary
survey to the Clay City Health Officer, directing that he fill the
same out according to the facts. Following is the survey :

SCHOOLHOUSE AT CLAY CITY, CLAY COUNTY.

Sanitary Survey—

1. When was it builtV 1882.

2. What condition of repair? Dilapidated.

3. Is it frame, brick or stone? Brick.

4. What kind of foundation? Sandstone. Very light, only twelve

inches thick.

5. Is there a cellar or basement? No.

6. If there is a cellar or basement tell condition, as: Is it dry,

clean, well lighted, vrell ventilated?

7. How warmed? Stoves in each room.

8. How ventilated? Windows and doors.

9. Are there separate cloakrooms for the sexes? No cloakrooms.

10. Are the cloakrooms warmed? No.

11. Are the stairs easy of ascent, or are they steep, winding and

boxed? Steep, winding and difficult of ascent.

12. Is the ground upon which the house stands, and also the play-

grounds, drained and dry? No drainage. Water always re-
mains on school grounds after a rain.

13. How about the sanitaries? If flush closets are used, or If there

are dry closets, or If privies, describe them fully, telling pres-
ent conditions. No sanitary privies used. Small, poorly con-
structed. Too noisome to describe.

14. Wliat is the percentage attendance? Seventy-six per cent.

15. Give amount and character of sickness in school during the year.

A great deal of sickness for past two years. Smallpox, diph-
theria, scarlet fever, coughs, coids, headaches, eye-strain, etc.

10. The most of the rooms are very poorly lighted also.

17. The building is not of sufficient size to accommodate the chil-
dren of our town who are of school age, so that it is over-
crowded or that some children are crowded out. And the
building is also considered unsafe, so much so that some of
the patrons have instructed their children to come home on
the approach of a storm. The whole building shakes in a high
wind, is unsafe, unsanitary, inadequate and wholly imfit for
use. Respectfully submitted,

J. A. MODESITT, M. D.,
Secretary Board of Health, Clay City, Ind.

Digitized by VjOOQIC

After due discussion it was ordered : That the Clay City school
house is condemned and that this order of condemnation be trans-
mitted to the school authorities of Clay City.

Adjourned.

Digitized by VjOOQIC

SPECIAL MEETING.

Office Indiana State Board of Health,

Indianapolis, Ind., May 6, 1901.

Present: Drs. Forrest, Davis, Cook, Wishard and Hurty.
President Forrest called the meeting to order at 4 p. m.

Applications to place waste into streams were considered for
the following corporations:

American Tin Plate Company at E>lwood, Gas City, Anderson and

Atlanta.
Consumers Paper Co., Albany.
Muncie Pulp Co., Muncie.
West Muncie Paper Co., Yorktown.
American Strawboard Co., Kokomo.
American Strawboard Co., Anderson.

These applications were fully and thoroughly considered, also
all the facts as presented in the surveys made by the Secretary.
Thereupon it was

Moved by Dr. Wishard, That permits are hereby given to the
West Muncie Strawboard Co., at Yorktown, the Consumers Paper
Co., at Muncie, American Strawboard Co., at Anderson, and
Muncie Pulp Co., at Muncie, to discharge the waste from said
establishments into the adjoining streams until December 1, 1901,
unless sooner revoked. •

Carried.

Moved by Dr. Cook, That the Secretary is directed to visit the
Tin Plate Works at Elwood, Gas City, Anderson and Atlanta,
also the American Strawboard Co., at Kokomo, and the United
States Board and Paper Co., at Carthage, make thorough inspec-
tion and report separately and in detail to the State Board, and
upon approval of the majority of the Board the Secretary is
directed to issue a permit, to expire on the 1st day of December,
1901.

Carried.

(«)

Digitized by VjOOQIC

The following resolution was offered by Dr. Davis:

Resolved, That all resolutions heretofore passed, which are in
conflict with resolutions or motions adopted at this meeting, are
hereby repealed.

Carried.

The following resolution was offered by Dr. Davis :

Resolved, That all Health Officers under the jurisdiction of the
State Board of Health of Indiana be, and are hereby notified, that,
on failure to report, on or before the fifth day of each month, the
deaths having occurred and duly reported to the local Health Offi-
cer, he should be discharged from office as provided by law.

Moved by Dr. Wishard, That Dr. Melville M. Haas, of Evans-
ville, be appointed to succeed himself on the Indiana State Board
of Dental Examination for two years, beginning at the expiration
of his present commission.

Carried.

Adjourned.

4— Bd. of Health. ^-^ t

/Google

Digitized by VnOOQ I

SPEQAL MEETING.

Office Indiana State Board of Health,

Indianapolis, Ind., May 28, 1901.

Present: Drs. Cook, Davis and Hurty.

It was moved by Dr. Hurty that Dr. Cook act as Chairman, and
the motion was carried. The Chairman called for the reports of
the Secretary of his visits to the Tin Plate Mills at Anderson,
Elwood and Atlanta, also for his report of visit to plant of Ameri-
can Strawboard Co., at Kokomo.

At this point Dr. Wishard appeared and as Vice-President took
the chair. The Secretary then made reports of visits to the Tin
Plate Works at Anderson, Elwood and Atlanta, also to American
Strawboard Co.'s plant, at Kokomo.

REPORT OF INSPECTION OF ANDERSON TIN PLATE WORKS'

PLANT.

In accordance with the command of the Board, I visited the
plant of the Anderson Tin Plate Co., May 10, 1901. The waste
from this plant is carried through an underground sewer, for a ,
distance of about 500 feet. Here it empties into a ditch in which
the waste flows for a distance of about one-fourth mile, and there
empties into a little run or small branch. This branch carries the
waste, the same being diluted with the water of the branch, for the
distance of about one mile and a half, and there it enters Killbuck
Creek, and by this stream is carried a distance of probably one
mile, and empties into White River.

The refuse from the tin plate works consists exclusively of
"spent pickle." This "spent pickle" is a solution formed by dip-
ping st^el plates into dilute sulphuric acid. The object of dipping
the plates in the dilute acid is to dissolve from the surface any iron
oxide which might be clinging thereto. The action of the acid is
to dissolve the iron, making ferrous sulphate, which is held in

Digitized by VjOOQIC

solution. The "pickle" finally becomes incapable of dissolving
more iron, and then is allowed to flow away. It consists, there-
fore, essentially of a strong solution of ferrous sulphate (copperas)
in water, slightly acidulated with sulphuric acid. The factory
produces daily about one thousand gallons of "spent pickle." This
"spent pickle" is a very excellent disinfectant and antiseptic, and I
think it could be caught, and, with little manipulation, be saved
as a product and sold as an antiseptic. It would also be possible
to recover from this "spent pickle" the copperas which it contains
and the product could be disposed of in the drug market.

The "spent pickle" flows from the underground sewer which
wa^ named above into the ditch, and at this point has not changed
its nature. Gradually, as it proceeds down the ditch, a change is
noticed. After it enters the branch, still further change appears,
and this change consists in becoming cloudy and in depositing
upon the bottom of the ditch and the branch a red powder, which
is ferric oxide. Further down the branch the ferric oxide (iron
rust) remains suspended in the water and imparts to it a reddish
color and muddy appearance. Where the water flows from the
branch into the creek, this reddish muddy appearance is increased.
The creek from the mouth of the branch, from where it empties
into White River, is very red and is so loaded with suspended
oxide of iron as to give it an appearance which I have already
designated as being red-colored and muddy. At the point where
the creek enters the river the appearance described prevails, but
very soon disappears after it has flowed about 100 feet.

This tin plate refuse does not and can not cause any nuisance.
There is nothing putrescible about it, but, on the contrary, it is an
antiseptic of the very first quality. Fish can not live in water con-
taining much of this refuse because it is poisonous. Neither can
vegetation flourish in its presence. The shores and banks of the
branch, and also of the creek, are well covered with vegetation,
but only at points which are untouched by the refuse. As the
State Board of Health has to deal only with unsanitary condi-
tions,and as this refuse is not unsanitary in any sense of the word,
and as there is no complaint in regard to the matter, I recommend
that a permit be granted to the American Tin Plate plant at An-
derson to deposit its refuse into the above named streams so long
as its nature is unchanged from what it now is.

Digitized by VjOOQIC

REPORT OF INSPECTION OF AMERICAN TIN PLATE PLANT AT

ELWOOD.

This plant empties into a pond condensed steam from the en-
gines and waste water from the "boshes," the rolls and the engine
pits. • Condensed water is nothing but distilled water, being pro-
duced by the condensation of much of the steam after it is used
in the engines. The waste water from the "boshes," the rolls and
the engine pits, is simply water which has been pumped from
deep wells and used for cooling purposes. The amount pumped
daily is estimated at 1,000,000 gallons. This water is as pure or
purer than the creek water. From the pond the water flows into
Duck Creek. There certainly can be no objection to placing
distilled water and water that has been pumped from deep wells
into any qreek, and I therefore recommend that a permit be issued
to the American Tin Plate Co.'s plant, at Elwood, to discharge
such waste as is just described into Duck Creek.

Up to about a year ago this plant discharged all of its "spent
pickle," which is a solution of copperas, into Duck Creek. The
copperas is a strong antiseptic and disinfectant. It can not pro-
duce any unsanitary conditions, but it does kill vegetation, renders
the water unfit for drinking purposes and will destroy any aquatic
life. With the past, however, the State Board of Health has
nothing to do.

REPORT OF INSPECTION OF AMERICAN TIN PLATE CO.'S PLANT

AT ATLANTA.

This plant was silent from July 19, 1900, to May 13, 1901. It
started the "pickling process," which is stripping steel sheetc in
dilute sulphuric acid, on May 20th. The "spent pickle" from this
plant is all impounded. None of it is allowed to run away into the
adjoining stream. The only waste from this plant is the same as
found at Elwood, namely, condensed water, from the great en-
gines and cooling water from the engine pits, the "boshes" and
the rolls. This water is pure and in no wise objectionable, and I
therefore recommend that a permit be granted to the American
Tin Plate Company's plant at Atlanta to discharge the waste
above described into Big Cicero Creek.

Digitized by VjOOQIC

BIPORT OF INSPECTION OP AMERICAN STRAWBOARD OO.'S
PLANT, KOKOMO.

In obedience to instructions, I visited Kokomo May 20 in order
to inspect the American Strawboard Co.'s plant at that point.
This plant pumps 2,000,000 gallons of water daily from four deep
wells. Straw is not used, but, instead, ordinary old paper stock.
This stock consists of news paper, brown paper, cut fragments
of pasteboard, etc. The same is placed into large beating troughs,
and, with water, is beaten into a pulp. This pulp is not washed at
all, but is taken direct to the paper machine and there made into
paper. The water which runs from the mill into Wild Cat Greek
is that used in washing the paper in the machine rolls. No chem-
icals whatever are used. The plant is turning out from ten to
fifteen tons of product daily.

The water enters a race just across the road from the mill, a
distance of perhaps 200 feet. This race enters Wild Cat Creek
about 800 feet below the mill. At the mouth of the race is situ-
ated Crutchlow's slaughterhouse, and in Wild Cat Creek at this
point there was found a mass of blood and animal matter in a high
state of decomposition. The mass reached about twenty feet into
the water, and extended about twice that distance down the
stream. The water of the creek is colored and the immediate
neighborhood stunk horribly. The bottom of the creek above the
strawboard plant was carefully inspected. This was also done be-
low the point where the waste water enters. The bottom was
found in both instances to be clean and free from any debris. The
brownish color is entirely free from odor and has no more taste
than the creek water. Samples of water were taken from the
creek above the point where the race enters into it, also imme-
diately from the chute where the waste from the plant is deliv-
ered into the race, also from immediately below where the race en-
ters the creek, also from a point about 200 feet below the slaugh-
terhouse. Analyses were made of these samples and are appended
to this report.

The analysis of the waste from the plant shows that it does not
contain putrescible substances. This is to be expected, for waste
paper does not contain matters which could putrefy, and this waste
could carry nothing except wliat it would dissolve from or wash

Digitized by VjOOQIC

off of waste paper. It is my conclusion that this waste in nowise
impairs the stream, nor can it create the least nuisance. The
slaughterhouse is, evidently, a pronounced nuisance, for the great
mass of putrefying matter found immediately opposite the house,
with its horrible stench, and the coloring of the water, indicates
a nuisance of the first class. The analysis of the sample of water
taken from the creek below the slaughterhouse shows abundant
pollution with animal matter. It also shows animal matter in a
high state of putrefaction and contains various animal toxins. The
sample from the creek above the mill shows the water to be of the
ordinary character found in such streams. It carries intestinal
bacteria and some nitrogenous matter and is certainly not fit for
drinking, but pure enough to make a stream that is pleasant and
free from any objections whatever. The sample of water taken
from immediately below the outlet from *he strawboard plant does
not show any more pollution than the sample which is taken above.

Above the strawboard plant about half a mile was found the
slaughterhouse of A. D. Kelly. The slaughterhouse drains into
Wild Cat Creek blood and offal which usually proceeds from such
places. The stench in the immediate neighborhood is strong, and
the stream is undoubtedly polluted by the matter deposited there-
in from said slaughterhouse. At both the slaughterhouses hogs
were kept and fed upon offal. From Mr. Jackson Marrow, city
engineer of Kokomo, I learn that the city has nine sewers empty-
ing into Wild Cat Creek. Two of them are very long and quite
large and the rest are short and smaH. Mr. Marrow estimated
the number of connections at not less than 1,500. It is plain, then,
that the city of Kokomo contributes very materially to the pollu-
tion of the stream by discharging sewage into the same.

Believing that the waste from the American Strawboard plant,
at Kokomo, is entirely inoffensive, as it contains no putrescible
matter whatever, and there is nothing suspended therein, I recom-
mend that a permit be granted to said plant to empty waste into
Wild Cat Creek so long as the present conditions exist.

Digitized by VjOOQIC

May 28, 1901.
American Strawboard Company, Kokomo, Ind.

Sanitary Water Aivalysis.

Samples marked "Wild Cat Creek, above the Stra^'t)oard mill, May 20,
1901."

Parts per 100,000.
Appearance-
Turbidity very slight.

Sediment very slight.

Color faint yellowish.

Odor distinct.

Chlorine 2.0

Solids-
Total 83.9

Volatile 6.9

Fixed 27.0

Nitrogen, as-
Free ammonia - 0.003

Albuminoid ammonia 0.016

Nitrites abundant.

Nitrates traces.

Bacteriological examination-
Intestinal bacteria present.

Opinion—

This Is a polluted water. It contains putrescible, organic matter
of animal origin and it carries intestinal bacteria.

May 28, 1901.
American Strawboard Company, Kokomo, Ind.

Sanitary Water Analysis.

Samples marked "Refuse at point of entrance to Wild Cat Creek,
Kokomo, May 20, 1901."

Parts per 100,000.
Appearance-
Turbidity marked.

Sediment marked.

Appearance-
Color none.

Odor very distinct.

Chlorine 6.2

Solids-
Total 103.8

Volatile 41.1

Fixed 62.7

/Google

• Digitized by VnOOQ I

Niu-ogen as-
Free ammonia 0.004

* Albnminoid ammonia 0.035

Nitrites abundant.

Nitrates traces.

Bacteriological examination-
Intestinal bacteria present.

Opinion—

This is a polluted water. It carries putrescible matter of animal
origin and carries Intestinal bacteria.

May 28. 1901.
American Strawboard Company, Kolvomo, Ind.

Sanitary Water Analysis.

Samples marked "Wild Cat Creek, 50 feet below point where race from
strawboard plant enters, May 20, 1901."

Appearance-
Turbidity very slight.

Sediment very slight.

Color slightly yellow.

Odor distinct.

Chlorine * 2.0

Solids-
Total 32. 9

Volatile 6.5

Fixed 27.4

Nitrogen as-
Free ammonia 0.003

Albuminoid ammonia 0.045

Nitrites abundant.

Nitrates traces.

Bacteriological examination-
Intestinal bacteria present.

Opinion—

This is a polluted water. It carries putresfll)le matter of animal
origin and .carries Intestinal bacteria.

May 28, 1901.
American Strawboard Company, Kokomo, Ind.

Sanitary Water Analysis.

Samples marked **Wild Cat Creek, about 150 feet below slaughter-
house on same aide of stream. May 20, 1001."

Parts per 100,000.

Digitized by VjOOQIC

Appearance—

Turbidity very slight.

Sediment : very slight.

Color slightly yellowish.

Odor distinct.

Clilorine 2.0

Solids-
Total 38. 3

Volatile 6.6

Fixed 26.7

Nitrogen

Free ammonia 0.002

Albuminoid ammonia 0.015

Nitrites abundant.

Nitrates traces.

Bacteriological examination-
Intestinal bacteria present.

Opinion—

This is a polluted water. It carries putrescible matter of animal
origin and carries intestinal bacteria.

Dr. Davis moved, after the Board had fully discussed all the
above reports, that permits be issued in each instance, as recom-
mended by the Secretary, said permits to expire December 1,
1901.

The following letter from the Richmond Country Club was
read:

State Board of Health:

Gentlemen— We beg to advise your Honorable Body that we have
leased the John P. Smith farm, immediately west of the city, same to be
used as a Country Ciub. A small stream. Clear Creek, runs through this
farm and carries the sewage from the P^astern Indiana Hospital for the
Insane. The sewage accumulates in various places, stagnates and be-
comes exceedingly offensive and unhealthful, especially in hot weather.

The membership of the club is over 20O, and we feel that we should
have some relief from this condition, and respectfully petition your Hon-
orable Body for relief. We remain

Very respectfully,

THE RICHMOND COUNTRY CLUB,

By Board of Directors.

In regard to the above, the following resolution was mtrodueed
by Dr. Davis. Same was unanimously adopted :

Whereas, upon complaint, the Secretary of the State Board of
Health, the Secretary of Wayne County Board of Health, and

Digitized by VjOOQIC

the City Health Officer of Richmond, Ind., visited the Eastern
Indiana Hospital for the Insane, at Richmond, and foiind sewage
from said asylum floAving into a small stream known as Clear
Creek, and

Whereas, It was the unanimous conclusion that the inflow of
said sewage from said asylum constituted a niiisance. rendering
said stream offensive and unsanitary, and

Whereas, Tliis day. May 28, 1901, a further complaint has been
presented to the Board from the Country Cliib at Richmond, Ind.,
declaring the stream foul and offensive and demanding relief,
therefore, be it

Resolved, That the State Board of Health of Indiana declare
the said Clear Creek in an unsanitary condition and a nuisance in
consequence of the sewage flowing into said creek from the Eastern
Indiana Hospital buildings, and be it further

Resolved, That the Secretary of the State Board of Health is
hereby ordered to serve a notice on tlie trustees of said hospital to
abate the nuisance by making other sanitary disposition of the
sewage as soon as practicable.

The following letter was then read :

Richmond, Ind., May 27, 1901.
To the S^tate Board of Health:

Gentlemen—The Richmond Gas Manufacturing Company, or Light
H<eat and Power Company, cause and permit to flow, run and drain from
their gashouse, through pipes and drains, into Whitewater river, water con-
taining quantities of crude oil, tar and otlitT refuse matter. th?reby^poUut-
Ing said stream, making the water unfit for stock to drink, causing a nau-
seating stench where raceways and dams are locateil, and tlierel)y menac-
ing public health. Fish in large numl>erK have lK»en found dead at points
where the water was still, at points below said gas factory, and live fish
have been taken that were unfit to eat because of the strong taste and
smell of oil. tar or petroleum found in them.

That this complaint may be more fully investigated, you are respect-
fully requested to cause an examination to be made of said drains and
river, and of such witnesses as you may deem proper to call before you
at Richmond.

Yours respectfully,

WILL S. ILIFF,
State Deputy Fish and Gume Commissioner.

Digitized by VjOOQIC

After due consideration the Secretary was instructed to inform
Mr. Iliff that the matter of which he complained did not come
under the jurisdiction of the State Board of Health, but it did
come under the jurisdiction of State Fish Commissioner. If the
Richmond Light and Power Co. is placing into the stream any
chemicals or refuse sufficient to kill fish the matter must be at-
tended to by the Fish Commissioner.

Adjourned.

Digitized by VjOOQIC

THIRD QUARTER.

May^ June and July^ I90U

Office Indiana State Board of Health,

Indianapolis, Ind., July 12, 1901.

Present: Drs. Forrest, Wishard, Cook, Davis, Hurty.

President Forrest called the meeting to order at 3:30 p. m.

The minutes of the last regular and two special meetings of May
6 and May 28 were read and approved.

Report of the Secretary for the quarter ending June 30, 1901,
was then read as follows:

REPORT OF SECRETARY FOR QUARTER EXDIXG

JUjS^E 30, 1901.

During the quarter the regular monthly statistics have been
collected, tabulated, classified, analyzed and published as usual.
The analyses printed in the April, May and June numbers of the
Bulletin set forth the facts concerning mortality in the State for
the periods named.

Xinetecn visits were made as follows: Seventeen by the Secre-
tary and two by Dr. Ferguson.

April 9— Greentown, account of smaUpox.
April 14— Connersville, account of smallpox.
April 15— Lebanon, account of inspection of water supply.
April 20— Earl Park, nccount of smallpox.

AprU 25— Yorktown and Muncie, account of inspection of strawboniti
plantEt

April 30— Alexandria, account of smallpox.

May 4^Fountaintown, account of smaUpox.

May 7— Shelby viUe, account of smallpox.

May 1>— Greenfield, account of summons to court.

May 10— Anderson, account of insix'ction of tin plate plant.

May 10— Muncie, account of inspection of Muncl« Pulp Co.'g plant.

Digitized by VjOOQIC

May 15— Erkhart and South Bend, account of smallpox.

May 20--Kokomo, account of Inspection of strawboard plant.

May 24— Elwood and Atlanta, account of inspection tin plate mills.

June 1— Stockwell, account of smallpox.

June 9— Vincennes, account of smallpox. Dr. Fer^son.

June 13— Colfax, account of smallpox.

June 15— Portland, account of smallpox. Dr. Ferguson.

July 6— Columbus,' account of smallpox.

July 7— Decatur, account of smallpox.

Full reports of all these visits are appended, with the excep-
tion of those concerning inspection of tin plate and strawboard
plants, which have been fully reported heretofore and acted upon
bv this Board.

VISIT TO GREEXTOWN ON ACCOUNT OF SMALLPOX.

On April 8 I received a message by telephone from Dr. Powell,
Health Officer at Greentown, Howard County, saying they had
what he believed to be smallpox at that point. His diagnosis was
disputed and the people were very much excited and, therefore,
he desired that some one from the State Board of Health should
visit the place and make an authoritative diagnosis. I left the
next morning, going by the way of Marion. Upon arrival at
Greentown, I met Dr. Powell and also Dr. Smith, the latter being
Secretary of the County Board of Health. With these gentlemen
I visited several cases of eruptive disease w^ithin the corporation
of Greentown and in ovovy instance found it to be mild smallpox.
We also visited several cases in the country surrounding, ^vithin
a radius of about three miles. All of these cases of eruptive dis-
ease were foimd to be smallpox. Quarantine had already been
established, but further directions w^ere given for the proper care
of the patients. A large company of the citizens met in an empty
storeroom and requested that I should speak to them on the sub-
ject of smallpox. I accordingly did this, telling them briefly
concerning the disease and how it might be prevented by vac-
cination. I have since learned that no opposition was made to
quarantine and no further denial of the diagnosis after my visit.
Xo more cases appeared because, presumably, of the efficient
quarantine.

Digitized by VjOOQIC

VISIT TO CONNERSVILLE ON ACCOUNT OF SMALLPOX.

On April 13 I received a telephone message from Dr. Spill-
man, of Connersville, informing me that he had two cases of
eruptive disease which he believed to be smallpox, but as the diag-
nosis was denied and as the people resisted quarantine, he re-
quested that a State Board of Health representative be sent. I
accordingly went there April 14, and with Dr. Spillman visited
the cases of eruptive disease and foimd them to be smallpox. The
opposition was relieved and quarantine easily maintained. One
week after this visit Dr. Spillman was taken down with the disease
himself, and it was almost one month before he was at work
again.

VISIT TO EARL PARK ON ACCOUNT OF SMALLPOX.

On April 19 I received a telephone message from Dr. Mc-
Ifahon, who told the old story in regard to the eruptive disease
which he believed to be smallpox, but which other physi-
cians denied to be smallpox. The Mayor of the town joined
with Dr. McMahon in requesting that the State Board of Health
send a representative to settle the matter. I accordingly went
to Earl Park, April 20, and visited the case with Dr. McMahon
and found it to be true smallpox. Xo cases appeared after this
visit and I believe it was because of the firm diagnosis and action
of Dr. McMahon and, therefore, congratulate the citizens of
Earl Park in the matter.

VISIT TO ALEXANDRIA ON ACCOUNT OF SMALLPOX.

On April 29 I received a telephone message from Dr. Osborne,
Health Officer of Alexandria, telling of several cases of eruptive
disease in the neighborhood of the city which had been variously
diagnosed. He believed the cases to be smallpox and wished the
advice and authority of the State Board of Health in the prem-
ises. The Mayor joined with Dr. Osborne in requesting aid
from the State Board of Health. I accordingly went to Alex-
andria, April 30, and, with Dr. Osborne, visited several cases of
eruptive disease within two miles of the corporation of Alex-
andria. All of the cases proved to be smallpox and the public

Digitized by VjOOQIC

declaration to that effect was made and proper quarantine es-
tablished. Only two cases appeared after my visit and I believe
this was due to the rigid quarantine and the general vaccination
which was practiced.

VISIT TO FOTJNTAINTOWN ON ACCOUNT OF SMALLPOX.

•

On May 3 I received a telephone message from Dr. Pierson,
practicing at Fountaintown, telling of a case of eruptive dis-
ease w^hich he believed to be smallpox, which was in the country
not far from his place of residence. He requested that the State
Board of Health send some one to confirm the diagnosis, as some
persons disputed it and it was hard to establish quarantine. Ac-
cordingly I went to FountaintoAvn the next day. May 4, and visited
the case, a woman of sixty-five years of age. She had been to
Indianapolis and stopped at a house next to one where quaran-
tine was being maintained on account of smallpox. Her
eruptive disease was unquestionably smallpox. All of the in-
habitants of the house were vaccinated and strict quarantine
established. Subsequent facts proved that the vaccination w^as
too late to prevent the disease, for every member of the family
had it, but in a very mild form indeed.

VISIT TO SHELBYVILLB ON ACCOUNT OP SMALLPOX.

On May 6 Dr. Samuel Kennedy telephoned me that he had
found two very suspicious cases of eruptive disease, that he was
much puzzled, and would like exceedingly to have advice and aid
from the State Board. I accordingly went to Shelbyville, May 7,
and with Dr. Kennedy visited the cases in question. They were
the children of a day laborer and plainly were not smallpox, but
were unquestionably cases of impetigo-contagiosimi. Dr. Ken-
nedy IS certainly to be congratulated for the care he took in this
instance to make sure in the matter.

VISIT TO ELKHART AND SOUTH BEND ON ACCOUNT OF
SMALLPOX.

Dr. Hill, of South Bend, telegraphed, wrote a letter and also
telephoned me that there were several cases of eruptive disease
in the neighborhood of South Bend, and he had heard it was at
Elkhart and requested the State Board of Health to aid them.

Digitized by VjOOQIC

On May 15 1 went to Elkhart, and upon investigation found two
cases of inipetigo-eontagiosum, but no cases of smallpox. In the
neighborhood of South Bend, in the country, there were found
five cases of mild smallpox. These were imder quarantine and all
dispute as to the diagnosis was removed, and the (juarantine made
^ectiv^e. I believe there w^as no spread of smallpox from these
cases, although several cases have appeared in the same com-
munity since, but evidently proceeded from other infection.

VISIT TO STOCKWEI.L ON ACCOUNT OF SMALLPOX.

Smallpox had prevailed more or less in Tippecanoe County for
several weeks, 'when I received a telephone message from a mer-
chant in Stockw^ell, asking that the State Board of Health send a
representative to settle the disputes as to what the disease was. I
accordingly went to Stockwell, on June 1, and there visited five
cases of eruptive disease and found every one of them to be small-
pox. Quarantine had already been established and fortunately
observed, desi)ite disputes which existed in the community. Vac-
cination was recommended and tw^o of the doctors of the place
entered heartily into the work, and many of the citizens, young
and old, were vaccinated that day. I have heard of no further
spread of the disease at Stockwell.

State Board of HealSi:

Gentlemen— In pursuance of your instructions, I visited yineennes,
June 8. With Dr. L. M. Beclies. secretary of the county board, I visited
the family of George Henry, and found Mrs. Henry in the pustular stage
of variola. All the other members^of the family had been down with the
disease and were practically recovered. I found the house under quaran-
tine, but no guard in attendance. One nienil>er of the family had worked
in a brewery, and another had worked in a basket factory during the early
eruptive stage. The exposed fellow- work men were promptly vaccinated
by the city health officer. The visit was necessary to establish diagnosis,
which was disputed, and in consequence quarantine was difficult to main-
tain. C. E. FERGUSON.

VISIT TO COLFAX ON ACCOUNT OF SMALLPOX.

Letters had been received from Dr. Lauihert, Health Officer at
Colfax, requesting aid and advice from the Stat<*- Board of Health
in regard to several cases of eriij)tive disease found in his town.
I went tc' ( "olfax June 13, and with Dr. Lambert and Dr. Mc(jluire,
visited five families and in every one of them found smallpox

Digitized by VjOOQIC

existing. In one family there were seven members and all had
had the smallpox. In another there were five members and three
had had the smallpox. The father and mother were vaccinated
and had good scars and escaped the disease. In all there were
fourteen cases discovered. The doubt and dispute as to what
the disease was, seemed to have been removed by my positive
diagnosis, and rigid quarantine was established and maintained.
Vaccination was advised and was generally practiced. There
has been a few cases in Colfax since my visit, but at the present
date it is entirely extinguished.

VISIT TO PORTLAND ON ACC^OUNT OF SMALLPOX.
State Board of Health:

Geutlemen— Affording to insti-uction, I visited Portland on the 14th
inst., and in company with Dr. J. (t. Itoss, county health officer, called
upon Mr. Wright, who waH recovering from an atttick of smalliMJX. I
found that every precaution had been taken. There was a girard at the
house, a nurse in the house, and a physician employed to look after the
case. All mem))ers of the household had been vaccimited. The visit was
necessary because of disputed diagnosis and dissatisfaction of the people.

C. E. FERGUSON, M. D.

VISIT TO COLUMBUS ON ACCOUNT OF SMALLPOX.

On July 5 I received a telephone nievssage from Dr. Kirk-
patrick, Health Officer of (\>lunil)us, Ind., giving information of
the ap])earanoe of a case of suspicious eruj)tive disease. He was
confident it. was smallpox, but some of the merchants and citizens
were not satisfied and one or two physicians disputed the diag-
nosis. He therefore requested that the State Board of Healtli
send a diagnostician to establish the character of the disease,
positively. I accordingly visited (\)lumbus on July 6, and was
taken to visit the case in question, a man about thirty-five years
old who had been removed to a tent outside of the city. The
case was unqucvstioned smallpox. The man had been taken from a
miserable house where probably ten or twelve persons had been
ex}x>sed. These were all j)laced under quarantine after vaccina-
tion. Before leaving Columbus, a number of physicians of the
city, with the Mayor and other citizens, met me in public meet-
ing in the council chamber. I was requested to give all the in-
formation I had uix>n the subject and any advice that might

5-Bd. of Health. ^ j

Digitized by VjOOQIC

seem proper. The said authorities were advised to procure vaccine
and oflFer free vaccination to all who would accept The Mayor
said this would be done. The physicians present were a unit in
believing that the case in question was pure smallpox.

VISIT TO DBOATUB ON ACCOUNT OP SMALLPOX.

Dr. Costello, Health Officer of Adams County, first wrote a
letter giving full information in regard to several cases of eruptive
disease existing at Decatur and in the neighborhood. He gave
the information that all of these cases, in his opinion, were small-
pox, but that the diagnosis was violently disputed. This interfered
materially with quarantine and with efforts to prevent the spread
of the disease. Afterward he telephoned twice and sent a telegram
urging that the State Board of Health send a representative to
settle the matter. On July 7 I went to Decatur by the way of
Marion, and, with Dr. Costello, visited several cases of eruptive
disease in Decatur, and found every one of them to be smallpox.
We also visited several houses in the coimtry, and found other
cases of smallpox. In the family of a Mr. Wood, who kept a
general store at Pleasant Mills, three cases of smallpox were dis-
covered, and the father, mother and older brother, who had been
vaccinated, escaped the disease entirely. At the house of a Mr.
Martz, a farmer near Pleasant Mills, all of the persons had had
the disease. This was evident from the history obtained and from
the pittings and markings which were to be seen upon the persons
concerned. At Decatur a conference was held with the Mayor
and the Board of Health, several citizens of the city attending.
The authorities were sure the cases were smallpox, although the
City Health Officer, Dr. D. D. Clark, denied that the disease ex-
isted. He was supported in this statement by Dr. J. S. Coverdale
and C. S. Clark. The very loudly expressed opinion of these gen-
tlemen made it difficult to convince the people that smallpox ex-
isted, and that it would be necessary to take active and positive
measures against it. The Mayor, however, accepted the situation
and assured me that all the rules of the State Board of Health
applying to infectious and contagious diseases would be rigidly
enforced. The authorities were advised to purchase a formalde-
hyde disinfecting apparatus and an abundant amount of f ormalde-

Digitized by VjOOQIC

hyde, and disinfect every house that was infected. They were
also advised to purchase fresh vaccine virus and offer free vaccina-
tion to all citizens.

Captain James L. Anderson was appointed to the position of
Chief Clerk of Vital Statistics.

By Dr. Davis :

Whereas, The Secretary of the State Board of Health is by stat-
ute empowered to appoint all clerical assistants ; therefore be it

Resolved, The Secretary has the power to suspend any employe
of the Board for cause, and any employe who is suspended shall
have the right of appeal to the State Board at its next regular meet-
ing ; and in case the suspension is sustained, the employe shall be
discharged. During the period between suspension and final dis-
charge no salary shall be paid.

Carried.

By Dr. Davis:

Resolved, That whenever any State Institution shall apply to
the State Board of Health for water or any other analyses," the
Secretary is hereby ordered to make the same at the expense of
the board's general fund.

Carried.

• CLAY CITY SCHOOLHOUSE.

Clay City, Ind., July 9, 1901.
To the State Board of Health:

As members of the school board for the incorporated town of Clay
City, in Clay County, Indiana, would respectfully request and petition
your honorable board to rescind the order condemning the schoolhouse in
our town, for the following reasons, to wit:

That the present building can be repaired with but little expense,
that wiU render it safe, if it is not safe at the present tin;ie.

That the rooms are well lighted, being five large windows to each room.

That the floors of the first story are not on the ground, but that- said
floors are at least^twenty inches above the ground and the space between
the ground and the floor is well ventilated, there being as many as twelve
openings in the wall for the air to circulate. The rooms are reasonably
high between Joints, and no complaint as to the health of scholars who
attended, and we believe the average attendance has been such for sev-
eral years that it would compare favorably with the best schools of its
class in the State.

That the playgrounds are high and dry and well suited for the pur-
poses for which used, and not muddy only when the frost is coming out
of the ground, at which time the soil, being clay, is somewhat muddy.

Digitized by VjOOQIC

The vaults of the pHvy nro kept clean and disinfected and are in a
good state of repair.

We believe that with the expenditure of not to exce?d $1,000.00 the
house will subserve its purposes until a fund can be provided for, so that
with the addition of 2 i>er cent, levy, a schoolhouse. in all things modern,
can be constructed.

The 2 \ror cent., the constitutional limit, provides only $7,440, which
in our judgment is not sufficient by half for that purpose.

We know of no other plan that can be adopted that will provide
schools for our town except to repair the present schoolhouse, to improve
its sanitary conditions, that it may be useful until funds can be provided
to construct a modern schoolhouse.

We are satisfied that some of the complaints or objections heretofore
made to your honorable l)oard concerning this school building have been
exaggerated.

We submit these facts to you, believing you will allow us to repair
the building, that schools may commence in the usual time.

Respectfully submitted,

W. H. H. ASBURY, President.

J. H. TRAVIS, SecretaiT.

Clay City, Ind., .July 10, 1901.
State Board of Health, Indianapolis, Ind.:

Gentlemen— I hear that our School Board, or one member of same, who
is adverse to any outlay for a good school here, intends to try. or has
tried, to get your honorable board to permit the use of our old school
building by putting a little makeshift repair to same. Enclosed you will
find an impression cojjy of a petition to said School Board, laid before
them in May last and signed by between fifty and sixty of our best citi-
zens and taxpayers and patrons of the schools of our town. Two members
of the School Board are in favor of complying with the requests of this
petition. The other me,mbcr is against it, and seems temporarily to con-
trol the town trustees, who adopte<l the adverse member's report in favor
of repairing the old building, in defiance of your honorable board, and
thus refusing to vote the money ne(»essary for a new school building. The
attorney for the School Board says the town trustees can not legally refuse
to vote the money for a school building, so their act is null and void.

The S<hool Board has had two architects examine the old building.
One of them pronounced the building wholly unsafe and dangerous.- Tlie
other gave It as his opinion that It would be inadvisal)le to try to repair
it, as it would then stand but a few years at best, and the outlay on it
would ])e heavy, and strongly recommendtMl the building of a new eili-
fice. But the opponents of this, who, in tlie main, have no children to send
to school, persist in ignoring the order of the Stfite Board of Health, and
abuse you. myself and all the friends of a safe, healthy and suitable
school building. The nuijorlty of the taxpayers and school patrons want
a good school buihling and a gmxl school, which, heaven knows, we np<*d
badly. All we ask is that the State Board of Health will stand by Its con-
demnation of the old building and will not consent to or encourage Its
repair, as it is fundamentally bad from foundation to roof, and has been

Digitized by VjOOQIC

so pronounced by every architect that has examined, and their opinion is
filed in writing with the School Board, by whom these architects were
employed. I can not find time to go around and get all the signatures to
this copy of our petition to the School Board again, as my brother did last
May, but send it to you with a few of these signers' names, so you may
see for what we asked and which two members of the three of the School
Board are in favor of doing. The one who opposes has possession of the
original copy, and refuses now to even let us see it, else I should have
mailed it to you. I thinli if the State Board of Health, when they act on
this matter, as I understand they are to do on the 12th, would order you
to advise our School Boai'd that if they undertook to use the old building
for school purposes the Attorney-General would bring suit against them,
that they would not attempt its repair, and we would get our new build-
ing and a good school. They can not do otherwise.

We leave this matter in your hands, and have no fear of the out-
come, as you believe in safe, healthy buildings and a good school. We
hope to hear from you, and am, very truly yours, •

W. H. GUIRL.

To the Honorable Board of School Trustees, Clay City, Indiana:

Gentlemen— "VXTiereas, Present school building of our town has been
condemned as unhealthy and unfit for use for school purposes by the
State Board of Health, and has l>een condemned as wholly unsafe and
dangerous by competent architects; and

Whereas, The secretai*y of the State Board of Health has advised your
honorable body that the Attorney-General of the State would bring suit
against the school board if an attempt was made to use the old building
for school purposes, thus involving the town in expensive litigation and
hurtful notoriety; and

Whereas, We believe it to be for the best interests of our town and
township that Clay City be provided with a first-class building, sufficient
and ample for the needs of a first-class graded common school, and suf-
ficient and ample for a commissioned high school as well; therefore, be it

Resolved, That we, the undersigned citizens, taxpayers and patrons
of the school, miite in petitioning your honorable board to ask the tnistees
of the town of Clay City to provide the necessary funds by a bond issue
and the Issue of wan'ants, to purchase the three (3) Oberholtzer lots lying
east of the old school building on White Sti-eet, and to erect a new school
building, modern in style, construction and sanitary provisions, and suf-
ficient in size to accommodate a graded school and a commissioned high
school, and to anticipate the growth of the community to whatever ex-
tent your board may deem wise.

We, the undersigned petitioners, think it veiT bad business policy, and
in the long run a waste of taxpayers' money, for the board to undertake to
use any part of the old school building, Iwcause of condemnation by author-
ities and because the foundation Is too low. We would not oppose the use
of any good brick that may l>e found In the old building, but do not
believe any other material there ought to be put In a new building.

In conclusion, it is the sense of the signers hereto that the new school
building should provide rooms and facilities for a commissioned high
school as provided by law.

/Google

Digitized by VnOOQ I

We believe, too, that all possible expedition should be used In securing
suitable plans and letting the contract for the building and in its con-
struction, in order that our children may not be without school privileges
for the coming school term.

We have at heart the good of our town for the present and future,
and believe that It is our duty, first of all, to give our children the advan-
tages and training of a moral and literary education. The common schools
are the hope of our town and country.

Signed by Fifty Citizens.

Clay City, Ind., July 12, 1901.
Indiana State Board of Health:

Dr. J. A. Modesitt has just handed me your letter of the 11th Inst, and
I note what you say with reference to Mr. W. H. Asbury's communication,
and as to his statement that It is a "financial impossibility" for the town
of Clay City to build a new school building, the fact of the matter is that
Dr. Asbury and other members of the Board of School Trustees know
that this Is not true. The School Board has a written opinion from the
best legal mind In Clay County that a school building can l)e built and
the money raised by an issue of bonds amounting to $7,440, which is all
we can raise In that way under the constitution, then the warrants of the
town can be issued for the remainder of the money and discounted. If
they could not get anybody else to build a schoolhouse in this way, I would
undertake gladly to do it myself and take the paper In payment. The fact
Is, these people haven't any children to send to school. They don't care
anything about schools, and they are determined unalterably that we shall
not have a new school building here, and make any kind of statements
and claims to bolster up their desires. As I have said before, the School
Board has in its possession from Its attorney, to whom they went on my
advice, a written opinion that there is no trouble at all about building a
new schoolhouse from a financial point of view. There is a lot of nasty,
dirty, pothouse politics underneath and back of this statement and letter
of Asbury's, and that is all there is in it. If the State Board of Health
stands by us, and I have not the least doubt that it will, those people will
be forced to give us a new and good school building, and I do not doubt
the issue for one moment. The State Board of Health, In my judgment,
should, through you, advise these people that the Attorney-General will
bring suit against them if they undertake to use the old building for school
purposes under any circumstances, repaired or otherwise.

I thank you for your letter of the 11th, and the Interest you take in
the matter and for your sympathy in our efforts to get what the citizens
of Indiana are supposed to have, namely, a school building that will not
fall down on our children or cause them sickness.

I hope to hear from you again, and am, very truly yours,

W. H. GUIRL.

Whereas, A petition signed by W. IL II. Asbiiry and J. H.
Travis, of the Clay City School Board, asking the State Board of
Health to rescind a former order of condemnation of the Clay City
schoolhouse, has been received and duly considered ; and ^ ^

Digitized by VjOOQIC

Whereas, There has been also received a petition signed by a
number of citizens of Clay City urging that the former order of
condemnation be sustained, therefore, be it

Resolved, The State Board of Health does hereby sustain its
former action condemning the Clay City schoolhouse.

Unanimously carried.

Indianapolis, Ind., July 11, 1901.
State Board of Health:

Gentlemen— At the request of citizens and J. P. Johnson, trustee of
Washington township, I made an inspection of school buildings Nos. 8
and 10 in said township, and found the following conditions:

These buildings were constructed about forty-five years agio. The
foundations were crumbling and full of holes. The buildings are badly
out of repair and dilapidated. A new floor has been put on top of the
old one in No. 10, and the old floor in No. 8 is in bad condition. The roofs
of both buildings are badly decayed. The ceiling in No. 10 is now and
has been propped up for several years and the flues of both buildings are
actually dangerous, being constructed on the celling Joist The windows
are not hung on weights, the upper sash being stationary, so that it is
impossible to properly ventilate the room without subjecting the pupils
to draft of air. The plastering is very old and broken. Light and heat-
ing are unsanitary in the extreme. I am creditably informed that average
attendance at these schools last year was only seven or eight pupils.
These can be transferred and much better cared for at Broad Ripple and
Nora, where there are new and much better equipped buildings. Con-
sidering the age and sanitary condition of these buildings, they are cer-
tainly unfitted for the purpose they were intended, and I therefore rec-
ommend that they be condemned for school purposes.

Yours very respectfully,

H. W. RIDPATH, Secretary.

After due consideration, the Secretary was directed to inspect
personally the schoolhouses named by Dr. Ridpath, at his earliest
convenience, and if he found them as reported, and if, in his opin-
ion, they were so unsanitary as to be unfit for school use, then the
same are hereby condemned, and the usual order of condemnation
should be issued and served. .

SCHOOLHOUSE, DECATUR COUNTY.
State Board of Health, Indianapolis, Ind.:

Gentlemen— This communication is in relation to the condemnation of
a room now being used as a schoolroom in school district No. 8, Sand-
creek Township, in the town of Letts, Decatur County, Indiana, G. W.
Fraley, trustee.

The majority of the patrons of this school have petitioned the town-
ship trustee to build an addition to the present school building. The

Digitized by VjOOQIC

trustee made requisition on Township Advisory Board for an appropria-
tion to build the addition asked for. The advisory board refused to pro-
vide the funds for that purpose.

The trustee made a reiiuest, which was recommended and approved
by the county superintendent .that the secretary of the County Board of
Health inspect the said building and take such action as might be neces-
sary to condemn it This matter w^as referred to the State Board of
Health for advice. A communication from the State Board of Health,
bearing date of June 11, was duly received, which says:

"We are informed by the Attorney-General, and have already fol-
lowed his instructions in every instance, that it is within the power of
the State Qoard of Health to condemn and close unsanitary schoolhouses.
The county health officer should inspect the schoolhouse and make a de-
scription of its condition; to this should be added the testimony of any
of the patrons of the school or of any officers who are willing to give
testimony, and also the health officer's conclusion and recommendations.

"Please, therefore, at your earliest convenience, proceed to the school-
house in question, in person, make an inspection and report as above
outlined, and do not fail to add your recommendations."

Under the above histi'uctions and order, I visited the schoolhouse com-
plained of, and the following conditions were found on investigation:

The main school building contains two rooms and an ante-room, or
entrance, on each side of which there is a cloak room the full length • of
the entrance, well arranged and commodious. From this hall, or en-
trance, you can enter either room. The schoolrooms proper are 28x30
feet, sixteen-foot ceilings. Each room is lighted by large windows on
three sides, which extend to within four feet of the ceilings. These
windows are screened, let down from the top, and can be raised from the
bottom, with curtains.

The building Is of brick, with a stone foundation, eighteen inches high,
slate roof, belfry and sightly appearance. Stands 150 feet back from the
public highway— a pike— fronting the north, in a lot containing about two
acres. There is a stone pavement leading from the road to the front door.

The surface water runs from the house on all sides. There are no
pools of water, low ground, or other surroundings that would favor dis-
ease. There are small shade trees along the pavement.

^There are no objections raised to the rooms described, except as to
the heating, which is by two large stoves, burning wood or coal. These
stoves do not heat the rooms so tlie pupils are comfortable in all parts of
the room.

There are 114 pupils enrolled in this school and (KiO in the township.
The village of Letts i.s very near tlie center of the township, and con-
tains aliout 2.")() population. Tlie school is a gradcMl school, and must ad-
mit scholars of the higher gi'adc^ from other portions of the township
when application Is made for admission. There Is not room enough In the
two rooms descrll)cd even for the pupils enrolknl in this school.

A former township trustee provid^Hl ^f or an emergency by constructing
for temporary netnls a room l<;x2<) feet. This room is built in front of the
main building, is resting on stone pillars at each end betwt^en comers,
the space being hidden by plank tacked to the walls of tlie house. It is

Digitized by VjOOQIC

weather-boarded with "shiplap" and neither lathed nor plastered'. The
inside of the walls, and also the ceiling, is lined with paper. There are
evidence that the paper ceiling and walls have been wet by the rain or
snow. The wind comes up behind the narrow baseboards and through
the floor and httic. The paper is separated at the joints of the walls and
celling and is torn In places.
' In this small room there are nineteen deslcs. This so crowds the room
that there is barely passageway for the scholars to enter or retire from the
room. It is, in capacity. Inadequate for the accommodation of the pupils
of either of these grades, and, necessarily, is a disturbance to the schol-
ars In the other rooms in their reclt^itions.

There is a small window in each side of the room, except the side
next to the main building. There is one entrance. Owing to the fact
that there is neither plastering nor other proper protection against the
cold, rain and dampness, It Is not possible at times for the room to be
kept comfortable, or in a healthful condition. This room is also heated
with one wood stove, which must be near one end of the room, and
while pupils near the stoves may be too hot, those farther away are cold.
This room was built with the intention of using It for a woodhouse, as
soon as a more appropriate room could be provided.

I have no hesitancy in saying that the last described room is unfit for
use as a schoolroom, from the conditions described.

Sand Greeli Township has property of assessed value worth $961,204,
without indebtedness.

The architect's estimate for one additional room, on the gi-ound, with
cellar and furnace, cloakrooms, etc., sufficiently large for prt^sent and prob-
ably future uses, all complete, would be alK)ut $2,(550.

This expenditure would afford sufficient room and heating for the en-
tire building, and make it possible for the trustee to comply with the re-
quirements of Act S. B. No. 73, p. 27, Appendix School Laws, 1890.

All of which Is most respectfully sul)mltte<l,

JOHN II. ALEXANDER,
Secretary Decatur County Board of Health.

I enclose the petition of the patrons of the school, the request of the
Township Trustee, endorsed by the County Sui)erintendent, also a letter of
a teacher in the last winter's term, for your consideration, which ^vill per-
haps fill the requirements of the instructions from the Attorney-General's
ofllce. J. H. A.

Greensburg, Ind., July — , 1901.
To the. Board of Health:

Having taught one term at the Letts Corner school, I would say the
following concerning the building there:

The two larger rooms are too large to heat with stoves. The small
one built supposedly for temporary use, was l>uilt hastily and was never
plastered. Building paper was nailed to the inside of the weather-board-
ing to keep out the wind, and the ceiling was simply paper nailed to the
Joists. Around the room was a baseboard. l)eliind wliich filth was bound
to ax?cumulate, as it was imiK)sstble to sweep behind it. On l)lustery,
snowy days, the snow blew in through the cracks around the window

Digitized by VjOOQIC

casing. The scholars who sat near the windows stuffed the cracks with
paper to keep out the snow.

The room is about twenty feet long by sixteen feet wide, and con-
tains eighteen seats, a stove and a teacher's desk. The seats along both
sides were against the wall. Neither was there any space behind the seats
in the rear of the room. The seats extend so near the front that two per-
sons can scarcely pass in front of them.

It is easily seen that the room was crowded when none but the regu-
lar scholars were In it. As I taught four grades, It was necessary to
have the other grades sit in one of the larger rooms and come to the
smaller one to recite. This being the case, there were from twenty-five to
thirty-four pupils in the small room nearly half the time. It was, of
course, necessary to open and close the doors of both the rooms numer-
ous times each day, thus making it hard to keep them warm. As the
weather-boarding is thin, it was hard to heat the small room under the
most favorable circumstances. Some were hot while others were cold.

Owing to the above conditions, the teacher who taught there prior to
myself was constantly in ill health. I also know pupils who were sick
from the same cause. And one child remained in the same year two years
as a result of sickness caused by the poor sanitary condition of the room.

The above statements are not overdrawn, and a look at the building
will convince any one of its unsanitary conditions. This, coupled with the
fact that a great per cent, of the pupils are away from the teacher to
whom they recite except during recitations, makes it impossible to ac-
complish the best results in school work.

Respectfully,

DWIGHT A. MURPHY.

i
Greensburg, Ind.. June 5, 1901.

Dr. J. H. Alexander, Secretary County Board of Health Decatur County,
Greensburg, Ind.:

Dear Sir— We beg leave to call your attention to the school building in
District No. 8, Sand Creek Township, Decatur County, Indiana, known
as the Letts Comer School. I believe the building needs the addition of a
new room, and of a better heating and ventilating system. The building
as now constructed, consists of two rooms of brick, each about 36x26 feet
inside and 16 feet high, and one temporary frame room about 16x20 feet
The brick building is heated by one stove in each room. Each room has
windows on three sides, windows extending to within about four feet of
celling.

The frame structure is boarded on outside and covered with paper
on inside, without plastering. It is small, poorly lighted and poorly venti-
lated. Only one-half of pupils In that room can be seated therein, others
being compelled to pass in from another room for recitation purposes,
making the room closely crowded during half the day.

There are 114 pupils enumerated in the district, with an attendance of
about 100. Three teachers are employed. I respectfully ask that you
Investigate the conditions from sanitary point of view and recommend
such changes as you see fit

Digitized by VjOOQIC

Fifty patrons of the district liave petitioned the Trustee of said town-
ship and the Advisory Board, aslcing for an appropriation to cover expense
of erecting a new room. The Advisory Board have refused to grant the
request of petitioners. Said petition accompanies this request I also ask
you to investigate the condition of the well and quality of drinking water.

Most respectfully,

G. W. FRALBY,
Trustee of Sand Creek Township.

I endorse the above recommendation's.

ELMER C. JERMAN,

County Superintendent

To Geo. W. Fraley, Trustee Sand Creek Township, Decatur County, Indi-
ana, and the Advisory Board:
Whereas, The little frame building used as a schoolroom in District

No. 8, situated in Letts, is. incommodious, uncomfortable and In every way

insufficient for the needs of the childi-en who occupy it; therefore.

We, the undersigned voters and patrons of said district, petition you to

build a room that will meet the requirements and comforts of the children

who may occupy it

Signed by Fifty Citizens.
Trafalgar, Ind., June IS, 1901.

Dr. J. H. Alexander, Greensburg, Ind.:

Dfear Sir— I wish to write to you Just a few words with reference to
the school building at Letts. I was principal of the school there for two
years and am well acquainted with the conditions of affairs existing there.

The last year I was at Letts the actual attendance reached 115. That
year, to the original structure of brick, consisting of two rooms, a small
frame building was annexed. This frame annex is in size about 16x20
feet, poorly lighted, heated and ventilated. It is lined with building paper,
in lieu of plaster, and has little or no underpinning. In mid-winter the
atmosphere, about four feet from the floor, may reach a temperature of
90 degrees, while at the floor it is not above 40 or 50 degrees.

This room was originally intended for recitation purposes only, but
later, owing to the crowded condition of the other rooms, it was furnished
with about fifteen desks. Hence, when a class enters from the other build-
ing for recitation, this small, i>oorly ventilated room contains from twenty-
five to thirty pupils. •

This room is connected to the main building by a small hall or "ante-
room" through which each class must pass in going to and from recita-
tions. You, who are a physician, are better able to judge of the effect
in cold weather of this frigid change of temperature upon the health of
scantily clad children than I. Each of the rooms in the main building is
large enough to accommodate about thirty-five or forty pupils. When I
was there the actual attendance in my room reached fifty-nine and in the
primary room forty-five. To make seating capacity, desks were so
crowded together that a pupil could not stand and work at the front
blackboard and leave sufficient room behind him for a class to pass out to
recitation, and the aisles were narrow in proportion.

/Google

Digitized by VnOOQ I

Investigation will show that the "Letts school has lost much time in
the last two years from infectious diseases. I firmly believe that the
wretched accommodations afforded are to blame for much of it.

The patrons there are contending with a parsimonious advisory board
for a new room. I earnestly trust that you will take the matter in your
hands and do for them all that 3'our office, as Secretary of the County
Board of Health, empowers you to do.

Very respectfully yours,

ORAN E. BURTON. .

Letts, lud., June 18, 1901.
J. H. Alexander, Secretary Decatur County Board of Health:

I have been a practicing physician in the town of Letts for two years
and a half and have examined the school building and found it in a very
poor sanitary condition. The lack of space for comfortable sejiting, im-
proper ventilation and poor facilities for heating are greatly to be deplored.
The small frame building has none of the necessai-y qualities of a com-
fortable room and should be condemned and closed. I realize that from a
financial standpoint it would be much better for me to have the building
remain as It is, but for the good of the community I would insist on an
improved condition.

Respectfully,

J. A. WELCH, M. D.

After due consideration of the dociiinents concerning the Letts
schoolhoiise, the following action was taken:

Whereas, It has been shown by abundant evidence that the
frame schoolroom attaclied to the schoolliouse in District Xo. 8,
Sand Creek Township, Decatur, Ind., known as Letts Corner
School, is very unsanitary and a threat against the health of the
pupils; and

Whereas, The ventilating and heating of tlie two rooms of Uie
original structure are so poor and insufficient as to con^stitute an
unsanitary condition which is a threat against the health of the pu-
pils, therefore it is

Ordered, Tlie frame room attached to the schoolliouse, District
Xo. 8, Sand Creek Township, Decatur County, Indiana, known
as Letts Corner School, is hereby condemned for school purposes,
and the Trustee* of said townshij) is forbidden to use or permit to
be used for scliool i)urp<>ses said frame schoolroom ; and it is also

Ordered, That the original two rooms of the schoolliouse. Dis-
trict Xo. 8, Sand Creek Township, Decatur County, Indiana,
known as Letts School, shall not be used for school pur})oses unless

Digitized by VjOOQIC

the same are warmed and ventilated by an apparatus which \sdll
maintain an even temperature of not less thaii 70° F. during zero
weather, and which will change the air in each room at least four
times each hour ; and it is further

Ordered, Because necessary for the health of the pupils, that not
less than twelve cubic feet of space shall be provided for each
pupil. The County Health Officer of Decatur County shall see
that this order is served, and-, in case of failure of the Trustees to
obey each and every one of the requirements herein set forth, the
said officer shall inmiediately inform the State Board of Health
that suit may be brought by the Attornoy-Cicneral to compel obe-
dience and enforce the penalties of the law.

Passed in regular quarterly session of the State Board of
Health, July 12, 1901.

State Board of Health, IndianapoUs, Ind.:

Gentlemen— We, citizens of AVest Baden, Ind., wish to call yonr at-
tention to the notorious nuisance, "The West Baden spite wall. ' It Is a
stone structure four feet thick, let Into the ^ound from six to eight feet,
ciittin<; into and tlirough sewers, bloi'liing up the moutli of «ame. Tlie
wall Is about eight feet above the surface and (KK) f<*et in length. The
town of West Baden is built on a hillside. This wall is at the foot of the
hill. It has not onlj' destroyed all sewers, but It spans the natural drain-
age of the town, and with every daslihig rain that falls all of the
lilth from the clnset.»< al ove (a great many of which are built without any
vaults), the garbage thrown out into the l)ack yards and alleys, together
with all other filth of the town, is driven down against this wall, which
forms a dam. Thence Into cellars along the line, keeping tliem filled with
this foul water, floors damp, mould accumulating on furnitur-e and stock.
Rooms fllleil with foul air are oflfensive at any time, so much so that ujK>n
opening up in the mori^ing it Is necessary to throw open the doors and step
outside the house until the draught has partly driven out the stench.
Along the wall tlie stench is as foul as tlie worst kt^pt closet. This wall
was built by the Monon Railway Company on/ year ago last November.

The increase of disease sin(H? tlien has been alarming. Malaria, In
all its forms, has increased. Typhoid, a disease not known In the history
of West Baden until after the construction of this wall, has been very
prevalent, with several deaths. Tlie people of W(*st Baden and vicinity
petitioned the Monon ofiiclals, with *iuite a long list of signers, to abate
this nuisance, which was ti*eat(Hl with silent contempt. Then we api)litHl
to the Orange County r(»pr€»sentatives of Board of Health, who came down
and looked around and that was all. There was nothing done.

Very recently the railroad company raised their track In with stone,
giving the water still less chance to flow away from the buildings and at
the same time making no provisions whatever for drainage.

Digitized by VjOOQIC

The water stands in the cellars the year around and is foul to start
with. Standing, as it does from year to year, a frog would die in It The
health of our people demands an immediate relief from this nuisance, and
we, the undersigned citizens of West Baden, earnestly and respectfully
ask that your honorable Board take such action as will insure immediate
relief from said nuisance.

Signed by Sixty-four Citizens.

In regard to the petition from West Baden concerning a wall
built by the Monon Railway Company, it was

Ordered, That the Secretary should, as soon as possible, visit
West Baden, make a sanitary survey, and if, in his opinion, a
nuisance or unsanitary condition was caused by the wall com-
plained of in the petition, he should communicate with the rail-
road authorities and try to secure abatement of the conditions con-
stituting a nuisance of causing unsanitary conditions; and finally
make full report of what may be done.

By Dr. Davis:

Resolved, Wlienever any State Institution shall apply to the
State Board of Health for water or other analyses, that the Secre-
tary is hereby ordered to make the same at the expense of the
general fund.

Carried.

Digitized by VjOOQIC

FOURTH QUARTER.

August, September and October, t90t*

Office Indiana State Board of Health,

Indianapolis, Ind., October 11, 1901.

Present: Forrest, Hurty, Davis and Cook.
President Forrest in the chair.
Dr. Wishard being ill, was excused from attendance.
Minutes of last meeting read and accepted.

SECEETARY'S EEPORT FOR THE QUARTER.

The mortality statistics for the quarter will be found, as usual,
in the Monthly Bulletin. The Bulletin also contains an account
each month of the smallpox reported. Compared with last year,
the same quarter shows less smallpox. The reports gave for July
60 cases of smallpox and 1 death ; August, 100 cases, no deaths ;
September, 52 cases, 1 death. Both deaths in the quarter occurred
in Daviess County. The usual comment must be added that many
mild cases have probably been called chlckenpox, and therefore
do not appear in the record.

Owing to the fact that more clerical work is now done by the
Chief Clerk of Vital Statistics, and also of greater interest and
efficiency of the old members of the force, it was found possible
to dispense with the services of one clerk. Accordingly, the last
person employed was informed her services would not be required
after the middle of the month.

VISITS OF THE SECRETARY.

The Secretary made visits during the quarter as follows:
July 15— Elkhart, account smallpox.
July 17— Gas City, to inspect tin-plate mill.

Digitized by VjOOQIC

July 20— Anderson, to inspect strawboard plant and American Steel
and Wire CJo.

July 25— Plalnfleld, to Inspect Boys' Reformatory, account of typhoid
epidemic.

August 1— Letts Corner, account unsanitary sclioolhouse.

August 2— Cataract, account unsanitary sclioolhouse.

August 8— Aurora, account smallpox.

August 13— Daleville, accoimt farmers' meeting, to consider pollution
of streams.

Augtist 17— Warsaw, account of suspected smallpox and to advise con-
cerning sewers.

August 21— Danville, account of smallpox.

August 26— Home City, account unsanitary conditions.

Septemlier 8— ()ldenl)urg, account ('pldemic typhoid fever.

Septeml)er 24— Lovett, account dedication of sanitary schoolhouse.

September 25— JeflFersonville, account of typhoid fever in the State
Reformatory.

September 30— Union City, account of smallpox.

Detailed reports of these visits are appended.

ELKHART.

Elkhart was visited July 15, in obedience to a recpiest of the
Health Officer, Dr. Iloopengarner, who reported several cases of
smallpox, and said a few physicians denied his diagnosis. He
further stated that the city authorities and certain newspapers op-
posed publicity and preventive measures. In consequence of all
this, he desired help from the State Board. Upon arrival at Elk-
hart, I visited six cases of eruptive disease, and all were unques-
tionably smallpox. The city authorities were called upon and as-
sured the disease was smallpox, and their duties in the case made
clear. The local Health Officer was tlien instructed to rigidly
enforce the rules of the State Board of Health. Dr. Hoopengar-
ner is entitled to couuuendation on account of the firm stand he
took and the good work done.

CONCERNING THE TIN PLATE MILL AT GAS CITY.
To the Honorable, the State Board of Health of Indiana:

State of Indiana, Madison County, ss:

American Tin I'late Co.. a corporation owning and operating a manu-
facturing estal)li.shment at Gas City, Ind., Ivuown as Morcwood Works,
requests permission to discharge from said works into the Missiasinewa
river "spent pickle" and waste from boshes, rolls and engine pits.

Digitized by VjOOQIC

It now represents that the said Mississinewa river Is at such a stage
that such "spent pickle"* and waste may be discharged Into It without
injury to the public, and It praj's your honorable board to jrrant and issue
to it— American Tin Plate Co.— a written permit, allowing it to discharge
such "spent pickle" and waste into said river aforesaid, and that your
honorable body do hereby grant such permit.

AMKRICAN TIN PLATE COMPANY,

By BERTHOLD GOLDSMITH,

District Manager.
State of Indiana, Madison County, ss:

Berthold Goldsmith, being duly sworn, says that the facts stated in
the above petition are true, as he verily believes.

Subscribed and sworn to before me, the undersigned, a Notary Public,
on this the 17tli day of April, 1901.

CLARK A. PRICE,
Notary Public for Madison County, Indiana.

My commission expires June 15, 1{)03.

VISIT TO GAS CITY TO INSPECT TIN PLATE PLANT AT
THAT PLACE.

The visit was made July 17. The "spent pickle" from this plant
is discharged directly into the Mississinewa River, after mixing
it with the condensed water and cooling water from the bosh(?s.
For a considerable distance down the stream the water is unsightly
because of the iron oxide formed by decomposition of the pickle.
As before reported in connection with other tin plate mills, ^^spent
pickle" is a stringy solution of copperas in water. This is pro-
duced by stripping the sheet steel in dilute sulphuric acid so the
molten tin will coat it. The copperas and oxide of iron (rust)
which attends the decomposition of the copjwras, do not produce
unsanitary conditions, but both will kill fish and vegetation. The
destruction of vegetation at the edge of the stream is no loss, and
several merchants at Oas City and Jonesboro freely express the
opinion that the loss of the fish can well be afforded if necessary
■ to secure the mill. At one tinie a pond existed at this mill into
which all liquors were discharged. At the time of my visit the
dyke around the pond was broken and all liquor's from the mill
flowed into the stream. I recommended that a pond be con-
structed and that all "spent pickle" be discharged therein, and
said if this were done I would ask the State Board of ITealth to
grant a permit to discharge the condensed water and water from
the boshes directly into Mississinewa River. This promise was

t-Bd. of Health. /--^ i

/Google

Digitized by VnOOQ I

given by the Superintendent of the mill, and in accordance with a
resolution of the Board empowering the President and Secretary
to act, if no injurious refuse were to be discharged into the stream,
the following permit was issued:

Whereas, The American Tin Plate Company, a corporation
owning a tin plate plant at Gas City, Grant County, Indiana, has
heretofore filed with the Secretary of the State Board of Health
of Indiana its verified application in writing, asking permit to dis-
charge into a stream in said State known as the Mississinewa Eiver
certain waste water- from the rolls, engine pits and boshes, and
showing in such application that said stream was, at the time of
filing and making said application, at such stage as that such waste
water might be safely discharged into said stream without injury
to the public, and.

Whereas, Said State Board of Health has duly inspected said
stream above, at and below the point where said waste water
enters Mississinewa Eiver and has found and finds that said waste
waters may, for the period hereinbelow fixed, be safely discharged
into said stream without injury as aforesaid, and furthermore,
finding that said waste water is surely as pure as the waters of the
Mississinewa River; now.

Therefore, Said the State Board of Health hereby grants and
issues this, its written permit, hereby granting permission to said
American Tin Plate Co. to flow and discharge the waste water
from the rolls, engine pits and boshes of its plant at Gas City
into the Mississinewa River for a period extending from the date
hereof to the 1st of December, 1901.

This permit is given this day. May 27, 1901, by the State Board
of Health.

SCHOOLS Nos. 8 AND 10, WASHINGTON TOWNSHIP, MARION

COUNTY.

Report op Saj?itary Survey op Schoolhouse No. 10, of WAsraNoxoN
Township, Marion County.

In ax!cordance with the orders of the State Board, I made sani-
tary inspections of Schoolhouse No. 10, Washington Township,
llarion County, Indiana. The building was constructed in 1855,
is frame, dilapidated, foundation very bad, bad roof and the
ceiling propped by poles. It has four windows on each side and

Digitized by VjOOQIC

all of them are in such poor repair they can not be moved. The
room is warmed by an ordinary stove, and the flue is in a very bad
condition. There are no special provisions for ventilation and
the air can only be changed by the doors and windows and not by
the latter unless they are repaired. The seats are old style and
many are broken, the blackboards are warped but are a dead
black. The outhouses are separate, but are dilapidated. The
water supply is from a dug well and the same, in my opinion, is
not pure and wholesome. No analysis was made. This school-
house is about one and one-half miles east of the town of Nora
and at said town there exists a modern brick schoolhouse, sanitary
in every particular. It would be cheaper to transport the pupils
to Nora, where there is abundant room, than to care for them in
a new schoolhouse which might be built to replace No. 10. The
enrollment is 15, with an average attendance of 8. I reconmiend
that the schoolhouse be condemned as unsanitary and unfit for
school purposes.

Report of Sanitary Survey op Schoolhouse No. 8, of Washington
Township, Marion County.

In obedience with the orders of the State Board, I made a sani-
tary survey August 7, 1901', of Schoolhouse No. 8, Washington
Township, Marion County, Indiana. This house was built in
1855. It is frame and badly dilapidated. The foundation is
brick and is crumbling and is broken in many places. The door
enters the room directly, which is unprovided with cloakrooms.
There are four windows on each side, but in such bad repair they
can not be moved. No special means of ventilation have been
provided and the room is warmed by an ordinary stove. The
blackboards are of slate and acceptable in every particular. The
seats are new and are of different sizes for small and large pupils.
The roof is in good condition and the water supply, being from a
deep well with good pump, is very probably pure and wholesome.
There are separate outhouses, but the same are dilapidated and in
very bad condition. The enrollment at this schoolhouse is 16, the
average attendance 9, and the distance from Broad Ripple, where
a fine modern, sanitary school building exists, is one and one-half
miles. As the sanitary conditions of this schoolhouse are very

Digitized by VjOOQIC

poor and the only way to relieve the bad surroundings would be
to build a new building, I therefore recommend that this school-
house be condemned.

Mr. J. P. Johnson, Trustee, Broad Ripple, Ind.:

Dear Sir— We eu<'lose herewith official notification to you of the con-
demnation of Schoolhouse No. 8 and Schoolhouse No. 10, in Washington
Township. Unless these buildings are thoroughly remodeled and made
sanitary, they can not be used for school purposes. The penalty for dis-
obedience of this order is a fiue of not less than $10 nor more than $100.

Secretary.

CONDEMNATION.

Whereas, It has been shown by full reports of the State Health
Officer, that the schoolhouse known as School No. 10, Washington
Township, Marion County, TncHana, is unsanitary and unfit for
school purposes ;

Therefore, The State Hoard of Health formally condemns said
schoolhouse, declaring it unsanitary and unfit for school purposes,
and commands the Trustee of Washington Township, Marion
CVuinty, Indiana, not to use said schoolhouse for school purposes,
under pain of prosecution, as provided in the statutes of Indiana.

Pa^ssed August 17, 1901.

CONDEMNATION.

Whereas, It has been shown by full reports of the State Health
Officer and the ^farion County Health Officer, that schoolhouse
known as School Xo. S, Washington Township, Marion County,
Indiana, is unsanitary and unfit for sch(K>l i)urj)oses ;

Therefore, The State Board of Health formally condemns said
schoolhouse, declaring it unsanitary and unfit for school puriK)t5es,
and commands the Trustee of Washington Townshij), Marion
County, Indiana, not to use said schoolhouse for school purpOvSc^,
under pain of ]»rosecution, as provide<l in the statutes of Indiana.

Passed August 17, 1901.

September 3, 1SK)1.
Mr. P. M. Dcfortl, Broad Kipple. Ind.:

Dear Sir— Yon ask information coiicerninp: the condemnation by the
Stnte Hoard of Health of ScliooUiouse No. 10 in Wasliinpton Township,
Marion County, Indiana. Tliis scliooUiouse was condemned l>ecause it
was unsiinitary and conditions exist which are a menace to the health

Digitized by VjOOQIC

of the pupils. It follows that if all tiusanitary conditions are removed
that the condemnation will then be without force. If the schoolhouse is
put in good repair, made safe In every way, and If a vestibule is built
by the front door, and if a ventilating heater is provided, and if adjust-
able curtains are placed at the windows, then the unsanitary conditions
which now prevail will be abolished.

We understand the school will commence next Monday. At this time
of the year, when windows and doors are all open, and when tires are
not needed, the ventilating heater, even if it were in the building, would
not be used, and, therefore, It is hot necessary to have this heater at hand
when the school is opened, but it must be in place, ready to do its good
work by the time it is necessary to heat the building. It will be further
necessary to supply either glass drinking cups or granlteware cups, and
permit the children to pump their drinking water direct from the well.
This will make it possible to rinse the cup each time in the flowing stream
and thus obviate the possibility of transference of disease by spittle from
one pupil to the other. The pump must also be supplied with ample fa-
cilities for draining away the waste. Also dry paths must be provided,
leading to the outhouses.

Hoping that this explanation makes the Avhole situation plain to you,
I am, very truly yours, Secretary.

Mr. William Shirts and Mr. Volney J. Dawson:

Gentlemen— You ask me the following ciuestion and request an an-
swer: "Is it necessary that the Ktate Board of Health rescind its order
of condemnation of School No. 10. Washington Township, Marion County,
Indiana, before anything may be done to Improve the sanitary condi-
tions?"

To this we reply **No." Indeed, we can not remove the condemnation
until the sanitary conditions are fully supplied. Where this is done the
condemnation itself will no longer have force.

Hoping this answer is satisfactory. I am, very truly yours,

Secretary.

September 7, 11M)1.
Mr. Granville S. Wright, I^'esident Advisory Board, Washington Town-
ship, Marion County:

Dear Sir — You ask me to answer the following questions:

No. 1. What must i>e done in order to put Schoolhouse No. 10. Wash-
ington Township, Marion County, in sanitary condition?

No. 2. Will the s<hool authorities be liable to pmsecution by the
State Board of Health if Schoolhouse No. 10, Wasliington Township,
Marion County, Is used for school purimses just as it now is, during the
open, pleasant weather? Or will prosecution be delayed until cold
wesither, thereby giving time and opportunity wlwMeby we will ])e al>le
to secure pro|)er sanitary conditions?

In answer to question No. 1, I will say: Provision must l)e made
whereby an even warmth of 70 degrees will l)e maintained in zi^ro weather;
also provision must be made wherel)y the air in the sclioolroom will be

Digitized by VjOOQIC

changed four times every hour. It is suggested that tne best way to secure
these conditions would be to purchase a ventilating heater of ample size.
The windows must be made tight, and permitted to be raised and lowered,
the roof must be made tight and the ceiling made safe. The present
double floor should be looked after as follows:

The top floor should be taken up, the lower one scrubbed with lye and
hot water, and a layer of tar paper placed upon it; and, lastly, the top
floor should be relaid. A vestibule must be built and dry paths to the
outhouses provided.

To question No. 2 I will say: There is a special order requiring the
executive officer of the State Board of Health not to bring action in the
courts until it is plain that the school authorUles will not and intend not
to provide proper sanitary conditions: Provided, If the conditions are not
met by the time cold weather begins, then prosecution shall be brought.

Under this order it is admissible to hold school in Schoolhouse No. 10
as it now stands until cold weather begins, any order of condemnation
to the Trustee to the contrary notwithstanding. I will further say that
under the orders of the State Board of Health, giving the executive offi-
cer the privilege of using his own discretion, that no action be brought
until it is plainly apparent that the school authorities of your district do
not intend and will not comply with the order of the State Board of
Health. Very respectfully,

Secretary.

VISIT TO ANDERSON ON ACCOUNT OP COMPLAINT AGAINST
THE AMERICAN STRAWBOARD COMPANY.

Company's Plant at That Point.

This visit was made July 20. A provisional permit was given
this plant on May 6, 1901. At the time of this inspection (my
coming was not announced) the provisions were not being violated.
Only waste water was discharging into White River. The concen-
trated liquors directly from the rotaries was being used over and
over and lastly impounded, as directed in the permit. The wash
water was slightly colored, but certainly did not carry any pollu-
tion. I therefore report that in my opinion the Board's permit
is being observed strictly by this plant management and that no
harm is being done to the stream.

AMERICAN STEEL AND WIRE COMPANY, ANDE:RS0N.

To the State Board of Health of Indiana:
State of Indiana, Madison County, ss:

The American Steel and Wire Company, a corporation owning and
operating a manufacturing establishment at Anderson, Ind., requests per-
mission to discharge from said works into Greens Branch "spent pickle."

Digitized by VjOOQIC

It now represents that the said Greens Branch is at such stage that
«uch "spent pickle" and waste may be discharged into it without injury
to the public health, and as it is a strong disinfectant, rather to the ad-
vantage of the public health, it prays the State Board of Health to grant
and issue to it, American Steel and Wire Co., a written permit, allowing
It to discharge such "spent picl^le" and waste into said river aforesaid,
and that the State Board of Health do hereby grant such permit
AMERICAN STEEL AND WIRE CO.,

By CHAS. GAUS.
State of Indiana, Madison County, ss:

Chas. Gaus, being duly sworn, says that the facts stated in the above
petition are true, as he verily believes.

Subscribed and sworn to before me, the undersigned, a Notary Public,
on the 10th dar of August, 1901.

Notary Public for Madison County, Indiana.

My commission expires May 3, 1905.

REPORT OF INSPECTION OF THE PT.ANT OF AMER.ICAN STEEL

AND WIRE CO. AND OF THE STREAM KNOWN AS

GREENS BRANCH, BOTH AT ANDERSON.

TTpoti July 20, upon request of the management of the Ameri-
can Steel and Wire Co., at Anderson, I made a sanitary inspection
of said company's plant and Greens Branch, a small stream, which
flows through the western edge of the city. The refuse which is
discharged into Greens Branch from this plant, The American
Steel and Wire Co., is known as "spent pickle." The refuse con-
sistfi of a strong solution of copperas, slightly acid, with sulphuric
acid. There is nothing in this refuse which can putrefy or fer-
ment, and therefore it can not produce unsanitary conditions ; on
the contrary, a strong solution of copperas is a valuable disin-
fectant and antiseptic and is a great aid in producing good sani-
tary conditions. Greens Branch is a very small stream of water
with .ordinary earth banks, which flows through the western part
of Anderson. This stream is really an open sewer, for it carries
large amoimts of sewage and surface drainage. In many places
outhouses have been built out over the stream and it is thus badly
polluted. Greens Branch contains no fish. It is my opinion that
the addition of "spent pickle" from the American Steel and Wire
Co.^8 plant is beneficial and may be properly considered of sanitary
measure. I think this is true because it seems reasonable to as-
sume that it would be desirable to add to an open sewer like
Greens Branch, an abundance of any good antiseptic chemical.

Digitized by VjOOQIC

I therefore recommend that a permit be issued to the American
Steel and Wire Co. at Anderson to discharge its '*spent pickle"
without reserve into Greens Branch.

Upon due consideration of this report a permit was allowed as
follows:

Whereas, The American Steel and Wire Co., a corporation
owning and operating a manufacturing plant in Anderson, Madi-
son County, Indiana, has heretofore filed with the Secretary of
the State Board of Health of Indiana, its verified application in
writing, asking permit to discharge into a stream in said State
known as Greens Branch, a certain waste liquid composed of
copi)eras in solution, and which is technically called '^spent
pickle," and also knowing that said stream is really an open sewer,
contains no fish, and is not in a single instance used as a domestic
water supply, and.

Whereas, Said State Board of Health has duly inspected said
stream above, at and below the point where said "spent pickle"
enters Greens Branch, and finds that said "spent pickle" does not
and can not cause unsanitary conditions, but on the contrarv', is
antiseptic and disinfectant, improving the sanitary conditions of
Gn^ms Branch; now,

Therefore, Said the State Board of Health hereby grants and
issues this, its written permit, hereby granting permission to said
American Steel and Wire Co. to flow and discharge "spent pickle"
from its works into Greens Branch from the date of this instru-
ment until the said instnmient is revoked.

This i)ermit is given this day, August 17, 1901.

VISIT TO PLAINFIKLD ON ACCOUNT OF TYPHOID FEVER
AT THE REFORM SCHOOL FOR BOYS.

This visit was made July 25. Typhoid fever first appeared at
the institution in April, and up to the time of my visit there had
been thirty -four cases and six deaths. The Superintendent, Mr.
York, was down witji a severe attack of dysentery when I was
there, lie then had been sick for two weeks and was very weak,
and dated liis attack from a day when he ate some ham and lettuce
salad. The easels had occurred in all degrees of intensity. I
found that the drinking water Avas taken from four springs, and

Digitized by VjOOQIC

analysis of samples of water taken therefrom (the same are ap-
pended) show these waters to be pure and wholesome. A sample
of wat^r from the pond shows pollution. This pond is a clear body
of "spring water" about 100 feet wide and 300 feet long, situated
between the administration building and the hospital. The pond
w^ater is drawn by pipes into the kitchen and into the shower
bathroom. In the kitchen this water is used for washing vegeta-
bles and dishes and general kitchen cleaning. The pond water is
also used for steam-making and sprinkling the roads and grass.
Upon further inspection it was discovered that the creek, just east
of the grounds, had been drained and the deep water so formed
used for bathing. The creek is a small one and as it flows by
fertilized fields, barnyards, pig pens and villages it must perforce
contain pollution. The water in the dam was stagnant and in
places covered with green sciun. Its odor was bad and every
drop must carry bowel bacteria. A thorough survey of the pond
showed its supply to proceed principally, from two springs, but a
deep well, furnishing sulphurated mineral water, is almost con-
tinually pumped into the pond. I found, also, that two 4-incli tile
drains from adjoining fields emptied into the pond. The analysis
of this pond water discovered intestinal bacteria, and it, therefore,
is polluted. It is probable that Superintendent York Avas infected
by germs of dysentery from this pond, as its Avater was used for
washing the lettuce t)f the salad he ate. The inmates who had
t>"phoid might have been infected in the same way or by drinking
the pond water when they were in the shower bath. Several of
the convalescents said they frecpiently threw back their heads and
allowed the shower water to enter their mouths. The infection
might also, most probably, be acquired from the dam in the creek
where the bovs were in bathing.

I reconuneud that the kitchen be immediately disconnected
from the pond, and that as soon as possible a new source of supply
for bathing be secured, and in the meantime, very positive orders
be given against taking tlie bathing ^water from the shower into
the mouth. The sewage of the Indiana Keform School for Boys
is discharged into the creek nearby. This sewage should be used
for irrigation purposes. The lay of the land is admirably adapted
for this purpose. At the time of my visit the institution fields
were ahnost burnt up by drouth and the crop of vegetables

Digitized by VjOOQIC

almost rained. It was stated by the Superintendent that it was
probable that vegetables would have to be purchased the coming
winter for the first time in many years. The drouth destroyed
crops and the great loss is much to be deplored, but especially so
when the proper disposal of the institution's sewage would have
prevented said loss and at the same time preserved the stream
from pollution.

I recommend that this Board advise the Governor and the
Trustees to dispose of institution sewage by broad irrigation,

ACTION OF THE BOARD.

After due consideration of the recommendation of the Secre-
tary that the State Board of Health favor and recommend to the
Governor and Trustees of the Reformatory that the sewage of the
institution be disposed of in some sanitary way, the following
resolution was passed:

Whereas, It is unsanitary and wasteful to discharge sewage into
streams; and

Whereas, The sewage of the State Reform School for Boys, at
Plainfield, is now discharged into an adjoining creek; and

Whereas, During the past summer the garden and farm crops
were almost destroyed by drouth ; therefore, be it

Resolved, That the State Board of Health respectfully recom-
mends that the sewage of the Reform School, now discharged into
the creek, be used for the purpose of irrigation, to the end that
the streams, may be preserved from pollution and the farm land
fertilized and preserved from the losses in crops due to drouth.

Carried.

VISIT TO LETTS CORNER, ACCOUNT- OP CONDEMNED
SCIIOOLHOUSB.

This visit was made August 1.

The schoolhouse at Letts Corner, Decatur County, was formally
condemned at the last quarterly meeting. The official document
of condemnation was passed on the schoolhouse by Dr. J. H.
Alexander, Health Officer of the county. In consequence the
Township Advisory Board and the Trustee of Sand Creek Town-
ship requested the Secretary to meet with them to explain the

Digitized by VjOOQIC

wishes of the State Board of Health. Accordingly I visited Letts
Comer August 1. The meeting was successful, for, after full ex-
planation of the unsanitariness of the schoolhouse and how to
remedy the same, the Advisory Board and Trustee said they would
comply with every part of the order of condemnation.

VISIT TO CATARACT ON ACCOUNT OF UNSANITARY
SCHOOLHOUSE.

This visit was made August 3, in company with Dr. N. D. Cox,
Health Officer of Owen County. The schoolhouse at Cataract
was furnished by the State Board and there was much complaint
that the warming and ventilation were insufficient. There was
also much grumbling among the patrons of the school, some ac-
cusing the State Board of Health of experimenting with the town-
ship in the matter of schoolhouses. A meeting of the people had
been arranged for, and upon our arrival the schoolhouse was well
filled. An examination of the house was first made and it plainly
appeared that the specifications had not been followed. For in-
stance, no vestibules for the entrance doors were provided and
they are absolutely necessary to secure efficient working of the
ventilation system. The hot air chamber was only two-thirds the
size ordered and was unplastered, thus permitting the direct trans-
mission of heat through porous bricks. The chimney was not
double, as ordered, and, in consequence, there was no evacuation
of -the foul air. The citizens' meeting was regularly organized
upon motion of Trustee J. M. Sipple, by appointing a Chairman
and Secretary. A delay occurred at this point until the Secretary
could go to the general store and secure five cents' worth of writing
paper for record purposes. Upon his return the speech-making
conmienced, Mr. Sipple making the first speech. He had much
to say about an over-taxed people, and plainly accused the State
Board of Health with having experimented in the matter of this
schoolhousa He emphatically protested against any district in
his township being so used. He also told how the house was cold
during the winter and for that reason it was necessary to place th<5
stove out in the room, running it from the air chamber. Permis-
sion was ^ven me to speak and T informed the meeting our plans
were not experimental, that the arrangement and scheme of warm-
ing and ventilation was in use in scores of schoolhouses in Minne-

Digitized by VjOOQIC

sota and Massachusetts, and besides, the plans and specifications
giv'cn were pre])ared hv an architect of accomplishment and high
reputaticm. T also made plain the points wherein the contractor
had failed to follow the plans and specifications, and explained
that under such circumstances the experimenting was entirely on
the ])art of the builder, and success as to ventilation and warming
could not be expe<ited. Dr. Cox was told afterward, by the man
who built the chimney and hot air chambers, that he was aware
specifications were not being followed, but the Trustee was re-
sponsible, as the Trustee ordered the changes. A citizen at Cata-
ract also told me that to his certain knowledge a special effort was
made to defeat the plans and specifications furnished by the State
Board. Dr. Cox and 1 came away convinced that the defective
ventilation and heating of the schoolhouse was on account of im-
proper construction and deviation from the original plans and
specifications.

VISIT TO AURORA ON ACCOUNT OF SMALLPOX.

This visit was made August 8. The Health Officer of Aurora,
Dr. W. C. Henry, a minister and another citizen, had written
letters concerning smallpox at Aurora. As usual, the physicians
were divided in their opinion as to the diagnosis. ViMm arrival
at Aurora I called upon the City Health Officer, Dr. Henry, and
together with him visited three houses which were under quaran-
tine. At all of these houses the eruptive disease was certairfly
smallpox. At one place two cases were found and the other two
houses had one case each. The diagnosis was thus confirmed and
as proper precautions against the s])read had already been taken,
nothing remained to be done exce])t to impress more forcibly upon
the Health Board the necessity of vaccinating the i)oor free of
cliarge. Xo ])romise was given that this wouhl be done. It was
also recommendod to the Health Board that it should reconmiend
to tliG st»Jio<)l authorities the vaccination of all the school children.
I was in Aurora only three hours and returned by the way of
Lawrenceburg, calling upon the Health Officer of that city, but
did not find him in. There was no smallpox at Lawrenceburg.

Digitized by VjOOQIC

VISIT TO DALEVILLE.

Visit to Daleville on account of conference with farmers in
regard to stream pollution. This visit was made August 13. A
farmers' meeting to discuss pollution of streams had been. called
at Daleville by a self-appointed conmiittee. The State Board of
Health was invited to be represented. Soon after arrival at Dale-
ville, Dr. Cowing, Health Officer of Delaware County, in which
Daleville is situated, appeared and represented the Health Depart-
ment of his county. A large meeting was held in the high school
room of the school building. Dr. Cowing Avas made chairman,
ilany speeches were made upon the evils of pollution, and all of
the speakers graphically described how they had suffered from
strawboard and pulp mill refuse in the streams. The demand was
loud and emphatic for relief. Mr. J. Harvey Koontz was the most
prominent speaker. The association of farmers formed for the
.purpose of bringing suit against the factories which dischargeil
their refuse into White Kiver and Buck C^reek was represented
by Hon. Mark Forkner, an attorney at Newcastle, Ind. Mr.
Forkner made a speech in which he forcibly brought forth the
suffering of the farmers who lived along the polluted stream and
declared that immediate relief must be had, as was due his clients.
On behalf of the fState Board of Health, I set forth as plainly as
possible the fact that the State Board was heartily in favor of pre-
venting stream pollution. The fact that city sewage is the worst
Ix>llution known was set forward as a fact not generally rec-
ognized. It was also contended that factory refuse should not be
permitted in the stream, also farm and barnyard drainage, and
also that the stream should not be used for hog wallows. It is
known that 80 i)er cent, of the hog cholera in Indiana occurs along
the stream and that this is because the water carries the germs
of the disease from one hog wallow to another. Abolish tlie hog
wallows and the streams would not be ])olluted with hog cholera
and there would consequently be no spread of the disease by this
means. That disease is widely spread by city sewage can not be
controverted. City sewage is poison from the start and may con-
tain all manners of disease germs, which may be carried by the
stream vast distances, and eventually find a soil in human beings
and cause sickness and possibly death. Factory refuse does not

Digitized by VjOOQIC

carry disease germs, but it is highly objectionable, for it
eventually pollutes the streams by clogging them or by furnishing
material which will putrefy and decay and thus produce nuisanca
The attention of the meeting was called to the fact that the State
Board of Health pregented a bill to the last Legislature, which,
had it passed and become a law, would almost certainly have had
the effect of removing all city and town sewage from the streams
and causing cities and towns to take care of the same in some
sanitary way, preferably that of "broad irrigation."

Attention was also called to the fact that many of the farmers
opposed this wise legislation because they did not understand it.
Some of them gave violent opposition in speech and in articles to
the papers without ever having read the bill, nor understanding
it in the least. The fact was plainly presented that if citizens al-
lowed themselves to act without studying their subject, nothing but
evil could result. In my presentation of the views of the State
Board of Health, I tried to very emphatically set forth the fact
that we understood the subject thoroughly and that the members
of the Board were reputable, honest and capable citizens, and that
if the farmers would accept our theory and not have opinions
without investigation, we felt certain the time would come when
the evils complained of would be either entirely removed or
abated in large part. The temper of the meeting seemed to be
to bring suits, secure damages and possibly injunctions. The per-
mits which had been issued by the State Board of Health were
thoroughly explained, and copies of the same being at hand, were
read. Particular attention was called toHhe fact that permission
had not been given to deposit refuse, but the provisos of the per-
mits specifically said that certain liquors after filtration and puri-
fication might be discharged into the streams. The tin plate mill
refuse was explained in every detail. The fact that this refuse is
simply copperas in solution was presented and the further fact
that such substance as copperas could not produce unsanitary con-
ditions. It could, however, by decomposition, furnish large quan-
tities of oxide of iron, giving the stream a very bad appearance,
the same as is given the streams which are filled with iron in mud
which gives the yellow color. It was not argued from this that
it was wise in every instance to dump large quantities of solution

Digitized by VjOOQIC

of copperas into the streams. It was explained tliat a permit had
been given the Anderson Wire and Steel Co. to discharge its
copperas into Greens Branch, which runs through the ci4;y of An-
derson. This permit was given because, upon survey, it was dis-
covered that this creek was really an open sewer and the addition
of the copperas would be beneficial, inasmuch as it would prevent
fermentation, putrefaction and diBcay within the corporation lines.
When the meeting closed a vote of thanks and confidence was
. given to the State Board of Health.

VISIT TO WARSAW.

Visit to Warsaw on account of the presence of an eruptive dis-
ease, and on account of the new sewer system being built in that
city. This visit was made August 17. Upon arrival I called upon
the local health officer, and with him visited two cases of eruptive
disease which were found not to be smallpox. One was, in my
opinion, an eruption upon a person with a tender skin purely on
account of filthiness. Some pustular patches were found upon the
patient's limbs and body, but there was no history of smallpox,
and as a filthy condition was plainly apparent, the conclusion was
that the eruption was somewhat of the nature of impetigo. The
second place visited was unquestionably nothing more than acne
in very severe form.

The city of Warsaw, some two years ago, took primary action
in the matter of extensive sewerage. This step was probably
stimulated by the fact that the Chautauqua Assembly authorities
at Winona Lake, which is but one mile from Warsaw, had, prior to
that time, built an extensive sewer system. This fact most proba-
bly brought the importance of sewerage to the attention of the
Warsaw authorities. The plans which were being followed were
those of a very competent engineer, and I have no doubt will pro-
duce the very best results the lay of the land and country will
permit. The work was being thoroughly done and this sewer
system will mark Warsaw as a progressive city, and undoubtedly
the public health will eventually be benefited.

Digitized by VjOOQIC

VISIT TO DANVILLE, ACCOUNT OF SMALLPOX.

This visit was niado August 21. A telephone message was re-
ceived from Dr. Hoadley, Health Officer of Hendricks County,
to the effect that several cases of smallpox existed in and around
Danville, and the usual trouble existed in regard to convincing
tlie j)eople concerning the character of the disease. I accordingly
went to Danville, and with Dr. Hoadley visited four families.
The firet place we inspected was a farm house about two miles from
the city. Two families lived in this house and the entire nimiber
of members w^as seven. A baby only three years old was found in
a pustular stage of smallpox. The character of the disease was
unmistakable and the case was very severe. AVe tried hard to
persuade the members of the family to be vaccinated, telling them
that they almost certainly would have the disease. They were
ignorant and I might say stupid, for all our arguments and all
the facts we could present would not move them. The father of
the child, in course of conversation, several times announced that
when he had made up his mind nothing could change him, and
this is my warrant for saying we had to contend somewhat against
stupidity. It may be here remarked that eventually every mem-
ber of the family was taken down with the disease and all recov-
ered. The other places visited were within the corporation of
Danville, and in all, five cases were examined, every one of them
being j)roved to be small])ox. The diagnosis of Dr. Iloadley being
thus confirmed, he was strengthened in his work by being posi-
tively commanded to continue strict quarantine wherever small-
pox was found, or indeed wherever any erui)tive disease resem-
bling smallpox was found, and if the same could not be positively
named. The city authorities w^ere appealed to to offer free vaccina-
tion to the poor, and to urge, by public proclamation, general
vaccination. I vaccinated in all twelve ])ersons.

VISIT TO UOMK CrrY, ACCOUNT OF SANITARY CONDITIONS.

Visit to Rome City, on account of sanitary conditions at that
])lace. This visit was made August 20. Several letters had been
received from the County Health Officer of Xoble C(mnty, and
from ilr. M. L. Jones, Secretary of the Cottagers Association at
Komc City, reipiesting a visit by tjie State Health Officer, in

Digitized by VjOOQIC

order to inspect the sanitary conditiona and make recommenda-
tions. Inasmuch as some friction had occurred between the Coun-
ty Health Officer and the Cottagers, I thought it best to make my
inspection alone, and thereforiB, upon arrival spent almost one day
in inspecting the town and cottages around the lake. It will be
remembered that the Noble County Board of Health passed a set
of rules one year ago, requiring that all cottages at this smnmer
resort should b© supplied with earth closets. This order had been
obeyed to some degree and the County Health Officer had arrested
two persons for non-compliance with the rules and they had been
promptly fined. Many of the cottages were conducted in the most
sanitary way, excrete disposal being effected by the earth closet
method. Others were in various conditions, ranging from bad to
horrible. When my inspection was complete I called on Mr.
Jones, the Secretary of the Cottagers Association, heretofore
named, and also searched out the Deputy Health Officer at this
place. With them I made re-inspection of part of the cottages
and then returned to give them instructions. It was unfortunate
that Dr. Miller, Health Officer of the county, living at Albion,
many miles away, could not be present. It was only possible to
recommend the thorough enforcement of the rules of the County
Board of Health, for they certainly were right and proper in all
save one or two minor points. A promise was elicited from Mr.
Jones that the Cottagers Association would do all it could to in-
fluence the inhabitants of the cottages to follow the rules. Mr.
Shimmerhom, the President of the Board of Commissioners and
also President of the County Board of Health, was met at Rome
City and a thorough understanding of the situation was had be-
tween us. It was with pleasure, in this connection, I gave an ac-
count of the sewer system and sewage disposal inaugurated by the
Grand Rapids & Indiana Railroad at Rome City. At present this
sewer system and disposal is applied solely to the island in the
lake. Upon this island is situated a large auditorium, several
pavilions and a hotel. There are possibly as many as 10,000 peo-
ple visit this resort, and therefore, the amount of sewage at such
times is very great. Formerly disposal was effected by disposal in
vaults with a production of awful nuisance at every point where
vaults were located. One year ago the railroad company em-

7-Bd. of Health.

Digitized by VjOOQIC

ployed Mr. Pearson, a sanitary engineer at Kalamazoo, to devise
a sewer system and sewage disposal method. The sewage is
brought from an island in an 8-inch iron pipe, which is suspended
upon the bridge and continued through the town of Rome City
until it appears upoh low lands. At the terminus of the sewer is
provided two lai^e cisterns which have constructed in them self-
acting syphons. These syphons conduct the sewage into two
sewage beds. These sewage beds are constructed after the well-
known method which has been approved by the Massachusetts
State Board of Health. They lie side by side and comprise one-
half acre each. The cisterns, with their self-acting syphons, are
emptied periodically and alternately upon the sewer beds. Very
satisfactory purification of the sewage results and the effluent
from beneath is allowed to flow into the adjoining creek. These
are the first sewer beds established in Indiana and the credit be-
longs to the Grand Bapids & Indiana Railroad. That this cor^
poration should have preceded all of the municipal corporations
is to be noted and the reports of this Board should fully set
forth this great improvement.

VISIT TO OLDENBURG.

Visit to Oldenburg, on account of typhoid fever in the Con-
vent of Franciscan Sisters. This visit was made September 3.
The Convent at Oldenburg is the home of almost 550 sisters. Ty-
phoid fever broke out in this institution July 26, and from that^
date to the time of my visit, thirty cases had appeared, with two
deaths. The assistance of the State Board of Health was invoked
bv Dr. Jos. Ziteke, the physician of the Convent. In his letter
he recited the condition existing at the Convent, and although he
felt sure the water was the source of the disease, he thought that
an inspection by the State Board of Health would result in much
good, and strongly urged that the same be made. Upon arrival
at Batesville, I called upon Dr. Ziteke, and with him drove to Old-
enburg, three miles distant. The Mother Superior received us
most cordially, and a thorough inspection of the premises was made,
after first visiting most of the cases which existed. The disease
was, without question, typhoid. From the fact that out of the
thirty cases at Oldenburg, nineteen had not been away from the

Digitized by VjOOQIC

1)9

institution for one year and over, I concluded that typhoid infec-
tion was certainly present at the place. The building is a new one,
constructed of stone and brick, with tile floors in all the corridors,
and with hard wooden floors in all the rooms. The institution is
surrounded by a high stone-capped brick wall, and the area so
enclosed comprises about three acres. Prior to about one year
ago, most of the sewage was disposed of in sinks and vaults within
the walls. At the time mentioned many improvements were made
at the convent and a large sewer constructed, which had, from the
time of its initiation, carried the sewage to a distance of one mile,
discharging it into a creek. The institution itself is immaculately
clean and is always kept so, and is also well ventilated in every par-
ticular. In the matter of ventilation. Dr. Ziteke had given strict
instructions and the same were followed to the letter. Upon in-
vestigation, I found the drinking water supply was from four dug
wells. Cisterns with steam pump and reservoir in top of the
building supplied the institution with bathing and washing water.
Samples of water from the four wells were brought away for
analyses. Three of the samples were found to contain the colon
bacillus, but the fourth gave no evidence of its presence. The
chemical analysis proved the presence of pollution. As the food
of the institution is cooked with the skill and intelligence which
is always known to be possessed by the Catholic sisterhood, it
could not be supposed that the infection of typhoid had been com-
municated through the food, unless, perhaps, such result had at-
tended through the ingestion of raw vegetables, such as lettuce
and radishes. It was discovered that such vegetables were washed
with the cistern water and not with the well water. The cistern
supply was very low on account of the continued drought, and
samples from the same were not taken. As the cistern was not
used in any instance for drinking, there seemed no reason of analy-
sis of the scant supply found remaining in the same. My analyses
are herewith appended. The Sister Superior, through Dr. Ziteke,
was recommended to immediately purchase a still of sufficient ca-
pacity to furnish the inhabitants of the convent with distilled
water for drinking purposes, and, as it had been demonstrated that
cisterns could not be depended upon for a supply of washing water,
it was further recommended that an engineer be employed and

Digitized by VjOOQIC

100

install a purification plant whereby the well water could be soft-
ened and made pure.

We have a letter on file from Dr. Ziteke informing us that our
recommendations have been adopted and will be completely fol-
lowed out

LOVETT.

Visit to Lovett, on account of dedication of the sanitary school-
house at Lovett, which was recomimended by this Board. This
visit was made September 24. One year ago Prof. M. W. Deputy,
County Superintendent of Schools of Jennings County, appealed
to the State Board of Health for plans and instructions in regard
to a new schoolhouse which was to be built. The Secretary had
promised Prof. Deputy that, upon the occasion of the dedication,
he would be glad to attend and represent the State Board of
Health, and, if necessary, make an address explaining the relations
of the Board of Health to the people and the advantages to be de-
rived from sanitary schoolhouses. There was a large attendance
at the dedication, probably not less than 350 people composing
the congregation. The dedicatory services were held in a grove
adjoining the schoolhouse, and the feature of the occasion was the
graduation of the class which passed the examination the spring
before. A speech was made by Prof. Deputy, conferring diplomas
upon the graduates and telling the part he had taken in the con-
struction of the "sanitary schoolhouse." This schoolhouse is built
of brick, two rooms, being lighted through corrugated glass from
one side only, and the ventilation ia such as to change the air in
the rooms four timee each hour. The warming capacity of the
furnace was warranted by the builders to be suflScient to obtain
a temperature of 70° in the room during zero weather without.
There are three cloakrooms in the building, each one having a
register, and, therefore, will be warm, and each is also thoroughly
lighted and ventilated. The water supply is from a new driven
well, placed in the front yard, and the same is supplied with ample
underground drainage to carry away the waste water. The out-
houses are of brick and widely separated, provided mth screens
and good paths leading thereto. This schoolhouse at Lovett marks
a decided advance for that locality, and unquestionably great good
will result therefrom. In my address the endeavor was made to

Digitized by VjOOQIC

101

present to the people the fact that the State Board of Health is
endeavoriBg to advance the interests of the State through the
preservation of the public health and the prevention of disease. .
How this was to be done was explained briefly, describing the
schoolhouse and entering rather extensively into the details of why
certain features prevail within the same. Altogether the dedica-
tion was a grand success, and I am confident the part the State
Board of Health has played therein is eminently to its credit

JBFFBRSONVILLB, ACCOUNT OF TYPHOID PBVBR.

Visit to JeflFersonville, on aocotmt of typhoid fever and tubercu-
losis at the Jeffersonville Reformatory. This visit was made Sep-
tember 25. Typhoid fever broke out at this institution last Janu-
ary, and since that date there has been sixteen cases. The food of
the inmates is all sterilized by thorough cooking, and it was, there-
fore, possible to secure the infection only through the drinking
water. These considerations were enough to prove that the water
was infected ; but two samples were analyzed, and the results of
the same are appended. In both samples intestinal bacteria were
found, and the chemical analyses proved the presence of polluting
matter. One sample was taken from a well without the prison
walls, which was a contemplated source of supply. The other
sample was taken from the well within the prison walls and which
has been the source of supply for many years. The prison also
purchases water from the Jeffersonville waterworks for the flush-
ing of closets in the cells, and the same is used in the cells in the
wash bowls and is sometimes drunk at night by the inmates. The
supply is from the Ohio River, and, as it is notorious that this
stream is highly polluted, it is very likely that this is another
source of typhoid. It seems proven that the well contains typhoid
infection, for it certainly contains intestinal bacteria. It will be
noticed from the analyses that the water is very heavily laden with
mineral matter. Thirty parts per 100,000 of mineral matter is all
that is allowed by sanitary authority for good drinking water, and
this sample contains 85.5 parts. It is well known that water so
heavily laden with mineral matter will invariably, in a large per-
centage of those who drink it, produce various gastric disorders.
Inquiry shows that this class of complaints has been omnipresent

Digitized by VjOOQIC

102

at thk'iiistitution. That the same may be attributed, in large part,
to the water is very certain. I gave it in my opinion in writing to
Supt. A. T. Hert and Surgeon H. C. Sharp that it would be futile
to try to secure a proper supply of water from wells either within
or without the walls, but it would be most practicable to use the
present abundant supply and erect a purification plant. This plant
should be of such character as to soften and purify the water at the
same time. The softening is necessary in order to reduce the great
quantity of mineral matter which is undoubtedly injurious. The
new cell-house, which has within it 500 cells, is supplied, as has
already been stated, from the waterworks of Jeffersonville. If
the purification plant recommended from this office is installed, it
will be desirable that a standpipe be erected of sufficient height to
discharge its water into the fifth tier of cells. The elevated tanks
now in use are not sufficiently high to do this. I confidently pre-
dict if the water of this prison. is purified that typhoid and diar-
rhoeal disease will be almost completely banished and the improve-
ment of the general health of the prisoners will result. It is a
pleasure to note the completion of the new cell-house and the fur-
ther fact that the renovation and thorough ventilation of the two
old cell-houses will soon te finished. At the present time the new
cell-house is overcrowded, this being necessitated by the fact that
the renovation of the other cell-houses makes it necessary to care
for the prisoners elsewhere. Tuberculosis has prevailed at this
prison many years, and during the construction of the new cell-
house, now in use, the prisoners, as stated in a former report, were
compelled to live under such circumstances of ill ventilation as to
be productive of tuberculosis. This condition still prevails, for
as just related, the new cell-house is overcrowded, and, as there
are no available funds from which to pay expenses of running the
ventilating machinery, the prisoners are denied a proper amount
of air. Such conditions will, of course, continue to produce tuber-
culosis, and this is a sad comment upon the practical management
of the State. It must be distinctly understood that the Superin-
tendent and Prison Board understand the situation thoroughly,
and do all that possibly can be done with the means at their dish
posal. It is feared that the new cell-house will become infected
"with tuberculosis on account of the crowding and presence of the

Digitized by VjOOQIC

103

prisoner affected with the disease. This will necessitate thorough
cleaning and disinfecting so soon as it is possible to use the old cell-
house now in process of being remodeled. At the present time
there are about 100 cases of tuberculosis. The surgeon could not
tell the exact number, because he was well aware there were many
prisoners afflicted with the disease who had not been examined,
and it also was fair to presume that in such an institution there
are cases unknown. We rejoice with the prison authorities that
very soon the evil conditions producing typhoid fever and gastric
disturbances will also be removed.

Santtary Analyses of Sample of Water frosi Indiana Reformatory.

County.

Clark.
Clark.

City or Tovm,

Jeffersonvllle.
Jeffersonville.

Name of CoUeetor.

Mr. A. T. Hert.
Mr. A. T. Hert.

Date of Collection.
September 7.
September 7.

DaU of Analyeia,

September 9.
September 9.

Well, River, Creeks
Pond, Spring.
Well pnmp.
Well pump.

Turhiditv.

Slight.
None.

Sediment.

Abundant.

None.

solids.

Color.

Yellow.
None.

Odor.
None.
None.

ntai.
41.1
85.5

Fixed.
33.7
64.0

Chlorine.
2.1
7.6

Free Ammonia.
0.00
0.003

Albuminoid Ammonia.
None.
None.

Nitrites.
0.001

None.

Nitrates.
0.400

1.000

Intestinal Bacteria.
Present.
Present.

UNION CITY.

Visit to Union City, on account of smallpox. This visit was
made September 30. On September 10 a letter was received from
Dr. Wm, Commons, Health Officer at Union City, giving notifica-
tion of the existence of smallpox in Union City, Ind. The same
letter told that the disease prevailed more or less in the Ohio part
of the town, for, as is well known, this municipality is partly in
Ohio and partly in Indiana. The Ohio side did not come under
the control of Dr. Commons, and he therefore had no authority.

Digitized by VjOOQIC

104

The two cases which existed on the Indiana side were promptly
recognized and promptly quarantined, and vaccination was rec-
ommended. Again on September 25 a letter was received from
Dr. Commons stating that smallpox prevailed unusually on the
Ohio side, and the Indiana side was in danger of being infected.
Accordingly, I wrote to Dr. Chas. O. Probst, Secretary of the
Ohio State Board of Healtji, informing him fully in regard to the
situation, and asking that he fix a date and meet me at Union City.
It was arranged that we both be there on September 30, and see
what could be done. When the time arrived, together with Dr.
Probst, I visited five families on the Ohio side, and, in every in-
stance, smallpox was discovered. It was also discovered that the
disease had been prevailing in Union City, on the Ohio side, for
probably two months, being mistaken by certain doctors to be
chickenpox. The old and foolish notion concerning Cuban itch,
Porto Rico scratches, etc., had found entrance among the medical
fraternity at Union City. In this connection I can not. refrain
from expressing regret that this nomenclature for smallpox, which
originated with the ignorant negroes of the South, should be
adopted by any Ohio or Indiana physicians.

Dr. Probst called the authorities of Union City, Ohio, together,
and plainly told them their duties in the premises, and explained
the penalties if they did not act. The promise was freely given
by the Mayor and the local Board of Health that everything would
be done exactly as he ordered to stop the plague. The precautions
taken by Dr. Commons on the Indiana side undoubtedly produced
good results, for close inquiry among the physicians, also among
the people, discovered but one case of eruptive disease, and that
proved to be a plain case of chickenpox in a child which had never
had the disease. The differentiation was perfect, and there can be
no doubt that the case was chickenpox. It is to be greatly hoped
that the infection will not find its way across the line into the In-
diana part of the city, although this can hardly be expected.

Digitized by VjOOQIC

lO.')

IN THE MATTER OF THE DISPOSAL OF THE SEnVERAGE AT
THE EASTERN HOSPITAL FOR THE INSANE AT RICHMOND.

Trustees Eastern Hospital for the Insane, Richmondy Ind.:

Gentlemen— In obedience to the commands of the State Board of
Health, I have the honor to transmit to you a copy of the letter received
from the Richmond Country Club, and also a copy of the resolution passed
by the State Board of Health.

Letter From Richmond Country Club.

State Board of Health:

Gentlemen— We beg to advise your honorable body that we have leased
the John P. Smith farm, immediately west of this city, to be used as a
Country Club. A small stream, Clear Creek, runs through thrs farm, and
carries the sewage from the Eastern Indiana Hospital for the Insane.
The sewage accumulates in various places, stagnates and becomes ex-
ceedingly offensive and unhealthful, especially in hot weather.

The membership of the club is over 200, and we feel that we should
have some relief from this condition, and respectfully petition your hon-
orable body for relief. Very respectfully,

THE RICHMOND COUNTRY CLUB,

By Board of Directors.

Whereas, Upon complaint, the Secretary of the State Board of Health.
the Secretary of the Wayne County Board of Health, and the City Health
Officer of Richmond, Ind., visited the Eastern Indiana Hospital for the
Insane at Richmond, and found the sewage from said asylum flowing
into a small stream known as Clear Creek; and,

Whereas, It was the unanimous conclusion that the inflow of said
sewage from said asylum constituted a nuisance, rendering said stream
offensive and unsanitary; and.

Whereas, This day, May 28, 1901, a further complaint has been pre-
sented to this Board from the Country Club of Richmond, Ind., declaring
the stream foul and offensive and demanding relief; therefore, be it

Resolved, That the State Board of Health of Indiana declare the said
Clear Creek in an unsanitary condition and a nuisance, in consequence
of the sewage flowing into said creek from the Eastern Indiana Hospital
buildings; and be it further

Resolved, That the Secretary of the State Board of Health is hereby
ordered to serve notice on the Trustees of said hospital to abate the
nuisance by making other sanitary disx>osition of the sewage as soon as
practicable.

Please take notice of this official information concerning the condemna-
tion by the State Board of Health of the present method of sewage dis-
posal at the E^astern Hospital for the Insane.

Respectfully,

Secretary State Boakd of Health.

Digitized by VjOOQIC

106

Ricbmondy July 26, 1901.

J. N. Hurty, Secretary State Board of Health, Indianapolis, Ind.:

Dear Doctor— I beg to respectfully acknowledge the receipt of your
communication of July 24, containing a copy of a complaint filed against
the Hospital by the Richmond Country Club, and of a resolution adopted
by your Board condemning the present method of sewage disposal in this
hospital. Your communication will be submitted to and considered by the
Board of Trustees at its next regular meeting.

S. E. SMITH,

Medical Superintendent.

PETITIONS FROM ANDERSON.
The following petitions and answers explain themselves:

To the Honorable State Board of Health:

We, the undersigned, citizens of Anderson Township, Madison County,
Indiana, respectfully petition your Honorable Board and represent and
say that the Union Traction Company of Indiana, with headquarters at
Anderson, Ind., is discharging the refuse from its powerhouse in North
Anderson, Ind., into Kill Buck Creek, a rimnlng stream; that said refuse
runs into a mill-race and gathers and dams up near a public highway;
that the same produces a horrible stench, is very offensive to the citizens
in the neighborhood and to passersby; that the same pollutes said stream
and is a nuisance and dangerous to public health; and that said condi-
tion has existed for some time, now exists, and will continue to exist and
be a nuisance and dangerous to health unless the same is abated by the
action of your Board.

Wherefore, We respectfully ask that you take the necessary steps to
abate said condition and protect us against a continuance of the same.

Respectfully submitted,

Signed by Ninety-nine Citizens.

State of Indiana, Madison County, ss:

Peter Goehring, being duly sworn, upon his oath, says the allegations
in tlie foregoing petition are true as he verily believes.

PETER GOEHRING.

Subscribed and sworn to before me this September 17, 1901.

W. S. ELLIS,

Notary Public.

October 2, 1901.
Mr. Peter Goehring, Anderson. Ind.:

Dear Sir— Your petition to the State Board of Health, which was sent
to tlie Governor, with a letter dated Septeml)er 19. has Just been referred
to this office. Had you sent your petition direct to the State Board of
Health, the same 'WOuld have been answerefl long ago.

Digitized by VjOOQIC

107

The local Board of Health, which is composed of the City Council and
Mayor of your city, has full and absolute powers in the matters of which
you complain. Your County Board of Health, which is composed of the
County Commissioners, also has full and absolute powers in the matter.
You should apply to your County and City Health Officers, who are re-
spectively Dr. S. C. Newlin and Dr. W. J. Fairfield, and to therm make
your complaint.

It will then be their duty to inspect the conditions which you say
constitute a nuisance and report the matter, in writinir, to their respect-
ive Boards with recommendations. The persons signing the petition pre-
sented to us should be present at the time the reports of the local Health
Officers are presented and use their influence with the members of the re-
spective Boards for abatement If your local Boards will not act, any one
of the petitioners or all of them are privileged to bring suit in your county
court for abatement of the nuisance of which you complain. You will
plainly see from the above that you have this matter in your own hands,
and if you wish, you can cause your local Boards of Health to take ac-
tion or you can proceed directly in the courts yourself.

Hoping that right will prevail, I am, very respectfully.

Secretary.

Anderson, Ind., September 27, 1901.
State Board of Health, Indianapolis, Ind.:

Gentlemen— The undersigned officers and directors of the Anderson
Commercial Club, have been informed that a petition has been filed with
your Honorable Board, asking you to take action to abate the alleged
fouling of Kill Buck Creek, near Anderson, by oil, iron, rust and refuse
from the powerhouse and shops of the Union Traction Company, located
' immediately north of this city.

We respectfully submit that the creeks and rivers of this State are
the natural drains afforded by nature and that all the citizens have a
right to a reasonable use of the same for the purposes of drainage. The
Union Traction Company, by the construction of its system of Interurban
and street electric railways, has largely advanced the prosperity of the
city of Anderson and other towns and cities, as well as the country
through which it passes. It has expended large sums of money in the
construction of its railways, powerhouse and shops, etc., and gives steady
employment to about 400 men. It has also furnished a cheap, rapid and
convenient mode of transportation between the cities connected by its
lines. In the construction of its powerhouse and shops adjacent to the
city of Anderson, and located upon the banks of Kill Buck Creek, it has
expended large sums of money> relying upon its right to use the said
creek as a natural drain from its said powerhouse and shops. We re-
spectfully submit that the refuse, oil and iron rust cast into said Kill
Buck Creek are not prejudicial to the public health, and at most are only
a Blight annoyance to the petitioners and some others along and about
said creek; that it is necessary in the rapid development of the State of
Indiana, and especially of that part of the same known as the Gas Belt,
that personal considerations and the convenience of individuals should

Digitized by VjOOQIC

1U8

give place to the public good, and that the object should be to secure the
greatest good to the greatest number of our people. For your Honorable
Board to make such order as would prevent the Union Traction Company
from using said Kill Buck Creek and the wat«-s of the same by casting
into said creek the refuse from their powerhouse and shops, would be
to work a great hardship upon and damage to the said Company, en-
tirely out of proportion to the inconvenience and annoyance that might
be sustained by the petitioners.

We, therefore, ask your Honorable Board to deny the prayer of the
said petitioners.

Signed by Eight Citizens.

October 8, 1901.
Mr. John P. Sears, Secretary, Anderson, Ind.:

Dear Sir— I thank you for your letter and for the clipping which you
have sent me. I believe the proper procedure is to save our industries
from suits and also save the streams from pollution. It is perfectly
practicable to accomplish both these ends. It has been done in many
E)uropean countries and notably in Massachusetts, and it can be done in
Indiana. That we need the factories and that they should be fostered in
every possible way, goes without saying; and that we need the streams
to carry refreshment and health throughout the land and for beauty, also,
will go without saying. The plan of procedure for the preservation of
the industries and the streams is to require that all industries must dis-
pose of their refuse in a sanitary way. For instance, the tin plate mills
discharge into the streams a solution of copperas. Let them be com-
pelled to save this copperas and crystalize it This will involve a small •
plant for the purpose, but all will admit the tin plate mills are amply
able to build such a plant and to crystallize the copperas from their "spent
pickle" Instead of discharging it into the streams. Even if there is no
profit attached to recovering this copperas, that would not matter, for
its recovery would be a benefit to the people. It follows, that what bene-
fits the people will, of course, benefit the factory. As for strawboard
mills, we must preserve them, by all means, if possible. Let us then
search out some way of disposing of the strawboard refuse in a sanitary
manner. Such way can unquestionably be discovered by sanitary engineers
and chemists. In Austria and Prussia the refuse from paper mills is
disposed of by precipitation with lime and earth in large vats and the
clear liquor is allowed to run into the streams. The precipitated refuse
is used upon land. The sale of this refuse is not of suflicient value to
pay the entire expense of purification, but the paper companies are re-
quired by law to purify, ne^'e^the^e88, for their own as well as for the
country's benefit. They have found recently, in Germany, a use for straw- *
board refuse after it has been separated from the great quantity of water
which carries it. This use is to mix it with plaster instead of using
hair, and to use it in cement where the same is put down for pavements.
It may also be used in asphalt for thickening the same. There are several
squares of cement sidewalk in Berlin which contain large quantities of
strawboard refuse. As for the purification of sewage before it Is al-
lowed to enter the stream, that is a problem which has been solved for

Digitized by VjOOQIC

109

oter thirty years. The great city of Berlin, with its 2,000,000 Inhabitants,
uses all Its sewage for the purpose of irrigating a farm which Is 20,000
acres in extent. The sewage makes not the slightest nuisance and the
farm is made to bud and blossom like the rose through droughts and all
kinds of weather. Barren land, not heretofore useful for agricultural pur-
poses, has been rendered fertile and productive. At Brockton, Mass., sew-
age is disposed of by "broad irrigation" upon farm lands. The products
from the farm are choice and sell for extra prices in the Boston and New
York markets. In addition to securing extra price, the productiveness of
the land Is Increased three-fold. In other words, it would be a course
of profit for Anderson to use its sewage upon land for the purpose of
irrigating and enriching the same. It would take considerable capital to
install the system^ and the sewage irrlgatl<Hi would have to be conducted
scientifically and not by politicians. If so conducted, the sewage could be
depended upon in time to pay the entire debt and finally yield a revenue.
In view of these facts, I am sure that you will agree with me that It
would be best for the State to take the proper steps to accomplish the
purification of the refuse from the Industries. If I could see you and talk
with you, it would be possible to give statistics and figures and examines
where all of this has been done, and if it will be agreeable, I will be glad
to call and see you next Saturday.

You are probably aware that the State Board of Health, under the
law passed by the last Legislature, has granted permits to various indus-
tries to use the streams to a certain extent for liquids which they wish to
dispose of. The farmers of Delaware Ctounty are up in arms against this,
and I have lying before me a letter which came in the same mail with your
own, from one J. Harvey Koontz, of Yorktown. He is very violent in his
expressions against the Industry and demands the revocation of all per-
mits Issued by the State Board of Health. Mr. Koontz has been answered
and told that the State Board of Health will meet Friday, October 11, at
3:30 p. m., and he can make his t)lea before the Board at that time if he de-
sires. It may be that you, as Secretary of the Anderson Gommorcial Club,
would like also to appear before the Board to make any argument you may
have In mind.

Hoping to hear from you further and hoping that we may all get
together to do those things which will advance the best Interests of the
State, I am, very truly yours. Secretary.

Upon due consideration of the matter of discharging of polluting
matter into TCill Buck Creek, the following action was taken:

Resolved, That as the corporation named in the petition from
Anderson is discharging its refuse into said stream without a per-
mit from the State Board of Health, that if a nuisance is the result
of said discharge, the matter is one for prosecution by parties in-
jured, and in nowise demands action by the State. Board of Health.

Digitized by VjOOQIC

110

REPORT OP INSPECTION OF SCHOOLHOUSE AT CLAY CITY.
TUESDAY, AUGUST 6, 1901.

(By Dr. Wlshard.)

On Tuesday, August 6, I visited Clay City, Ind:, and made an
examination of the school building at that place, and took the testi-
mony of varioiis persons interested in the matler.

I find there are two school buildings, one of brick and one a
frame. The brick building is two stories in height, and there are
three rooms on each floor. The south end of the building, on each
floor, contains two rooms. These rooms are 30 feet in length and
24 feet 6 inches in breadth. The ceilings are 11 feet 6 inches in
height. In one of these rooms there is but one door for entrance
or exit. In the other there are two doors.

The north end of the building has one room, which is 29 feet 8
inches in length, 23 feet 6 inches in breadth. This room has but
one door. The ^vindows are small and give wholly inadequate
light. The heating is by stoves. The floors are very weak. I
stood in the center of the floor in each room, and by a little mo-
tion of my body was able to shake the floor so that it vibrated
throughout the room. The walls of the building are 12 inches
thick and the foundation is of white sandstone. The walls are
cracked on the south end. The brick used in the construction of
the walls was originally a poor quality, and much of it is now quite
soft and crumbling in places. The building has a metal roof, and
stands on a foundation about twelve inches above the ground. Its
location is on elevated ground, but there is only surface draining.

There are two outbuildings, which are wholly inadequate, have
no drainage and are located too near the building. I made photo-
graphs of the building, which I present as a part of my report.

The inspection of the building was made in company with Mr.
E. F. Cox, a civil and mechanical engineer, of Worthington, Ind.,
who was employed to be present on behalf of the School Board.
After making the examination of the building above referred to,
I went to the Kline House, the leading hotel of the town, and no-
tified all parties interested that I was ready to hear their state-
ments, which were not sworn to, but in each instance read to the
parties making them and approved by them.

Digitized by VjOOQIC

Ill

p. T. Jett, Druggist: If the building is dangerous, he is in
favor of a new building, if one can be built. If the old one can be
repaired and used, he prefers it should be done. Thinks building
can be repaired, but flues especially need repairing. Has had a
daughter in school three years who has not been sick during that
time.

Dr. M. A. Freed: Has practiced in Clay City since 1882. Says
heating of building is poor, being only by stoves and ventilation
by windows, and consequently some parts are overheated while
others are cold. His own children have suffered from colds, caused
by above condition of the building. Not in favor of spending
much money on old house. He thinks a new building should be
constructed with proper heating and ventilation. School children
are entitled to a modern school building with proper heating and
ventilation.

Dr. C. H. Wolfe: Has practiced here for twenty-five years.
Membership on School Board terminated two years ago, after serv-
ing three years. Has no children. Is in favor of new building if
it can be built on legal assessment. If not, then he is in favor of
repairing old. While he was a member of the School Board, he
observed that the building was like any other building heated by
stoves, some parts being hot and some parts cold. During a few
days one winter, while he was a member of School Board, school
had to be closed on account of extreme cold. He thinks light i.nd
ventilation of building is inadequate.

Mr. B. M. Guirl, Manufacturer: He has examined the building
recently. Finds floors and ceiling sagged down in places. like-
wise the roof. The building has metal roof. The walls and win-
dows shake and vibrate when one walks heavily through center of
floor. Has four children in school. His children, he thinks, lost
half the school term by illness, which he and his wife think wholly
due to school building's unsanitary condition. He is in favor of a
new building and opposed to spending any more on old building.
Thinks it is economy to citizens and justice to school children to
have new school building.

Mr. J. A. Goshorn, Banker: Formerly school teacher in this
city. He lives near the school building and sees it daily, but has
not examined building for four or five years, although he has been

Digitized by VjOOQIC

112

in it in that time. He has two children who attend thifc school.
He taught in the building four years, his first term ending eight
years ago. Heating at that time was as good as could be done by
stoves. He considers stoves a proper method of heating school
buildings. He thinks steam is better. He thinks flues are in
very bad condition. Thinks the sanitary condition of the school
building is good, although he has not examined the building in five
years.

Mr. Joseph McGeiser, Saloonkeeper: Has lived here since
1882. Has five children, and three go to school. Heard reports
of unsafe school building last spring and went with another gentle-
man to the schoolhouse and examined it carefully. He found no
evidence of danger in the building. Building was erected in 1882
or 1883. Has had no sickness in his family as result of condition
of building. He is not in favor of building a new schoolhouse if
old one can be fixed, because there is not enough money.

Mr. J. W. Danhone, Druggist: He has lived here twenty-one
years. Has no children in school. Does not know very much
about school building. He has not been in building for five years.
He was on the School Board six years ago. If building is not safe,
wants a new one if it does not cost too much money. If old one
can be repaired thinks it should be done.

Mr. B. K Conley, Contractor: He has lived here twenty years.
Built the old part (south end) of present building in 1882. North
end was added about ten years ago. He has examined building
recently and thinks house is safe — ^that is, it will not fall down.
House has been poorly cared for and needs cleaning. He thinks
building is safe and could be used with some repairs.

Mr. E. F. Cox, Civil and Mechanical Engineer: He has been
an engineer twenty-five years. He had experience in the con-
struction of school buildings and has given attention to the sani-
tary question involved, such as heating, lighting, ventilation, etc.
He has recently examined the school building in Clay City. At
the request of Dr. Bronlette and Dr. Asbury, two members of
school board, he made an examination of building about two weeks
ago, with reference to the question as to the safety of the building
for use as a school building, but not with reference to its sanitary
condition. The examination was made to determine whether build-

Digitized by VjOOQIC

ii;5

iLg could be made safe. Found that the fault was largely in the
joists. The first floor joists are now carrying a dead load (the
weight of themselves, weight of flooring and also deadening, which
is of clay, etc.), of about 6*0 per cent of their carrying capacity.
This is also true of the second floor. It causes the floors to sag in
the center. The ceiling joists of second floor carry one-fourth the
load of the roof, which should be carried in the wall by trusses.
The brick in the walls, are, many of them, bad, being soft^ but
not enough to cause the building to be particularly unsafe so far as
being able to carry the weight required. The roofs were intended
to be tied together with 'Tiog chains" or rods which have never
been put in place. The flooring, in part, needs replacing. He
thinks roof is not in good condition, but can be made all right
He found in examining building that it could be made safe so
far as danger in falling down or danger to life is concerned, by
placing a wall under center of lower floor at right angles with joists
and placing a steel-eye beam under center of second floor joists,
with cast-iron column supporting center of same. The roof should
have truss braces over ceiling joists to support the roof. The
"tie" rods now in use should be fastened to walls. There are
half-inch joists now running parallel with second floor joists that
should be replaced by three-quarter rods extending entirely through
the biiilding. He thinks the lighting is fairly good. The ventila-
tion is poor, but as good as could be made with common stoves. lN"o
recommendation w^as asked for by the Board in reference to the
sanitary condition of the building. He does not think the build-
ing could be made a modem school building. Thinks the building
could he fairly well ventilated by ventilating stoves. Ventilating
stoves would heat adequately. Nothing could be done to remedy
the lighting of the building. Thinks about $1,000 would make
building last several years. He thinks it would be a thorough
sanitary building in reference to everj'^thing except light, which can
not be remedied.

John Gardner, Attorney: Has lived here fifteen years. Has
five children who have been or are in school. None of them have
ever been sick as a result of attending school. He thinks forming
children in line out of doors, waiting to march in when weather is
bad, has had much to do with bad health.

8— Bd. of Health. ^-^ ,

Digitized by VjOOQIC

114

Dr. J. A. Modesitt, City Health Officer : He has resided here
eight years. He has made a sanitary survey of the building in
question (in April last) and found it wholly unfit for use as a
school building, as to heating, lighting, ventilation and drainage.
There is nothing but surface drainage for the grounds and there
is no drainage at all for the water closets about 60 feet from the
building. From observation of his own children and his patronis^
children, he has noticed the effect of attending this school is to
produce many colds. He has known children who contracted colds
and had to remain out of school a few days. Colds were contracted
as a result of poor heating and ventilation. Thinks that a new
building is badly needed. Thinks building cSould not be repaired
so as to meet modem sanitary requirements.

Dr. S. C. BroniUette, Member of School Board : Resided here
seventeen years. There are 500 children enrolled and 400 attend
school. With the exception of the primary building, he has not
r^arded the rest of the building as overcrowded. There has been
some complaint in this regard. The teacher, last winter, had half
the children attend in forenoon and half in the afternoon, because
overcrowded.

There are 373 seats in the brick building and in the frame there
are 90 seats. This includes counting double seats to seat two.
Total seating capacity, 463. School enumeration, 441, in 1901.
The average seating capacity in each room in brick building is 62.
Seating capacity of frame building is 90.

On page 203 of the minute book of the State Board of Health
will be found some additional facts with reference to this matter,
which I have considered in connection with the investigation I
made myself on August 6, 1901.

As a result of my investigation, I respectfully recommend that
the order of condemnation, heretofore passed by your honorable
Board, be not rescinded. My reasons for making this recommenda-
tion are that I do not believe it possible to convert the present
building into a thoroughly sanitary one. It is old and dilapidated,
and the only use it can be put to is to take such of the old brick as
are not too soft and use them in the construction of a new building.
The frame building referred to in the first part of this report, and
used as a primary department, is utterly unfit for use as a school

Digitized by VjOOQIC

115

building. I appreciate the seriousness of the situation and rec-
ognize that the constitutional limit of taxation will not raise a
fund sufficient to erect a new building at this time. This is a
question, however, ^\^th which the State Board of Health can not
deal, and is one that rests with the people of Clay City, and it is a
question which would be equally operative if the building should
take fire and burn down.

To the Board of Trustees of the School Town of Clay City, Clay County:

Gentlemen— In comi>liance with your request, I have this 11th day of
May, 1901, made an examination of the school building in your town, and
beg leave to herewith submit the following in reference thereto:

I find that the four flues of the old school building are in each corner,
and that the comer walls of the same are only four and eight inches in
width, which leaves no corner, and which, in my judgment, is very im-
properly constructed and also very unsafe.

I find the partition walls between the four school rooms of the old
building are craclced, and pulled apart from the main walls at either end,
so much so that a rule can be run clear through from one side to the
other, or a distance of 18 inches. I think this condition of alfairs exists
from the foundation to the top of this partition wall at both ends. I also
find this partition wall bulged out to thfi west The cause of this will be
stated later on in this report. I find the west wall of the old part of
the school building bulging inwardly at the center, or second floor line,
and at the bottom or below the windows it bulges to the outside.

I flnd the Joists in all the floors in both the old and new part have
sank down 2% to 4 inches. I flnd cracks in the tower at different points
from top to bottom. I also flnd that the tower or entrance is leaning to
the south, and a strong wind would have a very serious, if not fatal,
effect upon it In the attic I flnd a deplorable system of architecture.
The main purlin of the roof is supported by wooden posts running east
and west, and I flnd but two of these posts supporting this roof resting
upon the cross wall. The others rest upon a single Joist. I flnd the Joist
in the attic sunk down at least 3 inches, if not more, which is caused by
the weight of the roof and of the Joist.

Now, the cause of the cross wall bulging as it does is because of the
fact that the main weight of the roof of the old building rests solely upon
that cross wall, which makes it entirely too heavy; consequently the wall
will not and can not support it. If this cross wall should happen to fall
down, the weight of the roof would crown out and throw down the out-
side walls, and this cross wall is, in my Judgment, liable to fall at any
time; especially is this true during a wind storm, or a heavy snow.

The new part of the building is not in as bad condition as the older,
but it is not safe, in my Judgment, because of the Improper construction
of the roof plan. These are no purlins and no supports, save the sup-
port composed of lx6-inch fencing board nailed to the rafter and to the
Joists. There is nothing to support the roof, except a few nails that are
In these stays that run from rafter to Joist.

Digitized by VjOOQIC

116

There is no ventilation whatever, and none could be inertalled that
would in the least degree purify the atmosphere of the school room.

From the above statement, my conclusion is that the school building
is totally unsafe for habitation by pupils, and that it can not be re-
paired so as to make it safe and insure proper ventilation and proper
heating, which should and ought to be a paramount question with all
School Boards. Respectfully submitted,

AMBROSE MOORB.

Terre Haute, Ind., May 25, 1901.
Mr. J. H. Travis, Secretary School Board, Clay City, Ind.:

Dear Sir— I made a careful examination of the school building and
found several things about the building cm my second visit that were not
talked of on my first visit. Below you will find an estimate of cost to
put the old building in anything like repair.

The* State, Board of Health would require you to take off all the old
paper and a greater part of the wainscoting and all the wood ceilings as
they would not consider them sanitary. As a business proposition I do
not think it would pay to repair the old building. The mat^ ial in it is
worth about $700 and could be disposed of for that. Take $a,507 and $700
makes $4,207 that the old building would stand you, and then you would
have an old building that would last not to exceed ten years.

I think the best thing you could do would be to take the old building
down and build a new one. The State Board of Health will undoubtedly
cause you to renovate the whole of the old building.

With a new building, with new heating apparatus, you would save
quite an item in the way of fuel. The old building has poor windows and
they would all be refitted and gone over, which is not included in the
estimate. Very respectfully,

W. H. FLOYD,

Architect,

ACTION OF THB BOARD.

Resolved, The order of this Board, as heretofore made, is hereby
reaffirmed.

Petition of W. K. Bailey, of Windfall, for a permit to discharge
waste from his cannery into Turkey Creek :

To the State Board of Health:

The undersigned represents to the Board that he is the owner of a
canning factory at Windfall, Tipton County, Indiana; that he is operating
said factory in the business of canning tomatoes and other vegetables, and
is working about 100 employes; that none of the pomice or other vegetable
refuse is permitted to escape or be taken from his premises, but in the
operation of the factory in canning tomatoes and the like it is necessary
to permit the escape of the waste water into a stream nearby, to wit,
Turkey Creek, which flows into Wildcat Creek, three miles away at least;

Digitized by VjOOQIC

117

that he is adyiaed and believee that the waste water from his factory may
be and is being safely discharged into Turkey Creek at Its present and
usual stage during the manufacturing season, without injury to the public.
He respectfully asks the Board to inspect said Turkey Creek at and
below the point of discharge, and upon such inspection being made, grant
and issue to him a written permit allowing such discharge Into said stream
for the months of August, September and October of this and future
years. The factory is not operated in the other months of the year.

Respectfully submitted,

W. R. BAILEY.

An inspection of the conditions at Windfall was made by James
L. Anderson, and hie report is attached.

I have the honor to report that I visited the canning factory of
W. R. Bailey, at Windfall, Tipton County, and inspected it as
per your instruction. I found as follows, viz. :

The factory has a capacity of 3,000 bushels of tomatoes per day,
and employs from 100 to 300 hands when running. Owing to the
drouth and late crop, has only run a few days this season. The
pomice and ofFal from his factory is hauled out into the country
and thrown on high ground as a fertilizer. The water from the
vegetables is run in a wooden tank and from there is distributed
by an iron pipe over his ground about 150 yards from the factor}'.
Nothing but the waste water from the engines and from the floors
is permitted to run into the little branch called Turkey Creek,
which is about one-fourth of a mile from the factory. Practically
no waste reaches Turkey Creek from the factory and no pomice has
been emptied into the branch for two years or longer, though pre-
vious to that time it had been don© without complaint from the
property owners along the creek. I also interviewed the following
persons, residents of the town and vicinity :

Dr. Longfellow, Health Officer, states that he is continually
crossing the stream in all directions near the town and has heard
no complaints on account of the contamination of the water and
knows of none.

Mr. George Summers, of "The Windfall Dry Goods Co.," states
that his father was a stockholder in the factory from 1890, the year
it was started, up to 1899. That there has been no complaint on
account of the contamination of the water from it, although they
emptied, all the offal into the stream at that time. That his father
owned a farm up to that time about one and one-fourth miles north

Digitized by VjOOQIC

118

of Windfall, through which the stream called Turkey Creek ran,
and that his cattle and horses drank from the stream at all times
and that he had never noticed any difference in the water.

Mr. Matthews, a farmer, living three miles from the factory,
states that he has been employed by Mr. Bailey for three years to
haul the offal and pomice from this factory and has been disposing
of it on high ground of a farm away from town.

Mr. William Owens, farmer, says: The creek runs through my
farm (a part of the Sunmiers farm spoken of before) and stock
won't drink the water. I have an old gravel pit that is full of
water, and raise fish in it. The fish always die about the time the
canning factory starts. They have not died this year. I have not
seen any offal in the creek this year. Have been told that the fish
above me have died, and the smell was just awful bad. Have seen
no dead fish myself. I do not know what would cause the water
to be bad imless it is the offal from the canning factory. It is that
way every year until a good rain comes to wash the stream out ;
after it is washed out the stock drink it all right.

A man named Legg, and his son, seem to be the only other parties
that are complaining, and I made the investigation more to satisfy
the Board than because there waa any groimd for it. Mr. Legg, Sr.,
is a banker, and Mr. Bailey does not patronize him. Mr. Owens'
fish are dynamited every year about the time the factory starts.
They were killed this year, but he doesn't know it yet. Turkey
Creek has not had enough water in it this season to let fish six ^
inches long get to the place where the waste water empties into it,
therefore, there could not be such a stench from dead fish as Mr.
Owens' informant claimed. The water is unfit for use, as it is
covered with a green scum most of the way for a mile north from
the railroad bridge, where the waste water empties into it, and
will not be until a good freshet comes to clear it out. Lastly, the
creek is not contaminated by waste from the factory, as none gets
into it.

I therefore reconomend that the permit be granted, with the
proviso that the pomice be not allowed to be thrown into the stream,
but disposed upon high ground away from town, as is now being
done.

No action was taken because the factory is now closed for the
year.

Digitized by VjOOQIC

119

VISIT BY A DELEGATION OP FARMERS TO CONFER IN REGARD
TO STREAM POLLUTION.

Mr. J. Henry Koontz, accompanied by Mr. Albert Baker, attor-
ney for the Indianapolis Water Company, and six gentlemen in-
troduced as farmers from Madison and Delaware counties, asked a
hearing before the Board on the matter of stream pollution. As
the time appointed for this meeting was almost consumed, and as
Dr. Cook was compelled to go home on accoimt of the serious illness
of his son, it was mutually agreed between all parties that a special
meeting to consider the matter would be held Thursday, October
24, at 10 a. m. in the Board^s rooms in the Capitol Building.'

Opinions of the Attorney-General in the response to requests
from the Secretary :

July 18, 1901.
Hon. W. L. Taylor, Attorney-General, City:

Dear Sir— The Health Officers of Parke and Vermillion counties are
very anxious to learn who is responsible und» the following circum-
stances:

On an island in the Wabash, which is not claimed by either county,
was found a smaU camp of persons which was infected with smallpox.
At this camp flroquent orgies were held, and it was likely, on account of
the many visitors on the island, that smallpox would be spread over the
surrounding country. Indeed, several cases were directly traced to the
camp upon the island. The Health Officer of Vermillion County, Dr.
Loomis, invaded the island, established a quarantine, and in order to do
so, employed guards. By this means, and through enforcing other sani-
tary measures, the smallpox was entirely suppressed. The question now
arises, can Vermillion County be held for the expense? And if not, is
there any provision under the law by which the cost of this sanitary work
may be defrayed? Very respectfully.

Secretary.

July 29, 1901.
State Board of Health:

Gentlemen— I am In receipt of your inquiry respecting the payment of
the expenses of establishing a quarantine and suppressing smallpox in a
camp on an island in the Wabash River, between Parke and Vermillion
counties.

Section 2 of the act of February 7, 1899, amending Section 8 of the act
of 1891, defines the powers and duties of the County Boards of Health.
It makes it the duty of such Board to '^protect the public health by the
removal of causes of diseases when known and in all cases to take prompt
action to arrest the spread of contagious and infectious diseases/' etc.

Their Jurisdiction is not strictly limited to the country. It is entirely
proper for the County Commssioners of both Parke and Vermillion coun-

Digitized by VjOOQIC

120

ties to stamp out smallpox even though it be on an island in the Wabash,
that is "no man's island." Smallpox will kill just the same on "no
man's island" as in somebody's palace.

I advise that you re^commend to the County Commissioners of Parke
and Vermillion counties that they divide the expenses occasioned by the
establishing a quarantine and suppressing smallpox. If Parke County
then refuses to pay her share, It will be the duty of Vermillion County
to pay the entire expense, as her Health Officers had authority to con-
. tract the indebtedness. I have the honor to be.

Very truly yours,

W. L. TAYLOR,

Attorney-General.

August 5, 1901.
Hon. Wm. Taylor, Attorney-General, City:

Dear Sir— We have several inquiries from city and town Health Offi-
cers asking how far beyond corporation lines cities and towns have Juris-
diction in health matters?

The State Board of Health respectfully requests your opinion In this
matter. Respectfully,

Secretary.

August 20, 1901.
^jtate Board of Health:

Gentlemen— In answer to your question as to how far beyond the cor-
X>oration lines cities and towns have jurisdiction in health matters, I have
to say that in the case of the cities under special charters, namely, Indi-
anai>olis, Evansville, Ft. Wayne, Terre Haute and South Bend, the same
provision is made. These cities have an extra territorial jurisdiction of
ten miles from the corporate limits "to authorize the cleaning and purifi-
cation of water and water courses by the Board of Public Works, to pre-
vent encroachment or injury to the bank thereof, or the casting into the
same of olfal, dead animals, logs, rubbish, dirt or impure liquids of any
kind whatever."

For other purposes of the Board of Health extra territorial jurisdiction
of these cities is four miles. For all other cities in the State the extra
territorial jurisdiction for health is two miles. I can find no provision in
the statutes giving towns any extra territorial jurisdiction whatever.

I have the honor to be, very truly yours,

W. L. TAYLOR,

Attorney-General.

Tlie following order was passed upon the motion of Dr. Ilurty:
HEALTH ORDER.

Whep&afi, Smallpox in typical and atypical form now exists, and
has existed in Indiaiia for the past three years, causing many
deaths and great alarm to the people and detriment to business,
and,

Digitized by VjOOQIC

121

Whereas, Many physicians are unfamiliar with either the typi-
cal or atypical forms of smallpox, and, in consequence, mistakes in
diagnosis of this dangerous disease are oontinually being made to
the danger of the health and life of the people, it is, therefore.

Ordered, That while smallpox exists in Indiana — and the time
of its disappearance will be officially announced by the State Board
of Health — it shall be the duty of all physicians to immediately
report to the Health Officer having jurisdiction, all cases of erup-
tive disease which even remotely resemble smallpox, and which may
come under their care, and isolate until action has been taken by
the Health Officer. It shall then be the duty of the Health Officer
to promptly quarantine the case or cases of eruptive disease re-
ported until fourteen, days have elapsed from the time of outbreak,
or until the eruptive disease is positively determined not to be
smallpox. Any physician failing to report or any Health Officer
failing to quarantine, or any person failing to remain in quaran-
tine as herein ordered, shall be fined in any sum not less than $10,
nor more than $100.

Special Action in Regard to Smallpox.

Where a person has been exposed to smallpox and returns to his or
her family, how shaU the ease be handled? Shall the whole famUy be held
in quarantine for fourteen days, or only the person who was exposed di-
rectly to the disease?

In regard to the above, it is ordered, that in instances where a
person, who has been exposed to smallpox, returns to his or her
family, that all concerned shall be vaccinated and disinfected, and
if they can be trusted they can be allowed to go their way, previded
they will promise to present themselves to the Health OflBcer for
examination after twelve days f rem date of exposure and every day
thereafter until fifteen days haVe passed after first day of ex-
posure. If these conditions are refused or rejected the Health Offi-
cer shall quarantine all concerned for a period of fourteen days
from day of exposure.

Adjourned.

Digitized by VjOOQIC

ANNUAL STATISTICAL REPORT

FOR THE YEAR 1901.

Digitized by VjOOQIC

125

I §
•2 3

<»>c>

•2

sss"" s»a8 : as^a : ."g»s " ■■ ■.'°

ss*-

m«'

5S»'^

eo<e^io«-4 lAiO

^Sg8«»« s

S25

•«&3«|S:S S2^

^•^gSgl ^

gggj^r- uagUJO^r* OJ^rng^

5ii;s«s s^asa**

«-^eoci ^^696964 0^«O

S;3«55 •S

S^i^-^fc sss^ag-- "^a^gj

33lS^fe li^S^S : ^« :S

gg«Cg| oog5g|

:#t*M^ SB^^q

► a

£52

M P c8

. a-o

• o ^ : s • • » a

,gr-g

i'^gas ^

^§ss ^

r-<09iOC4k<: r-li-lf-lOk«

"i-^

t*Ej»rO »-•

^•^gsa «

"gss ^

nil

"3 "3 "3 .2

.bflflJ s^sS-2 5^R3 3

Digitized by

Google

12G

a
o

"^•«i^a» e4iAeoca'<«< got^

T-«MeotrO» oect*«ooo o>"«««

0^;O» 0ect«<0

f-«CCt^Cat» Oi-l©0C^ "^•'OO

'5il*- 8SSS

MiO !fe"^ «D«*i«iO© t'O

CIQtA 2£^^Ci^ ^'^

^g'^* SSISS

eoiAtosoo o»ooaoO)eo r-too

<4iMi-i^t<- ao<otoiAeo rHoo

n^eotooi ooc9t«'<«ieo «ogo

•oeocvjsao <occ»oo)M eo<o

aOr-< i^C9QOf-4eO

cOf-t 'fHt-M^

OO-M C4C40C^;0

-*« i-iM© .••«•

»iO •^•*o»iot^

o>i-< iMMooi-<e^

OOiH r-IC^lA 'to

QO^jo cccot;<eeo

Oiccoi ^^^SS^S

e^M2}t» "^••coffioiQO

SS?5 «S3^8

SS8 --«»8«g£

85Jg5 ^S§!?-5S

'-S!^?? -^^^SSfS

gt;. *e;Sj8»8

SSg3

Oeoaoo

M-^sa «»-!

(NCO^^O g^^o^ «c»t— gl-"

85SI «SSSS

•-5

f^QOtOQto OO^iA^iC t<-<P 'OO

a
5S

'^S

=•5 2

o o a

o -' -" a ••"< o

a 1.1 -3^18 5

08 « O O O

O O O O g
^ i< h> M-^

V p O O h

races BCc aj3

0>»cS«S«a (BeSeSflSw

Digitized by

Google

127

^§5 'H^cg^^ S252S« '^'-S : : 3 :§8;:5! g«5! :S :JS«« : ^85:3 :>

-^^•OiOjQ «0

«o «Scl<»^

§53-

ass g'«55'^S ^s^

^ss

-c4<ee«'<«<jQ CO

S^S

00 o»o>r« CO

Sasi 8*^8^S :S^«'-' »-fSS

^^«o»e4(» t«

V eoootoic eo ••»?-•

•^aS S'^5:;'^'* r-.w'*© . «>g§«35

-tO«OC9t> «0.-H^

fo eotrtO'^f-t i-<

o»eoo> "tjjeJr-i-f^ ct'itiaoc^tH lo

S"a

8§

o>o«p t- •» .o* •b-eoc9 • tc

=gg^8

-TOt-iOtOO <4iiOror-tt« t«f-ioaiA'<«< eOdiO

''^^S S''^S3*~'^ ^'^

!Sg^^

-ooiAeq<4i» Acacseooo c^cpoooe^

» a»C4g|eoao c^«poai

^'-ass g'-g

eo w^coi-*^i-t •^»QO»w^i

iSS'-

^SS |*§8

O OOiMUd • -vfiAJpc^Oi

•Ciit-aoMco eOi-ii

3 "'-S

^ Oaotoe0'<«< r^

rH "^'-•»S!5J CltOCOfHO* f-iOaeOM

eitocOf

1-it^b-ooea

^(OC4 .«> C4iM^rH«& f-iOOOi-lOl

i-«QOOi-<©
iH-^ 1-11-4

i-< 0>i^

Sas S^'Jo'^J:; •^'^^

DiQC<ie0«O

SSS g'^SJ

QO '<«i;«|ir-ieOiH kOt<-'<«<

S "eS

cowoo

1:1

■ SI.2 X.2

.aS :^o .2a :«3

-r^ ^ o ^ o o S 9

n H

r " : fl «

t> >»

2*-

i =

HOOPPM

Digitized by

Google

128

.£

a
o

Digitized by

Google

129

^"-««i-<M M I'^SS Hi'^fe'®'^ eoi-«N -i-i i-i"^ :J*?5 c««f-i>o

^i-if-Hoo-*^' •eO'^o

• i^eOf-ii-« 1-1

*-<i-i'*Cl^ •-• i-«

sss

:5g

:$<?*

I'^S^

2S ^'-SS

^g5^o«

■•-•i-fC^ «>^.-iw<«

■ •-• pcj-^ec

Mco j-H •^ o» •-• 'i'

■-*' c^c

00 ..-le^ N

Ift l^ »0 • rH lO

^S5 ?: :^

2-^3

C40O eC i-<

M^ro CO

1-iQOCsl (M

«g <o :g^

eo oc^oi-i«o

^^^S"

C^r-I f-«

»^C«<lO TfrHrltCeC

r-id^r-ICI

i-( eOC^iAf-)'^ r-ec

"^rH .|-( »C

S8«

T-li-ieCrH

W «0 C^rHi-H •3'<0

S*^

B 5 « ffl-

ri^ig^ -

•Si ^^

5 a^ c.* fl*

** 2 S S'« t.t^

2 e-S± 2 «^^

E t p ■:^ 3

£ * s *; «

.55 g

etc

.- bo

tea

J3©

•5 §.2

C x >

v< p,e3

"SS-S-" TSJ'^5 003;=©

Ss*f-S .s|-5'c° 522*'5

^ a'lZsi ^ t o a, © w ee^^^ g

OSs«OOPQ PQx&mM< ^Z^OOW

9-Bd. of Health.

Digitized by VjOOQIC

130

*f«

-«

«£.

t-.*

• S

o .

CJ "^

- e

?»>.'^

2 ^

fe «

"^ ^

•§ fe

^0^

r-t

2 -;

¥S3

K ,

S'^^

.5^

«5^

53«

eoc

t*co

%S^

??^

B* sa

tOfH

«g^g

MOO

S28

g«>^^

■5- a*

cogeog c.

eoeo

S5S

SSSS'^*'

wejuo ON.-i»

»• tH

F4C9

J85g

0>t>CI99 »-•

-§?- •

'"g«S '^

■♦«

^34

UJ«

t* tH

f-iMfH oeo

?-•

.g««

iftt*

^S^

g**««>

«& : •'"

00|«2

•00

85^

oo^c^^ ^

^gj^ goo

«>J^« ^

«2^

«o^i-< «

«a

«o^

^0|«3« ,-.

-^s

S2jf5

t^^WOi C«

i-g<N U5^

^«gr^g -

«*?2

^s^

«^ ■♦

g3S.

»o

«|-s ..

«e4

S5S

fe'^'^S «'"r3'^

^ :3g«»o ^

eo 1

»o5©

s ss^gs

JOC«T-lt»

^5581*

r-ie4C«

Q
95

o^eo

<© g^ecg'*

Jl:-«0»-i

»-lN

0» OOOkOiO

•H

©«

:S^

?-•

CM*

»•«

^ ^^9:^

W4^

iSS"^ :

-J

sa^a ssss- "'^

:«55* :

•*

^S8S -^

-*«

■

s
<

■
If

h
t

e
£

■

• c

a
> a

«e

a; «

3 s

■

■c

"=
E

t s

•■!

■ q

C
«

1
1

> •
r a>

Digitized by

Google

131

:^s;2:s*'

flBv O O o

Ti'JZ ** t* u

^43 o o o

Z>»* «SflB
QQGOQQO

Digitized by

Google

132

eQOt»94C4 CJ -00

»o«ri'-*2ft c^

isg^a i^Tj-^a

t'-a «©»::?

83^

:S^3

aojDj-joQeo »-• .o»fH

°8S'

SSS

OCOOt-^TH <*r-l<*

f«pi^oiot« <ao9o»

• lOtAA ejeqao

'55

25:8

fOeoeoeO'^ -r-fW

i-««o«-i9 eJ'*'?9 •«»-<&<

■^S 53*S

?2g

SSS*

f-i >o>o>o I;: 'Ooc^to ci oo^

fe :

^S4

'>t>-g*^COf^ 1-t to

S-^is;

^5$

og*^^

• eoe^co 3r»^»-«

s-^s

S2^

««gtOr-|i

84 94 .M

•C4v-l«0 3PC>I«0

o> 'ne^ c^t-

^2g§

S2§j

52S

U.CO

C^QOOOi-^rH

2^-"

-S-^

.a o

o
S

-1

j= : g

flS -^

•2 :a

•I:-N<0 a-*"*

|C^»HQ QCIO)

»-• W l" — C< • "^00 •

•a • r^t-

s-^^

.2 S'^S

S? .''''^

:5S §

:5:^^ g

:^^g S

« B C O O
S?B.

!!: k3

^ C

OCX

♦* a, ♦* 5j au
O— C C8 © '3
4*— © !"•- ®

08 — X t *

« a© a £ a,

e! * «5 g g
© » 3 P g

a 3

■ eS M >c

V a a©

_ o «

c >i':: a

En 00 V
•Cot*

» S c 5-

B^ O as 93

Sv. K c; © ©

S^tl © © ©

o -t; « ». «i

B ©—'4, gf o

a5 .S.S.i — *- -,

:SSo

>'i^

^^ScSS

.fiS: ::

* ©73 »:T3

• 2 e*? a
V..2 * < *

fc< b k h H

o © ». k u

b^ « e8 OS

Digitized by

Google

133

-MOCaOtH O*-*

■ ^ •©«« f-^

r^04p->C4r^ r-l

.eOr-l . v-lr-4C4

fHcoeOi-«^ « .j^eOrH i-^t-t

•i-< r-lMiOOOOj 0)CO<-40f-i

rHC»»H .00 t^rHdr^

rHl-r-4CSl» C09)»M|-I

iCr-4&lC4 fHdSQCM

eooSeSc

•0 * O 3 m

Jig -sS

I- 3 >

Ci u O

^ a * flfi ^

- «** B jg

3 O ?* 0) oj
hJOOO-<

5?S

■ c^s^eoio w

> c

C 9

§>^ *'£ *

05 d-- 3 CO

to g g I

S*-*j 3 ©

» ® ©TS'S

XItS » « Hi
U V fc. fc. fc.

o eB o s o

at. aaa

oq' £ a : a 3
S c "^ fl ® S
^ o M.2 « Sj

O 4* ,

5*0

0hO^0h(^

« c o 2'-
fc. hs («^

COOPhO

Digitized by

5® «o3 5
3 fc. c »r.2 >.

o " £ «> 2 *

•0.2 ®.2 a.ti

.25 5g§

Google

'gi

134

a
o
O

sse

««

»-H-^

f-l«C

0»^r-<

ss4

i"*

oej« j

f-l«0

g?--

jjeoco

c4t«eo I

a*s

:»s4

;t-

cieoeOf-i

•-S

.^co

^ i

f-I^MOOf-l

«e«jjj

8SS

«DC^f-li-i

00 «e

s;"^

lONW* •*

'♦fnm

OOrHt-

958

•t>

iAi-«»o •

.S^

■«f-ie4eo eo

•*^«o

o»f-ioo

S5!S

•a»

eoc9^ .»-i eo^

,5^

t- |»-no

eoc^'O

■<*« '-at

S2S

'♦^eo 1

•o

COiO

«o.-i |«o

«■«* I"*

"-S

858

—

eoN

' ejo»

*goo i-i«*»-*ioc«

NOOrHO rHOO |«0

ass

•S

ejf-ieo j

tOfH^QO t-id '0400 rH

•^C^tA

858

—

• 00

•ONt-rH

«S

8^ <M

•rnt^cg

c^oseocj

lOf-iN

S5a

•S

C4rHiOf-l

»-<•«

«•

^ :t^j3

tHOO |»-l

csi I"*!"

SSs

C4 \

• :«a <'•

^ l-H

jeo

•°5S

•«••

^c^

.-1 • |o» eo

f-ICI

eirHiO

•d

?-•

•oo»

: jd o

F4f~(

r-trHCO

^;s

•?-•

lO j

MfHrH

•8

»•»-•«■♦

jo»

•«

: > gr^OOC

r- j«

S^ :

cooo

<& jr-iei ^Qoeo<«c4

eocog

.£
S

a
C

«
5E

"pis

lOQCC

■•s
1

OE
1-

■
■J

9
S

•Es
=^
is

1 «

c
a

• i

• • Ci

: : J

■2°

III

a
«

s
,c
">

c
c

c
e

■i

GQC

Digitized by

Google

13J

E-«

5»§

ft:

•mox

*p9)J0d

•^opiiML

•MiiOpij^

•pwjjiTK

•lanig

'pe^jod

*a4iojoj

avoiMmy

•pejoioo

•'niqii

oiioaiinn

85g

2S8

S3g^

gSS-i gss|8 §s-|- -sssg ;3-«sp

350.r^« ^

«Q>eO 00^ 'O

Dfico eoi

HgOl g«

1-iiAeo

|S*S5 ^'^.'^gS 88^35

S^-o

'«*

SigSte ^'-

§^?3

gg8«g

2SSS*

g^^g^ co^igco

&«j|»H

fH •e409>

S* g«-.05

'"^^

gSSSg gggga

S'^'^Sff

jt*e»ec rH-^eosio *- • -lO

•sa*

gpss 3ES§« gs'S" "sgjs

sss

8" g"

«•- S*

g-* 83"

•go

hi O (S

?liS8 --US- ilS-sS
Slhs •StssI S-tsIl

QQHMmS (S^QmQ OHOPL4<<

'-JS

'"^

' a> o • 0

1555 S

ooo-S

« as «««

ooSg
e'S'o-S

•> «B 0 h ^

522 J S

Digitized by

Google

136

c
o
O

pq
<

•4«1ox

*p9^J0d

•Mopijii

•J»MOpi^

'pOIJJVK

•ajjuig

*po9iod

*a8i9J0j

'uvauoinv

•pojoioo

•»iiqM

S5i8§g gS^gS |53^|Si SSgS& ^•ggS ^SslSf

oto aoe>4<0^tn e^io

**i^;2 SS5:8:3 *s

eiokj^io • 't^ioc^ iC«-<

'»?28|S gS5ig?3 giic

jco rHcoeoto

» • C4«-l(OC0«O

fHioottoor^

doeotA ^«0"-c^

<0— '94SO

:g5S "^SS*?? '^"SISS S:X§S5

Sa^g^* '♦ccagco ^<»'^:5;'o «»j;;«^

fHi-<W»H to-* ••«?-« '♦'^ 'lO

-ggg «5g«8

o^ ^^*g.-.«g

io-«f<ecco »-•

CO rifH f^

SSS535

r-ttOC^Oi ' «OeO .'«»-l "^<tl.^(

gis «5ili

t*»^c^ 1-^eOj-jcog

S3$S;9:::2S§ €::SS;:^ Sf^

Digitized by

Google

137

ssass 8SSSS assss a-'B-'^ s^fcss S^s'-u a gss* sssssa

t-l'*"*^?

- i® jr. «>gg-«:.rH j

•o

• CO jt«0>t:« g*00 'to

'. ^ :«- «g

-"53

osoece*

: iS^-^S SjgSS^ :

*« :5S8 g"^'"^

;5'^ : i ^-g

^t^

*-a>icc«

c>»»-it* jo» '^S*'^-.

:-^;5g3S S*S^;5

00 • J 1 eocjji

*^5I

§?S2a*

^"ss^fe s|S5;s ^^8

^'"gFSr: ISfe-^S S Fi"'*^ Sg

-B

'^ssg?! s?ss*g ^|s^=^ '=^

<^' t5-g;f23E g*?"^* ^ ®«35- *|g528

ooooeo

r-« |eO |C0 '*ggOOi-lN

: :«>o4© ^gr-i-* |r-

Qo :•-" : ^J3«^^{5

*-»CJ^

'^'-8 :^ SISS*^ *^

■<*«

: :g?S8 g"^^*^gS •« S j-^^ ^8-"«S

:5S|2S| SSgSS 112^^ o*----.^ ^"^ggS I^S""^ ** S^^"^ '-^SS^^

COt-lt'tHj;^ •Of^'V

iCr^ 00 •«*<«-<

OOeOrH • r^«OOr-iar>

Sf^gfeg SSgSi^ ggsgg S^g

^{OrHC^I t-JW

liQO M ff3»-<

S^Sa i::^S

«0 t^^OlQO^

'n!?i S^'^SR 'Oi rH o>

dt-f-IC^

s «§S2:«

5j^ g^gj^g^ ^ j-j^

a a
o o

2 *

;5®

^- «•;

B9 4

.Sfl

^=•5:3 2 5

3 a

«P ee

2s ®

O^ 00

- a©

X 2

tt**^^ fl Wi (W
-21:22

a S ® « • o

H OB * ®^_C

S|55 3^-S|| STT|| SSSps |S^«5 |5?'|g* i|2«is

S=|S SA^U ?^^^^ I^IbjI iifgg Sisia ll-lii

00«00 HOOPCh

^ ^ =-^ a .2 .2 »•£ 2

1l5g|

S u o

OJZ o * ">

2^'n • ^

A OS C*^ P

««.2 5 55 *

Digitized by

Google

138

c
o
O

•mox

•Mopijii

•JOMOpi^

'POIJJV)^

•9l»aig

■p9)J0d

'aJ9iojO£

avauamy

•pojo[oo

■»1!RM

aMoa][aQ

S2g

^5^

^|g*g feg^g ^ SSfS*^ gg««« 035Q;Sg !;«

;ii^

«0 C9<Or-«4D

?-• as t-«

SJ3 is '"g

SS^^S ^Sg'^g

«oo|2e« • <«e4e« -f-i •«•* .c^ • .^n

«0«-40«0 • <0

^-S'

^•cSS'^ 8a

sssisi'^ fsa

^8§«8 ^8«S ^ P!S3gS

<Otn 'to rHOOfHCD

S8 :53 ^8 :«

cej|i-

v-lCl<«C4rH eO

eoM io<oaoo<o S9<&®':9^

»ssss a**

-8g«g 8ig«a

« fccaweoeo O:*;:*;'^

sssss 5S*gs^

s :a

"troojQW • «

»-< -00 CO 00

^Ig'^g Rg^g - S2§s^ 28?«««^ S8a;ss s*|s^^

lO e^io«-iio

a «a

: 0.2 ®

•^ fl o

* * £ fe-"

-- a «— ®

e8"" • © OQ

I slot

€8"

9> 90

oer2^

o o

«s^-

g**"

"5 2 o © © a

SSgagg
PQOQwO

c tD a> o 3

.2 fc. © g o

<'<PQOP

,o On— •

« ©"^
55-3

oofe

Si
as

fc 3 > ®

« h O ^

«©5sa

■ ^- E o ©

- - - « «

- "T > '2 ©

a ©

I-

a-Sv* S «
k » », ». h

9 tf 6 © O
Au AAA
h O »« Im h

©^ o • o

Digitized by

Google

139

''ssaa s o'^gg S'gs'' sssa*-' sg-'gg "saaa gssss '^gag

COr-* 'w^

t«r-4i-^o» eoeC'^i-H«

OO 'i-^tH 1^

§3;3

<0 • -i-^ ©'♦N

§8^^

<o -c^i-i • «©3 .^"^ .o»C4^^ eO"*t«-»-<»H '000000

«C3 :5|

gjcooo

•«aofr>ooo ei eo

oioir^eor-. «-5j|.-^ri55 ^§8'«S2S S*«*S*S ^S^SS

©''tf'COClO »-• »o

g^ S^^SS-" JS-'S'**

§g «geo«2g g;5555;a

g?*53

tecac^'* coi-ieoiot* f-io«

?2 :9

t* • eoco-^c* • ^O •^lO •MvHC^t^ t«c4C« -co

8 rit-^ :g5

g-^s

gg S^gfe'^ S?S?8*''^ Sg'^iS '*S*a55 gSSafe

Qooeo

ifd •SS* 'OOC^Ii-Hr-l

■•s 5

rHOjeo©

■*?28 S^ga-" I5;SS*'^ JSSS-SS ^8*«S rrSSS^J^ :S§S

«^

^1 ^

i?"

'8^3^ ^ —

. .'3

•So

•Tl-^ «•€ a 5 © -3 w

JO 2 3^

u e S S e

OC.2C

OSzj^coQ'^ a^ifriOO o&t-i^O« «a2feW-<

g.sS

•Sg.2

e» t»

.2"2 s 2:2

B 4 V « d
a B *-*»^

e3 ©

9 O

Oca

|:-f§

► g © «

Digitized by

Google

140

•2

«
S
.«

*«9ao|0!jV

*jooa«o

ivjodjotifj

'viaongai

Ivai'ds-ojqojdQ

-•1(1 l«a)qJJ«i(i

-viaoaznaaj

qSno^Jaidooq^VV

*80lfl«a]i{

'J0AOJ lOIJVOS

•dnojQ

•vuoqiqdiQ

•jojiaj pioqd^x

'siBOinajaqnx
JO 'smio^ wqiO

*aoi)dcanB
-ao3XJvaoai|nj

.i9A0paii8J«0X99

'OAisniaaj 'f 0% i

•jtwi I Japaa

•gqViqilllS

I »ggr^o.ft 5?SS;''58 S^'^SJS S5igi;:J gS'^SS;

»o^ooiflt- rHiot.g»^ ^^piOMeir* e^t-^QO 0'«e>i<^

s --^

fNM eCr-tt^CO-^ C* •eOC9« t^r^e^r^ Wi-I -^

a»io (O'^ooe^ aor^tDateo ooio^^ •oc4C9c^

eoeoeieo • •^n-^r-<*o cioi -fH-^ c4e4-« • «o-^

rt •OSROJWN CiN-^f-iOi tr^b-^t^cO «0>0»0 iO«"*«

g S^SoSS §55581: SSJ^SS^ 8^82 S^lSsSJS

i-tC«iMrt . C>^rH • 'CO -i-JOfl r-t i~*'*i-^r-l

•fHM0O<-4 d

f^ r-l • •!>■ • »-lM •!-• C^rl -Ol

^ »H»0 . .1^ .r«rHv-ICO

S3 :*

CO 'i-H-tf-i • .CO^iM ON

S «g3

eo(NC3^ao -^cceo-^^ t-ieo<DeOiO i^-*«o»o t^-cDcoOk

iOQOvHf.0) '<roa>t^go ot^co—i-* «»o«0"* «OfH«oco

t^tArHCC'^ oeocOf-iao coiOMtneo ^(oao<<i iAi-iiAtc

I ssssss S3S2g2« ^§^5ig s^g§3 So'-^^;:

§ Sg^8S ssSSB;:: 88$$S sssloS 2^SS

^ Qi r-l i-H O rHr-l »H r^r^rH r-t rH

■"♦•MOCOIO
CS|«©r-0<rH

a«®2* «l-

SJS??S5 ^SSJ:;

§ I I ?2S5g3S§^ SoPIS^E: SS§§gg£2 5SS;£2S ^^^Z

O. ■* ,H rH i-irH

OMj—ccQ «»o--.-g

3S2*55S *-^a§* S^^S"

•uoii«indo<TOOO'IJ»<'

o -^toiqioo aOi-<c>aqaq «qo)»C(Coo otoc^u^ oat^t^^i-o
ei wecrHooo Hi!ec<>jf-iHi« rO'-^rMcc-n eoVco^ cociow"

1061 J«0A »qi JOJ
po^jodan sq^tiaQ is^ox

s i§§Ss sssis i^s^i gssg iSis

•0061 'sngaao
ao pagvg uoi)«indoj

S ^gSSg SIpJSi gj§il i||2 355§£

§ StfS^'S' ^'S^'S'S SgJSSSSi' S'SiSSf sss'ss

^ o

I P

*1 -J

il4S

I Jiiss s2sJs rfi^i |iii| im

g <:<<PQmu oahpmo mm^*^M ^3^1^93 ssszi^ck

Digitized by

Google

141

«DOOt« ^*" »-<QeC»fteO t-jO'-'i^O •ft»-<eO'«<«»H

dar-^ a)(^OQCO> C4j»3»c4

sa^*

->u5.og5

•-iC4C9ao

•««rHlOO»

;:SS*^^

r«tp«t«o

g3S*;S-»

aot<-9Cuoo

: :*''*

ec ••-< :

ec |i-<e«eo

^lO j»oeo

UO^«Mr-lCC

lOoecMift j

jo* |iOr-l

e^ci^ 1

«^?28

--►-e>i«^

uso^cgug

3S3«S5S

^***S

J::5dS53S

i^^o>to<o

;^««<N

i"*"*

f-ri-i |ci

■*»Heo«»-i

JeoeoecM

|c4rHpH 1

<OOSeC'*rH

»H«f Jeoeo

^rHN 1

S2^S

0O«O»iO

«S«53S

S5JSSS

sssss

f:3??;2:JS

SS^J^^

?5c5§i«

USJ2S

S?§5?;:s

^SSgsg

??S9^§^

^SSS85

^|^-:2S

S5Sg3:5S5

^^«.^

r-l^ J«rt

c^ |e« 1

rH-^^ j,-l

00^ : : :

C«coeoei5r-'

^4 • -rH

'.^^ :

|«co j

00 1 JCOM

-itoiH :,-i

|f-ieo«oc<i

■^ ii-« I I

-• jr-i<»N

^-.^ :

j J«ec

: i*^®*

e^vHC^ 1 \

Mr-ie^r-4 J

C^f-IWNrl

QOOT-«eo j

r-l»-l I |r-«

ji-iiO *.

*»H |C0

: ': :^ :

1^ I tr^fH

rH j 1^ j

^'^CC j j

»-iC>< 1 •

eooc JN

■^-♦WOJ

toto jtfSO

|asr-i«ec^

tCN-rC^C^

85:<^ j-^

.OiO*© \

iC-^N^-J 00>i«l-

^CjiOOOO 00>©i-<3»

o oo>©i-<3» S'i'-'*'-' «e"*o>o»«D iceC"*

icec-*!-*

e* -T-ioo *»c«jeceo »c t-r-i-«»o«o iowi-n£)»o <oioeot»^ "*joecoo»o ec-^©*©iO "^i><»

;2;SS§8 §5?S?t:S5 g^ 5gS8S?8 ^SSS55 g2§5^^ ggS?S5^ 5lo?8S§? SS&=

s8:Cr^aS ;^^^ss I as;^ss ^^s^^ 3«3;s^g

Si'-OiQCCrrt

^gs sgsss

S2;2;5 S 'coS55:5§§? §5feS82 SSS^iS ggsSSS 2Sc^Sc5 t^^^^

g55!Qg

ffiSfe:? § S3feS|g S|5?oS^ 8SSg5? ||g^S SSScS^ SSSS

r«iceo<c •*»Q<©i-i

?:sss ?o sJS'^tiS

ioo>t^25 e-^<©o>»o

^:2;::gS

ssjss^ isaa-

SSBs

sisi s iisii ic§is §1118 i§iig ag§^-g nm^-

IPJ

'♦05 3»-rflC

S5I2SS S255S8 ggSSS

jooo^te

^00000}

I i

!5& I sjjli il&is |§j

,£3

„ a

„ O fl * o B

^^^^ S mmm65 qqpS££ »»9qn^ >^SSS;^ ooS^tSS

;2S5.o
JS.S'.S'S

ODHHP

Digitized by

Google

142

i^
«'

*99n0[01^

'190UVQ

■vimeoi^deg
' ivjddjon j

"«six9n0ixx

•iiiiaaiaew
l«aiag-ojqoj93

•§ japan M
-■Id i«dDqxi«i(i

*irtaomiioaj

q JnoQ Mni <f o oq^^^

'SOIBVOJf

•j»AOj loiJvas

'dnojQ

•vuoq^qdid

•J0A9J pioqd^x

'■fsoinojoqnx
JO smjo^ •xoqiO

*not)dina8
-noQ Xji«noniiii({

JOAQ pnv Bjvej^ 99

'OAisnpaj *fo%l

'iV9x I J»pna

•■qiJiqnj^g

*aon«indo j 000*1 ■'»<'

•1061 "•! »qi joj

po) jod»H 9^%vt9(i i»^ox

•0061 'sMnap
no pO0«g aoi)«indoj

B8*a I ssass sasss asas" "s^aa

•8"a g s-'ss" •««»-s s'S""" •"»*-sa

eoeoc4 eoiocOMM ■<<• -^f-ie^ ••noieoeo

^SS^t: t; Qoo^oao e4f-^eeo« eqtotrr^o oitO'^iOeo

00 •M £9 OO-^OftMrH COOM-vT vH •iCO^fH r-r .C^MOk

ogoeo g ist^gggj sssasa s:ss?as :s?5sss

29gSS S^ 3^2^:$ SS^$28S SSS^^SS ^!9SSS

S : : S2

C« •IOC4C4 •CO-* "lO »-lfH00'*'<O •^MCOOO

■*« •« .i^^pHCO

r-lf^d • 1^11 '"^lO

C4eO • • «fH^f-li-l

^eQriliA ^ <Oi-H<*e4Q0 SS^'^'^S '^

^fe^s s {9'=^8»-s isassa a««as

^t^^^ g ?;'^''*^'^

otooioco-* oeoMio

ssss;

SoS"^^ I sas^uss ^ss^s ss^s^eS ^sssss^

s^^S S ^ss^s ssaegsss gss^fsg sss^s

?5S*a g 5385:88 8^S«S a85Sg ^S^SS

SgS^S S sS^Se:! SS83& ?39So^S '^t^fSSS

S!8^8 2 8*"S;S53

t^Of^Ot dOOOD

S^^SS

^ss

i-4C<4<Oi-jao

§is§ § iss^g §iig§ iSsSi ^sigf

PaI i IIP^ sipi §pss.

2o t:

i.i|| I lllll llisi IW| iliil

»^^ g 5£;:;fia ta:s;rs^ 4^«h3S ooewpuo.

Digitized by

Google

143

{;•«• OigfS^

00iOt«^

g^SISS

M j-*«

^oo* i

a*-*-s

eogjoo*

•* •««

e9eQC4r4

••5;&

^2SS9

SSSSS3

^sss

dCO-^CO

ll-* JN

: i^S

: : :**

Jeow \

:- : :

: i®*®'

: i*^*^

jeoeooo

€400^ j

S«?3*

«?3as

r«io^ud

eo<3»ao<o

8^Sg

S3gSS

g^s^

S§g3$

ssss

•S6S

s^ss

8§f2S

«^«Jg

S8SS

1510

ill

iS^s

g§§§

162

1,096

330

308

Pi 111

1^ ft^"?

P^OQQQOQ OD^"^^

Digitized by VjOOQIC

144

Deaths hi Indiana During the Year Ending Deceinher Sl^ 1901^
Statistically Cla^^sifiefl hy the Bertillon System, with Annual
Rates per 100,000 Population, Census 1900,

2 0

CAUSES OF DEATH.

No. of
Deaths

Death

Rate

per

100,000.

All causes.
Stillbirths

I. QkKKRAL DiSfiASRB.

1
2
3
4

4a
5
6
7
«
9

9a
10
11
12
13
14
14a
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
;i2
38
34
35
36
37
38
:«
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59

Typhoid fever (abdominal typhus)

BxaDthematic typhus

Recurrent fever

Intermittent fever, malarial cachexia

Malarial cachexia

Smallpox

Measles ^

Scarlet fever

Whooping cough

Diphtheria and croup

Diphtheria

Influenza

Miliary fever

Asiatic cholera

Cholera nostras

Dysentery

Epidemic dysentery

Plague

Yellow fever

Leprosy

Erysipelas

Other epidemic diseases

Pyemia and septicemia

I Olandcrs

Anthrax

Rabies

Actinomycosis, trichinosis, etc

Pellagra

Tuberculosis of larynx

Tuberculosis of lungs

Tuberculo!»i9 of meninges

Abdominal tuberculosis ,

Potts disease ,

Cold abscess ,

White swellinir ,

Tuberculosis of other organs ,

General tuberculosis

Scrofula

Syphilis

Gonorrhea (adults) ^

Gonorrheal affections of infants

Cancer and other malignant tumors of the mouth

(■ancer and other malignant tumors of the stomach, liver.

Peritoneum, intestines, rectum

Female genital organs

Of the breast

Of the skin

Of other organs and unspecified

Other tumors, except of female genital organs

Acute articular rheumatism

Chronic rheumatism and gout

Scurvy

Diabetes

Exophthalmic goiter

Addison's disense

licukemia

Anemia, chlorosis

Other general diseases

Alcoholism, acute and chronic

Lead poisonings .^

Other chronic poisonings of occupation

Other chronic poisonings

364>44
1,795

1,198

187
10
21
161
149
181
67
487
1,0*9

33
263

248

420
82

167

114
90

201
52

103

204
24
Pi
24

124

1,452.1
71^

47.6

7.4
.3
.8
6.3
5.9
7.1
2.6
19.3
41.6

1.3
10.4

3.3
.1

9.8

.0
.1

2.1

4,115

163.5

153

6.0

187

7.4

2.3

3.1

1.9

1.5

16.6

3.2

6.6

4.5

3.5

7.9

2.0

4.0

3JJ

8.1

4.9

2.6

Digitized by

Google

145

Deaths in Indiana Classified by the Bertillon System^Continued.

c
o

CAUSES OF DEATH.

No. of
Deaths

Death
Rate

II. DiSIASRS OF tHB NBRVOUS SYSTKM AHD OP THE

Organs of Sbnsk.
Ell r-nhjiliiis

180

553

236

128

1,264

129

986

129

406

183

7.5

Siirj im' ihiTjinntis

219

61a

Ej ' i ■ t'Mij \-- 1 'ftTebro spinal meningitis

9.3

Pr*pt;ri?''>i^'e locomotor ata^cia -

0( \^i• r n i "►■■■i j(sq of the Spinal cord

5.0

C<u] t;i' 1 r i 1 r]i and hemorrhage of brain

50.2

Sc'tf ►■[! iun "f the brain

5.1

Pa Ml [ Mr L- , 4 .a nae unspecified

39.1

Gcrarriil I^EXI-JllvsiS

2.2

OlluT fnnna uf insanity

3.0

E^'i'i-i'sv , , i

5.1

C<jm ^ ulf jf3nfl (not puerperal) ..*

1.5

Ci'N '- iil^toiis of infants

16.1

Trt^inii^ ♦, ■

2.5

73
74

Ci I. ?< .

Ot ' ■ 1 r, . .'I ui diseases

.5
7.2

D ■ ■ the eyes i

D : the ears

125

1,754

161

377

185

480

2,989

354

127
14
156

648

1,776

395

203

362

III. DiSEASKS OF THE ClBClILATORY SYSTEM.

Pericarditis ;

3.0

Acute endocarditis

4.9

Organic heart disease

69.7

Angrina pectoris

6.3

Diseases of the arteries, atheroma, aneurism, etc

3.4

Embolism and thrombosis

1.2

Diseases of the veins (varices, hemorrhoids, phlebitis)

Diseases of the lymphatics, lymphangitis, etc

Hemorrhage

3.1

Other diseases of the circulatory system

IV. Diseases of the Respiratory System.
Diseases of the nasal fossae

Diseases of the larynx

2.4

Diseases of the thyroid body

Acute bronchitis

14.9

Chronic bronchitis

7.3

Broncho pneumonia

19.0

Pneumonia ... .

118.7

Pleurisy

1.6

Congestion of lungs, pulmonary apoplexy

. 14 9

96
97

Gangrene of the lung

Asthma

.2
6.0

Pulmonary emphysema

99
100

Other diseases of the respiratory system (phthisis excepted)

V. Diseases of the Digestive System.
Di^i;aSflit! i>r the mouth and adoexa

6.1
1.4

101

Di^♦'n^"^ "-i 1 he pharynx

1.6

102

Di-i-'ii ■=■(,♦ H r 1 the esopnagus

103

Ulirir '►f Ml- stomach

2.2

104

01 lur 417=1 ;i ' 'IS of the stomach 'cancer excepted)

25.7

106

DtJii riu ji ml enteritis (under four years of age)

70.5

105a

Dirirrfi»-itn 'liTonic

1.3

106

Di n rrh^ ir m i . [ enteritis (four years and over)

15.6

107

In!r>tjn!i t hirasites

108

Ht'iTiiu, iric< -ttinal obstructions

8.0

109

Ot hi'^r i|iM' ' -«js of the intestines

14.3

110

A<*it+: V(i hw atrophy of the liver

111

HviliLisil r II Ljior of the liver

112

CirrJiii^ifi . r the liver

160
27
320
9
354

6.3

113

Bilmry < jii, uli

1.0

114

Olhtf ilf-1 1 .(8 of the liver

12.7

115

Di*'cn^C'.- iif 1 he spleen

116

Siiiii'le }n*rironiti8 (not puerperal)

14.0

10-Bd. of Health.

Digitized by

Google

146

Deaths in Indiana Classified by the Bertillon System — Continued.

3,0

CAUSES OF DEATH.

No. of
Deaths

Death
Rat«

icKooo.

117
118

119
120
121
122
123
124
125
126
127
128
129
130
131
132
133

134
136
136
187
138
139
140
141

142
143
144
145

146
147

148
149

150

151
152
163

154

155
156
157
158
159
160
161

Other diseaflei of the digestive system (cancer and tuberculosis ex

cepted)

Appendicitis and Iliac abscess

VI. DI8EA8B8 OF THR GrNITO-UbINAHY StSTKM.

A . - 1, ibritifl^,.

B; i I'M*

Of .^!^p of the kidneys and adnexa

Uri ri ii rv r liti/uliid

DiscE^-'^t.'i uf thi' Li[ft<i'lor

DiftML^cs Hjf ibe urtttira, urinary abscess, etc

Di-easfls of the proslate

N^'n-venerefal diienae^ of the male ffenital organs ....

Mttriris 4 ,

U^ i«ri DC hemurrhn^ffo Inot puerperal)

Uterine tiirnur [not OAncerous)

Otlji-r disfeiii^eg of the uterus

Ovjirian f^jstfi Atid f>ther ovarian tumors

Of it I r di«efifeh of tbt female genital organs

Di^i'^i>i.« of the brfljiai (not puerperal, not cancerous)

VII. PUBBPBRAL DiSKABKS.

Aecidentj! of t»r«£n^mijy

Puurpenkl hvmorrh iLki:e

Other &er^idiFibt« of liibor

Puorperal aeptii?L^i]iin

Puer[u;rul iLlIruminciria and convulsions

Ptierperai phlflginnsiu alba dolens

Other aueidetitfl of pregnancy, sudden dekth.
Puerperal dtficaaes of the breast

VIII. DlSfASRS OF THE SkIN AND CbLLULAR TiBBUB.

Gangrene

Carbuncle

Phlegmon, acute abscess

Other diseases of the skin and adneza .

IX. Disrabbb of thb Locomotob Sybtbm.

Diseases of the bones, non-tuberculous

Arthritis and other diseases of the joints (tuberculosis and rheu-
matism excepted)

Amputation

Other diseases of the organs of locomotion

X. Malformations.

Congenital malformations (stillbirths not included)

XI. Diseases of Intanct.

Congenital debility, icterus and sclerema

Other diseases peculiar to infancy

Neglect

XII. DiSEASBS of Old Age.

Senile debility.

XIII. External Causes.

Suicide by poisoning

Asphyxia

Hanging or strangulation .

Drowning

Firearms

Cutting instruments

Precipitation from height

137

142

1,066

146

234

180

1,175
68
4

1,265

112
1

48
16
52
9

5.4

5.6

42.3

2.1

. 5.8

1.5
.0
.1
.1
.3
1.0
1.1
.5

2.7

1.0

9.2

2.3

2.6
.6
.6
.9

.3
'"6

7.1

46.6

2.7

50.2

4.4
.0

1.9
.6

2.0
.3

Digitized by

Googre

147

Deaths in Indiana Classified by the Beiiillon System — Continued.

CAUSES OF DEATH.

No. of
Deaths

Death
Rate

i(S?obo.

ie2

Gruf hing

136

788

165

90
11
33
112
717
31
66
27
47
1

194
20
360

163

Other methods

164

Fraetnrei

5.4

166

DisIocatioDs

166

Other acoidental injaries

31.8

167

Burning by fire

6.5

168

Baming by corrosiTe substances . . . :

160

Sunstroke

3.5

170

Freesing «. ; '.

171

Electrical shook

1.3

172

Accidental drowning

4.4

173

Inanition

28.4

174

Inhalaiion of noxious gases (not suicidal)

1.2

175

Other acute poisoning

2.5

176

Other external violence

}1l

176a

Homicide

176b

Mob y iolence

177

XIV. Oaubis Ill-Dbfinrd.
Dropsy

7.7

178

Sudden death (not puerperal)

179

Causes not speciflea or ill-defined

14.3

Digitized by

Google

148

SSSS a{5JS S"^* fc''^* 8SS ^^

•*amoi g'-"^ Sli^S o»«o-^ SS*^ SSI3S S**^ ^^

sss $5158 Jo;ss3 ;3'-^ ;2;3^ SS55 a'"« ss''

g3S* S52S^ a;ss S*S S*S S?2* S*«* {::s«

??s:s

§^3S

2851S

OtOO

§?«;s

a«^

■♦r-t-

wr-o

ao«ff^

$^!3

c?;5J:;

JSS**

a;s;s

^:2;s

»«•?

ss-^;:;

8«S

fisa

sias

o«t^

1— t--«i«

aisrs

o»«eM

1-1 1^-*

S;::^:;

8SE^

s?S:s

<»'*«0

j«00>

S«G

©»oo

8S2

§5)2-

^35

as2

1— «»o

s*;s

g§8S

.-10000

«r-Ok

5il?5S

gSs:^

§!5555

aoaoo

ss«

g§i2«5

(OOkt-

ogc^io

8S® $S5g 5aS S**^ S*2 55S2 ?3S2 ?;S;S

§;::s£ S5:s SSSS ;s";: S^S SrSis ;2:*^» a*;s

5|1 5|i 3|1 i|l i|l 3|1 5|1 5|1
a£ ^l£ ^i£ ^l£ 5l£ ^^pS hI£ ^t.£

-2

Digitized by

Google

140

ass asa ass ass as;5 aat; tess sss as* ssa as* sss

^;ss

ess

SS5

a>nto

eo^o»

SS;3

9;s«

SSS

as*

ssa

8SS

^2S8

ssss

^^^

I8SS

SSiS

joaot-

S5;5JS

?9S??

g3S:;S

8s;5

S3^

8«;3

53i=S

55SS

^^^

§?f2S5

ecSS

S*"*

^»9l

fiSS

8S2S

&SS

S53eS

SSS

S^S^

l?SS

^^^

SS53

S^SS

<OQO0O

5S51

8123

8*5=

^855

s:;§3

^s;?

9^8

^ae^

:^n^

SS3

53SS

55«2

g^JS

§SS8

S8S

r-i r-i

Sf;i5

SSSg)

SSgJS

9%^

sss:;

Os^iO

p-t-'*

SS*

aoso

OBj^OO

S5S;s

588

<©«co

S8S

$?J8

Pi^^

S2S5

?i«8

oc^m^

S^'S

s;2:2

8SS3

J(?2J=

sss

S'^^S

98gi

^^^

5SJa

^s::

8SS

S^S

;?ss

^i3S

^^52

s^ss

^8gS

$:;i5S

^S^?t

s^s

s?^«

?Si2

:;558

?i^-s

S{f5?5

?cJ::8

ass

SJ:;S

S??J=

2SSt=

35353

Qg^s

8S5:

loSJ::

^8552

sss

28^«

?c?3;2

g?t;^

5288

iH=^§

g^O^JD

588

SSSI

^»s^

^iH^

??S;2

8;::"=^

$88

^§52

??2;5

S^JSS

f2g?5

^::z

SScS

OB ..OD .•« .•■ ..« ..OB .-ao .•» ..OBi ..to .•« .•»
© • • 9 ..a) ..© ..flj ,.q; ..© ..© ..4) ..© ..flj ..«>

5|i 3|§ 1|§ 1|§ 5|§ 3|i 3|l 5|l 3|e 3|I 3|I 3|i

hSpc4 h?5ph hS&^ ,hScm hSph h^p^ hSp^ hS&- E-iSps< hSs^ E-SPm hSpm

(S p »

Digitized by

Google

150

c
O

JSS** Sa<5 SSSS ass SS^ !8a« 5aS5 ai*!3 J82?;

bjoook

$SIS

aas2

«gr->a>

rjooo

ass

s^aa

55;S

a*-s

^
5

as^

99S

s*s

5i;:s

0500*

9aa

saa

jsas

ass

o»eOto

ssss

8SS

r-Aoo

t^o»ao

3as

S2sa

asa

ass

aDO»o»

5SI8S

^SS

a«s

ejiot-

5aa

Sf55

asa

9sa

ga»t^

SS1S9

ass;

5h*;3

S«S

^ass

S:9to

^^^

9aa

r- jr-

ass

s;:'^

S^*-

gojeo

53SS

S8S:

ass

I5SS

^^^

sss

JS*"**

S*"£3

oeor>

^^^

s$s

ass

asa

ga*

8SS

a<*s

as:::

cg«e-

ass

^!S);c

sss

asa

as*

5?sa

feSS

as*-

ass

sas

S9S

ass

.$aa

a*s

^aa

^ss

as«

8SS

^as^

^aa

a«s

sas

as* 5a53 5IS5; asa ass kss S555 a*s saa

■ ..« ..■ ..« .>« ..oe ..« ..« ..a

O ..« •.«» ••■> .•«) ..» ••• ..A ..ffi

3-fa 3-§a 3-Sa 3-Sa 3-|s 3-|a 3^a 3-|a s^t

hSCn HSCKt hSEh hSekh hS&h HS^&m HSSDm H^B^ hS(x<

2 B

s a

Digitized by

Google

151

s** iiS55 ass ssa aaa «s3a ^ca &s*- s3ss ass s^s ss'-

ass

feS«

8S«

RS*

ass

asa

t^iOd

ass

ss^

s«^s

«•*

^^eo

^(S;!:

S8as

ass

aoeito

i;s«

ass

ss-*

a*-s

as33

S*"*

SiSS

$s«s

ass

ssas

ss**

aas

ass

s*s

ass

SiSS

s*-s

ass

sss

ass

aas

s^s

as-*

ass

8;*s

sa»-

ssa

a«s

5!as

ass

aas

9aa

0keQ(O

as*

saa

SiSS

a«s

»«•<«•«

ss*-

a»s

s«s

ass

s-^s

a«s

9sas

ass

ss*

ass

as**

^ss

a*s

as*«>

9S2S

MtAt^

aas

ass

ss*

jg<o<»

ass

as*

s;;2:s

Soas

9Se^

SKS^S

saa

S*^

asa

sss

as*

ass

5SSS

s«

ass

9;:!:a

ass

asa

ss*>

9S^

asa

•ot-op

ass

as«

S5SS

ss*^

^aa

^sa

sss

5ISS

S*"*

tosa

5?sa

CPOOOD

ass

9SiS

sssa

^sa

tcSS

aas

^aa

s**-

ass

asa

ass

3|l 3|1 ill 3|l 3|1 3|l 3|1 311 3|i 3|l 3|l 3|l

ds.S ^^£ ^SpS ^|£ d:l£ ^-Sf ^jgdS ^a£ ^l£ ^s,S ^^| |j|

(»
^

Digitized by

Google

150

c
O

I :3

SS** Sa<5 8SS ass S3^ !88« 5^3 35*!S RS5;

►

r>coOk

$SIS

ass

jDr-o*

j5flo«

sss

saa

5553

a*-s

s;?^

5as

aoaoo

55SS

0500^

9sa

s^a

jsas

ass

aeoto

sas

8SS

»5«oo

550*00

gas

s?5a

asa

asj=

ago»<*

9SS

RSS

a«s

ejiofc-

5as

§&;9

asa

9SSI

«DO»fc<-

snsi

a:ss

{5*S

?5«S

^ass

frSto

^aa

^^^

•-a

t- jt-

a2?2

ss-^

s***^

C40>eo

sss

9SI^

ass

RSS

53S;3

cssa

s****

s^a

S«^

S5J:;

8SS

asts

asa

855*

s;s:s

a**s

»ss

««oe-

8JSS

^S8^

9SSS

asa

a?:*

ssiaa

fcSS

83*-

asa

sas

$9S

^ss

isaa

■s

a*s

9Sia

g3SS

as*

ssa

$asj

gas

S«S2

sas

as* 5aa 5is^ as55 ass issa ^5:5 a*s saa

« ..« ..w ..■ .•OQ ..ao ••■ •■£ ••■
« ..« ..g) ••« ..A ••« ••• ..«> ..m

SS:1 3|a I'Sa 3|l 3-si 3-§s 5-§a 3-§a i-si

hS^^ HS^Em hS(^ HSSEkh hS(^ h:^(s4 HSSQbi H^Pe* hS&e<

s
3

Digitized by

Google

151

s«»« s;S55 ass asa aas «s?3 555:9 ?5g*- s;sj5 ass a^s ?5S^

SIS2S

55S«

as*

ass

sssa

fe«iOC4

aas5

ass

ss*

s*s

S*«

a«^s

ass

aas

ass

a^s

a:3S

eoe««

as*

ass

US"^

a*-»

SISS

s«*

as?3

9as

ass

asa

aas

5;S*-

aas

ass

s*s

ass

s*-;3

ass

sss

ass

aas

S^S

aa-^

ass

a*s

ss»-

ssa

a*s

5Jas

ass

aas

9aa

0keo«o

as*

saa

ass

a*s

t^^eo

as^

a»s

s«s

ass

s«s

a*s

aas

ass

ss*

ass

as*

gss

a*s

as^

9sa

MtOt^

aas

ass

ss*

JO«0!3S

ass

as*

ass

ioas

9sa

sras

saa

S*^

asa

ass

as*

ass

S3SS

55S5S

as;:

ssa

ass

asa

ss*

$s^

asa

•otocc

ass

as*

ass

as**

5siaa

^sa

ass

5sa

s»-*

^^a

5sa

«Daoao

atis

9&;S

«8a

^aa

tcSS

as^s

!;aa

j©o»»*

ass

asa

ass

■ ••00 ••■ ••■ ..to ••■ ..00 •>■> ,••• ••■ ..OQ .•«

0 ••• ••• ..« . . 9 ••• >•• ..« ..« ..o ..« ..o

3|? 3|1 3|l 3|^ 3|1 3|1 3|§ 3|1 3|l 3|1 3|1 3|?

H96Pe4 hSPm hS^Pm HSSPm H«Sta hS;^ hSSbei hSPm h93p^ HaSCM tri^f^ hSpm

« 3 o

n 9 IS

•-a

Digitized by

Google

152

sssa ass s**- tsias i;as as* sajs ggg &»*=

S;5:f2 gJSS S2* saS 85S5:: S3S* S8S? ggS Sg-

^2S 53SS ;S*>* 3?lc5 qJSa SS* S8^ ggg

5iaa S!Ji5t; 8S^ ;S«?i 562; g5t;?i SSS ggS SSS

Sa 8F3* S'** SSS 85SS SiS:5 |»$ ggg J5S*'

saa i;i2« as« gas ssss fcsa ss^; gstz ss*

^S?J g35:::5 S^^^ JoSf:; SS*^ S*2 SSgS5 ggS S*"^

552 ass S*-" I3S53 5855 aSS fc25 gg| 555:;;?

S**^ SSa*^ o»o» loe

5as ss;:: $S55 Si;?i as*

isass 5as ass sas ssa ass ss5 tas ass

s^Si as;:: s^s'' ^as s;:?^ j?a;: 35^ s^g a;5S

H
SQ

ssaa asj:: sss gsus saso fe^a ss^; ssss ^ss

^^Se9 ^"709 ^^£4 .M^^gs M>Qfl8 ^"Bc8 _*>d _Ke9 ^ » ri

3-2S j-fa i^a s£a S^a 3-|s 5-5a 3^1 3^a

S B ; 2 I § a «

J3 j

4
73

Digitized by

Google

153

S5;:* ass ss;:: aS!:; ss^ **-**^ S;ss '^^^ gsss ^*^;: sj^s s*^

;ss^

8SS

SJS2

SSJ3

s«s

OW9IO

CROO»

Ni-irH

0900^

8SS

g3S*

^aoo

S*;3

as;:

S5«~;5

«SS

SS'-

gfCt-

SS-'*

«•-<«

S*S3

^^"^

8SS

83?5S

SS2J

saa

ss;s

or-oc

ss«

o-«<o

ti'-S

COrHW

«*o»

lOOiO

8S;S

ass

8-?;

S:ss

S2;::

^SS

8SS

00 US 00

cs;?^

<©rH»fl

a;s;s

00 e- 1-1

SS^

sss

sg;s

^2ti

SSS

s;5:s

g|»S

«oot^

^^<^

«'*'<•

ass

r^ooo*

«5SS

a'-s

^oc«o

S5:;s

s«s

ooatok

SS«

o-««o

j*0»iC

oacc«e>

ss«

a»00r-l

Si2;3

;z^^

g5«oc

a:::22

S25:;

a;2i«

o^«»

s^ss

e«

o>««;5

t^t-g

^t^«

s^s

72'*'*

g?c3J^

55)9 «=*

^J:S

55;2;s

0^*

SJSS

l-iOOfl

SS*

OS»-©J

sss

«;2:s

S;52

ss:sgi

S*?2

!*S?3

s;:s2

ooooo

rHrH

J33S

'*•'*

woo 00

8SS

35JSS

S52S

g^SS

SS3S

s;2;s

s;sa

?52S

o>eo«»

f^^^

•OtH-*

^2S

S32J:;

S:;*S

g55:s

§?SS

3SSS

sss

5:3?::

S'-^

s«s

S5;5S

«OC4-«

S2S

jococo

S5;=52

as*

»«Sce -•£•< •— iSflS •— IP'S ^^^73 •Job's w^ '"'a ^ "'2 ^"'cs «j£ea ,^"08 m«~«b

5-fa j-ls j|a 3^1 3^a -.Ss 3|i 3.2a s^e lis 3|s J|i

HTSP^ HSP^ hSc»< hSc^ hS&4 hSe^^ hSPx< HSPs^ hSSP^ HSf»< hSCm hSPm

s
i

S S ^ ;z; ^

Digitized by

Google

154

55553 ass 883S ss-^ a*s sss a*« ss* *«•«

3S:3 a?s« SSJ5 *5S*- $;9'*. 833 s«* aas '^""^

8SS as^ a;sa s«* s;2»^ asjs s«s s^s '^•^^

ass 55«* ass s*"* s«s ssa aa?5 ss;: ;s-

as* s«s «5;s s*-* ss* ssas; ss** ss« ••^^

515153 ass 5iias 2«*- S8SSI sss ss« s*-** s-^a

c
c
O

l-H

iQceo* (ooi^ !a^t« «-4eo0O t;^^ 2K*<3^ ooaoo 2'

sas 53«s Siss '-"''^ fcss !sas :?•• a;ss s«*

asa;? ass as* j^'-s as* ass aa*- ass =«•

RSS5 as* sas3 s** 1555s 8S55 ass asa s*"

saa a«s saa ••^^ ;sas5 55*55 sas s?:s «*•«

iiss ass ^sa :=-« ^ss ass ass ass ss^

• •W ••« ••«» .aV ..W ••« ••«» ••« • • w

^ **S «-« *'3 ^ vis .J "IS ^ ">*S »! ''tis ^ ""iiS >-^ 2*3 ^ 5 le

S-Sa 3-Sa S-gS 3^s 3-28 s^b s^b s^b s^b

^^£ ^l£ ^i£ ^^£ &^& ^ii &i£ Si£ Ss£

Digitized by

Google

155

5s;3 ass •'*^ s*-* S53« as^s ^'^'* 58S sss «-«^ sgsss sas

sis**

ass

S'-*

AI^C^

S§8S^

g^sa

s-^*

s?sa

s««

«««?

S2SS

0O»-i-

5355S

asts

0»<0M

s-*^

^5a

^as

OJ^O*

s?j:s

as;3

lAC^eo

s$a

55S«

SS?3

ass

sa*-

o»io^

ss^

^^^

jDO»r.

£S^S3

ass

t«C4«A

85SS

i-ooo*

S:S2

jot-oo

ago»»

o<o^

s^s

^^^

e«»*«s

feas;

gsss

«e^iA

S!99

ss*-

ssas

ass

eot««o

s«^

r:s^is

g^s^

ss-*

58S

as'^

loweo

gf3S

c^oo«««

35SS

ssss

0«D0

«OiOi>4

9S^

ass

a»ecto

^ss

J5S»-

C^fHi-l

a99

i^<veo

S-'S

ass

s****

r<-q>ao

SI^SS

ass

;500»

ssss

moDiA

•O-^rH

S^^

S5SS

SsSS?

ass

«0i-<«0

a;3S

ssoa

gjsa

e^«><o

ssas

ass

t^^eo

sss

ass

ssas

8SS

ot^eo

53'«?2

SSoSS

^aa

•ot^co

^s^ss

ass

l><-i«D

s^^

ass

IS?^;^

855*^

^00 «o

as^

S35:

^aa

aas

$ss

s«s

Nt*^

S^^

s;::s

SSIS

SSS

goooc

aas

^5?3

ssas

eo<or«

ss8a

§sas

S^*

SSSS;

s§ss

^■sa ji-Si sie a^a 3-|l 3^a 3^a s^b s^a 3|a 3-Sa 3-§a

H^h hSSCh h99:x4 h2^Pe4 hS&e, hSsm hSS^^ HSP4 HaSB^ hSPm hSPc4 hSPe4

i i ^

s »• s

s 5 5

OQ CQ CQ

Digitized by

Google

o
O

JZ5

156

S!«:8 85S?^ •^^ f!S* gSS fc^S «as SflS

*i^5 85SS "^^^ ass «S* SgaS 5SaS 8*S

F^iSSSS

S8^S

lOOOS^

a^!S

s^«*

SiSSi

;5«;3

S'-S

8SS9

8;s«2

t-'tOi^

9^:%^

asss

S^S^

«ss

j*00«O

sss^

«ss;

eo«Dfe>

liSS

8S2S

SoSS;

sss

QOOOO

§s^

S5S$2

<o^e<4

:SEi§S

loSS

5as

83S

oouaoo

»-3

Jt^SS

&as

0>iO'«

S^S:

s;3»-

$SS]

CO 00*0

eoao<a

S^SS

s»-*

CO 00

joi^oo

ass

sas

SJ;::^

^JJO*

365:5?

asis

a»'*ic

SS'-^

fc5?a;s

S^S3

000 94

eo»^r-«

s*s

S^eS

8s^

S«g

ss«

s::?2

fSS:':;

eo^^»H

»'»0^

S^$

S2:s

OOl-rH

ass

sss

s^s;

g^;s

8S«

St8S gsS^ ^»'S fcSS a»?3 g^^ §J=^-S §5SS

.M^ee .^^afi .«■* _J ■•'3 —^ w'S •-« • oS v« •''3 -J • b8

S'fa 5-2S 5-|a 5-2a s^s s^a 3|a 3^a

hScm H?5a4 ehSp^ hS^ hSj»^ HSffa HSpt, h5Sp«4

Digitized by

Google

157

^=" m

**s II

ass 1^

Mjr^oc g«

»"' ill

JS*S §1

8S- SJ

ass §g

3|i |i

o * K ,* ©

Digitized by

Google

a
*-»
a
o

w
<

'r.

SSg

ss«

»
o

SS8

-♦r-t-

58S

ass

MiOl-

0>iO'4>

s*^

00 r-^

t*^*©-

SSs

eo«Dr-

^§^s

ss»*

(oeoeo

toeieo

5«S

«eoeo

JS-^S

S2ig

tO"*^

^S9^

ooeoio

«D^e«

jl^ooeo

o«^

•Oi-^^

CO |co

iSSg

•000

^sss^

^«oao

00 -♦^

«•«

03.01^

•OflOM

<4*eo^

S2!8

M-VQO

So^a

aoeoio

COfHCSI

00^

ejt^o

M.-II-I

COi-iO«

^&i.

oor-i-i

s?ss

■♦^-^-

-^•-leo

■ocieo

a»eo<o

c« 1-4 1-4

Ol-i^

85s

eoiAoo

5SS2

o^«

•00900

lAMM

igtDO*

•ifiOlC^

r-oiiA

»&t

S'**'

9»S

••w*

ai»m«

a>Mt«

S2*

eo9ifi4

S4"**

858

S'^S

SSSS

55**S

«>e4eo

OP 10 CO

u^OO

0 ;wa

*^aoeo

ssa

ooeoio

:$ais

««>r.

eoN»-i

!S*—

OtO"*

r^-^eo

M>^Vi

U^U

158

Ir-'iOC^ a»tf3^ «t^iO ooiceo nt^ro

tOr-iiO <<iDie4 M»

to «OIO>^ C4C9

otO'^i iS®£!3 >ot«ao «oeoc4 ^-<o•-l «o9i-<4< to-^f-i o»«oeo

•^

'i«<e4G<9

loeow

N^fi^

»N j»«i*

•oeod

c^ |©«

COr-«C«

M1-41--1

jgt-oo

tONco

C^i-li-l

•oeooi

eoi-HDi

C^rsrs

i-H |»-4

to«oeo

SS«

a»<4i*0

COi-hM

<OC4'i«<

OOCOiO

«r4i-l

1-HrH j

gjt»«o 2fi^®

^o S3<^C4 tocoN *-**ato ^ooco i--ieoao o«D-«

gss^ss sss s^ss So^a ssiig &SS; s^ss ^s^s

Ui L

is i

is :

is i

\i \.

is i

is i is

_M*ri >M9rf ^*tf i->BBtf _«*d •rf*tf BM^^d ^^94

lis S'la S'Ss 3|a 3-Sa 3-Sa S'ia j'Ss

o « o o ■ o o • • o • « o^ « o • « o "I « o "^ •

hS»^ hS(^ hS»^ hSpm hSpn hS^ hSp^ hSbe*

Digitized by

Google

150

5SSJS ss^ as3a ss^ j;»«?3 s«s sss 2«s &aa

l5r4r-« i-H

c-it^io >S«|t

«ss

!!?:::$)

ciior-

SISS

jH«ao

a«*s

joao«

aS<* 55*-S

»ss

tO'«>'^

Sosa

aa*

8SS3

ss«

Jilj0»0

b-iO»9

as*-

a*«*

;5«*o» 53«c2

sss

ao«&c«

555555

as?;

sss

ass

j^Oioo

iocoe4

s*«s

g^to

gt-o. S^-

s-s

iO^r-*

t9a55

sss

»^*-s

a»<oeo

s*-«

tO^"*

s«s

a»fe«c4

e4»«io oo<oe4

a*s

Atoeo

• 00©

^55JS

s«s

a»<«io

Qoeoto

s«*

a«5;

s»-»-

tDcoeo 3»OM9

ass

ojeook

a«s

Qoojg

«ss

SflS

^^00

to CO 04

ejjeook

s-s

giows tew*

ass

;-J«0

a*s

s*s

s-^s

a;5*

s^s

o»»«^

aOr^lr-

Mt^iO

•41 '•<« aoo»o>

553S

S^*

a^-s

ss«

8SS

s*s

S"^S

0.0^

ss*^

a»iO'«

j*t*lr- a0©l«O

a«s

OkO-V

ss«»

8?2S

»Qt«ao

a*-;?

S'^S

0O<4i^

2$SS

as*

ao«»o jS"^*

Ic2«5

-* j-*

s««

n-***

^s;!

S'-S

ot-co

OkCOtD

a«s

O*-*!©

Miftf 3«0«»

s^a

^r-t-

•^COOO

Oft-^iO

OJOO-*

o>b-e«

«oei'4i

»Of-i<«

aoM»eo

CO-^M

«o^e4 ano-^

•000-5

OkCiir-

•©-♦C4

•or- 00

ass

s^a

lO-*!^

«9 JM

s«s

MC4 j

•00004 <Of^ie

?;***

S^*

oi^eo

•^CICI

eor-ie*

df^rs

a»<oco

NiHfH

•Or-i-V

M :«

^-H

•O"*.-^

s«^

l-l»-« J

e4i-lrH

eoNi-H

eoMi-H

OOCOiO

Cli-li'^

tow-*

Ir-Mie

•^esic^

0494

tf»^-*

s*^**

(oeoeo

t>eo^

^iio<o

0»-*iO

^«OtO

Ofc'*!©

«DC4<«

a»'4iiO

«o^e4

^cooc

lo-^l-l

aa*

s«*

04i-if-i

^«.D

«ceoo

«^S

ss'-

OO-*-*

855«»

S*»^

ss^

««•

as*-

as*

J5S«

So$S

ss^

SSSo

SS^S^

gg^

sssa

^ffis

r^$a

is«

pia^

ssa

•aS? -aSS dS* -a 8* ■sS'' 'sS'^ •aS* 'sS'S -sS"*! -aS* -sS* -dS'^
Hi l'3§ ^-s^ -^1^ ^-ss ^i^ ^i^ ^-3^ ^"S^ -^Is S-^B s^a

E-iSpc4 hS^Pm HSSPn hSSCm HS^Pe, hS^Bei hSSPsi hSPn H^h H^h H^Pm hSPm

1 ^

Digitized by

Google

160

o
I

S2e

rjiOcO

sss

tiS-*

i5*«S

s*s

S^S

SSSS

tt-^tO

S^S

S3S

^^.^

«*s

s^a

ot-«

ss^

g3''S

?J^S

iftA-.0

822

S3s
S£8

Nior-

8SS

e«'*oo

<oo^

ooei*-i

ssa

ss?5;

S2SJ

s*-^

•H^f-

jgflor^

0»fr>G<9

ooe>«to

J::2'-

SS'-

ecxic

eci-O

S2g

00'*'*

SS3**

ooioco

CO jco

oowto

•COiXO

sss

;:^''

eci-«»

S2iS

"*"* i

OiOkO

o<©-*

'*»^00

o^o

SS'^

^;:s

oc-^-o

cie«o

1 825

■*eOi-i

c5«S

0>'*iC

•ftNW

ao-^t-

sss

C^l^iC

•♦••OOV

g2a

0>tQ<0

S2;5

«o)r-

«'*0»

owe*

S'-S

85S

S'^;::

iO«/iO

1 ■ ■

a 2^

«««0

SS};^

OO'*'*

;5U.O»

ecr-ie^

opaoo

5il2c5

f-cay.

2*"?^

a2a

ooccio

s^s

o^«

«..«

;s^s

s«s

5?S;5

S2S2

'<^«OX)

' S2S

eoo*,-^

a»o<»

j-jWO>

«Oi-4iO

00 |ec

g3*2

SS''

83*2

tOO»;D

S22

ia2o

oo^c^

0'*<0

O0-*i*

»oeoe^

iOeoc4

fr»ODl

a*s

^00 00

"♦Nff*

i-tftC^

?3SS

S'*J5

0'*f-i

eOM«-i

XH«^

2*2

MC0O4

!-««?•

-<:

M«^ j

'* [^

M^i-l

-^wci

•^•^ :

uieO'M

1-1 -F-l

tCr-i-*-

c<ic« 1

«•

Iftl-*"*"

t-eci"

eo--N

f-Hl-l .

t-w*

I-.-*«C

eooDo

COC^f-f

( «D'<fie>« t^CC-i^ t^iACI OOMri *-!

1-H ^C^Cl COtOt- »— t- eO*1'^

^iOto e^i-irt ooooo i-^«co »»"*eo octcyi >SV9^ S®'^ 'Cooi-

tcyi ^^9^ S®'^ '*'^°'

I 5SS ?.Sg5 5??Q 5c22 «S8 2SS? gSS£ §2:8 gS^Sr

'■

—

-: ?

—

a
"3

: ■ *

•■

2 .5 ■ : : : §

Digitized by

Google

161

t-o<N «Ob-o» 120.0 g5joo6 g;-jg 5-cja* g«eg ^^©c, jot^oe ^^o;^ gjcoo joaoi*

eji*-3 t^*,-. Oftr-ej ««« goo g^cjo* oc;-.^ eo^M «too r;Ot« oocr.o» 03»o

r-^eo oo««o •*'*o <3>ao^ oo»o» ««« JSS*^ NrH,-i ««5« ^«« S*^"* **"*«^

«^«N r-^« 0«0^ «-ui ^<»«) ;5t-i- ^o»«> eor^w ooon oot-^ ooo©« ;:3«»«0

«»-«) 0'*« «>»-<«3 »-u3«o oi-oj ^«« O'*^) i><N»o oseoo N*--i «>^e4 jg««

t-'^w »-cooo *-^ec c»^oo -*x» «o«o --ooeo cjuai^. to*a^ t-co^ ooioeo jot-oo

teoj-* e*^oo «©tf5^ •'^^IS «o»t- oiftio ««« oouico ^jc^* ^t-« O'**© S2"S

C4tA^. «Daoao (-<

^to ec<£>r* looot. ooo^- *-«^2 toeoci «5«eo •2«^«> ^•*'* JS"*?3

ioweo gi-ej j^-jtt- J©^^ o»««> 5^t-o g^« c»<Nt* weoo* goo rneoao ectot-

aoaoo oo-*»-» 2*~S S^'^S ?5*^''* S*'Jh '^*=^'^ JS"** eoSS "

eo ocoo

tC«o» ooooo t^»-i«o ict^oo e-'^ec 5Jo»«^ S^** cj.oi'- «i

«oto eoNi-< o-^w

■*eOf-i t-.-*eo lO^f-i o»«oeo — i"-^ »cc«o <soec«o •*•*

t^ioe4 lOCON coMi-i eoc^t^

^eCQO 0»tf3-« i-w^ ^-*« a»eo«o j^«« JSJ'^S ^'^^^ o»o« loc^eo -^eor-i <odI"*

eo«-4C4

eoM^

0404 j

Oif-irl

•^eor^

QCCSCO

,^^ :

COf-lW

W^rH

i-^rs j

WW 1

Wf*^

«0«i-i

o>-*»o

tH»-^ j

W-HOi

o<c>«

Ol J04

•ifiOSIOl

-♦NO*

<«09C4

r-i

coeoeo **-*« ««a^ co^im t^iooj oo'*-* eo«rtoo loc^eo ^'*«^ toeceo tow-* <oeo?o

«'*•* eo«^- eo«»- 2"** J^S*" JE^U*' eS^S "a-"* g^;?'" S*^"* ^•''^ teW'*

SSo5 SS85 SSS SSSS S5SS S5C£5 |S5? S3SJ:; SSS ^5551 5gSS 58SJ

ill ill ill ill ill sil ill ill Ml i|l ill ill

hSSpm HSfc hSPm HSfa H^h hScm HSf«< hSCm hSPh hSp»4 hSp^ HSf^

« o

» s

•5

11-Bd. of Health.

Digitized by

Google

162

o
I

IT)
<

S50

a«£i

ass

a>oa>

t^— O

8SS

I^XO*

28SS

gSS

a«»;^

SB'S

SS2=°

t^ObOO

s:;*

«ootc

o5SS

Oit*M

g^8i?3

|SS8

wt-o

£58

s*s

took CO

o^«

ass

5SS

»C4t^

sssss

i5«

CJ»^

S23

J5S«

OOkrH

eOMrH

S5°°

t*Ot-

«0-«C4

;;asf:i

gss

QOCX

i55g

t-^oaoo

e«<o«o

OWStfS

00030

QOCOO

04»eo

gisss

S3S

CO jeo

52s?

ass

Mt««o

•^r^eo

oO'*'^

SS"

ot^ao

s^si

gssg

r^dtA

S520

sss

egooio

«ow*

lOr-ao

j^OXN

OkO^

5JSS

gss

loeoci

S3g?

^JJOOO

ev'^X'

1-«f-l 1

a*s

g$a^

c^e^ii:)

5SIS?5

coco J

S2g

8«S

to-^csi

lecieo

as;s

e«*oi^

S;:;-^

&;^gs

ges

4-"* CO

S3^*

i^is;?

^1004

coc«^

i-» r-i

JOt-O*

a^JS

gss

MOt-QO

JS5g

|:j*S

a»«oc<o

»Of-l'>*

(oa»i-

C^t^tA

•*0O«O

ass

558

I-COi-i

S2;5

«Dt^O»

C^iOC<l

eoi-iCM

Cil^iO

OOlOCO

s***^

<oo»^-

Sg*8

lOf^-^

us^o

a*52

aO-v«i

o-^ci

as"

s*^

ooeoto

^»s

$S!S3

--.««

t^to-^

0».-»i-l

f-HrH j

«-<•«

o<-»^

•*eor-i

<i««oao

»S^

e4«^^

r-'X'co

1-^ |f-l

OkOOCO

0Or-«C<1

•Vr-iCO

-.•CO

s^as

<«e«e4

i^eooo acoeo coc*-^ oco-* <»'«tc ^•'♦o

S^S g^JSS ^g^s

ass s^s

o.o« g»:j-5 jijoe. g5o.;5 ggg^

2S$S

^OkiO

gSS ?2SSi

35SS !?fcS aS§ g5£5 gSS

iSi

s»s

31 i ill 3|i ill ill iii ill ill ill

||£ ^l£ ^s£ ^s£ ^l4! ^s^ ^a£ ^l£ ^JBiS

Digitized by

Google

853S

Dcoeo MOftcc

163

OiCO<D S9^^ »Or-i^ fOt^Oi .eotot* »— a>c^

ot<«cc -^ecr-t e«toi>> iciao eocoio «C4-^ fi^O» c«r-«rH r-«ic<o >oioo a>«oco c^tor-

rH r-« Pi rH «f-<»-t r^ «rH MrH rl i-l r^ f^ rH

r-»oc^

0»^QC

OS'^'iO

8;::^

•»1:>C<I

««rH

o»oio

1-1

loeoci

C0l^«O

iMcoio

Otf)'*

eerier

t^ot*

^'^M

^t-«>

.-aoeo

•oeod

S^'S^

00 .-It-

QOCCiO

C4t«0

<3>»0'«l«

iCf^-*

^t^^

f-r«0«)

^COOO

©»OiO

eCrH«

t«»oc«

•^

*-•

lOCOC^

tOM-*

Jt-C>4iO

U3<NeO

o>««

^s-^n

«oo»o

l^'-S

r-«io

eor^c*

0»^QO

toeo«o

O-^^O

CCr^C^

o»«t,-

OSCJl-

« |«>

S"**^

e^t^%o

>^eoc4

CJt-iO

e*r-».-i

«>'4>C4

<Or-l«0

•-•(NO»

CJ'»»«0

o>-*»o

aooato

oceoiA

w^taro

t-<Oi-H

lOC^M

ui^e^ec

•*rieo

lACOt-

(NtOt-

cor-o

CD^-^

;-|^r.

Tft«-I-

e«-*oo

cci-«o

o<©-«<<

eo-HC^

OiOOtH

S :S

^-eo•^•i

iceoN

Odoo

^io?o

^:2S

JDOO

^ss

i-««iO

eo 'n

?;s^

•^

«^o»

OSio-*

OOt-jH

oO-*'*

<ot«9 oiAio oc-«a» oocato

e«-H^

OiMOO

»-teooo

"M JN

lO jlO iC-^rH

coe«r-i

'-'

^tHCO

eooo j

CCiMi-l

ooioco

JftOCt-

r^oDO*

iftt-^-f

eco«f-i

•^rHCO "tf'MtM

Oitoxo

r-^I>

eocsirH

o>irt-i*

CO 04 to

«^.-i

»OiO 1

o»

•Mi-ti-^

^rH :

«^l-«

»eoco

eOfHC4

rH jrH

lOCvjeo

tM .»-i

rl jrH

«0«eo

C^C<I

eor-ici

tH ji.H

M«CO^

fHFH 1

CS1C1 1

Wf-r,-(

0»"*«0

-^fO»C1

OCC«5

eccct-

■*o»c^

00 |eo

^ jl-l

fr-eo-*

eONi-r

"•wo*

(£>C^-^

OOOlOk

iCTDO

»^00

-^r-t-

C«'*QC

«c<^

OtO"*

^rH

QCtrtOO

icc^eo

■*<ooo

^Ci«0

««S S5S3 ^5J8 ?:^g5 I8S?S3 §!§«£ SSft -^-"^ JSSS SS5S SS^Si ?2^?S

SSb a^e £st --ss js-2i 5-Sa 3|s a-Js 3|s i-^s s^^s 5|a

HSPm HS&< HSfe t-?3>^ HSfa nS^fe HS;*i hS5h hSPm E-Sf»H EhS;«4 hSpn

I i

Digitized by

Google

1G4

S5g

83^

:S3$

S2g

J55g

S2!g

S?2$

S?2^

^2^

S2^'

22*® S22 SiSS £2*'* 53:22 S63£3 o»G3t- coi-»-« t^-^eo

2«« t2«o«« 2£ri*~ Qoeo»« «Bf-it« rjo.^ •©«-♦ «oeo« looieo

oe^oo coco

coaooo r«<«eo -^eoi-i gS'^o^ toeoeo ia<oo»

•Cl-aO 0^«0 r^*ei*0 COiOrH 0«0-« f-i

ic«o 00'^-^ QOecto '^eoi-H

:258

S2«3

•o^o

oo«ceo

t- -t-

oo«ao

f^ Iwt

t^OC^

XC9«0

^-00-*

OOODO

ece^f-i

jor-o

OMeo

>Aa>«o

•oojeo

OOCOlft

N"**"®

«3«M

JOr^iO

'«e>4Cii

^l-*!-

l'-94iO

2»2

■*«!-«

0> -Oi

<Meoo»

ooeoiA

Qoe4«o

C4I--IF-I

M«lt-

i-'^eo

eo»ooo

■^ i'*

lACCCI

«»OQ0

t*eo->««

eotot'

lAMM

«Ci««C^

OiAtO

!-• r-l

««-*

cot^«

;5'*o

C]iCK«

os-'fiO

•*eo^

1-3) CD

i-«»ft

a;:33

lO^-*

00 r^ t-

i-lC^a»

lOQOt-

lisoor-

O-**)

CC l-SJ

o»<o?c

S3«3

00-*-*

■^h-l—

eoooo

'^rliO

diot-

eQr-i«

i-eo"*

•oooe^

S*"*

'♦eo^

CCC4r-l

• O'^

•oeocsi

CO CO

lO^-*

7^l>«0

« ^00

■<<<aocD

•O-^f-H

•*5S1C^

O"*?©

Cir-*^

Wt jl-M

eci-iw

CI [Oi

MrHr-l

loeoe^

C4 |C9

rH -r^

-*«•-.

eCr-^CJ

Or-l-4

CO sow

CO .«o

lO-^i-l

t—^eo

eowrs

tOCOC^

-^^ :

•*eo^

tH jrH

fr<«a

^04 04

e^iot-

r- :,-H

90r-i94

i«^'*

•^ .^

'•♦'^eo

W ;«

Oi<Nt-

ooccio

SJ^;::

«»0f-l

'vtasi

i-a>M

OOCOu'S

eoi-.«D

»ot-ao

rS5

5SJg3

s?§

sss

S'£^

SS^§S

8fc§5

9^^

S:;2-

5|1 3|1 5|1 3|1 5|S 3|1 3|1 3|1 3|1

hS(^ hSck hS:^ hScx hS^ hSck hS;>4 hScx hSp^i

Digitized by

Google

165

eS^SS J^S*' SS"* NoO'*' ^Jgg joaot- ccioc* SfeS «ct-o> r-i-i«D »-o>c^ «oo«

wo«o «ot«a> 0004^4 oeor- kqoh^

ooeoto 9t^eo eot^co <Op-<io >Qe>4<» •oiooo

SS^

«5<DO>

<0r-<«0

»«eo

g3S«

5:2;^

"*eOr-l

§83S

•AQOt«

«D<^C4

sg§s

t«rH«0

jOt-OO

oseow

«De0 9O

t^-^eo

c?;;5S

«DGOao

001*^

a;2;s

f-ieoQO

C4M j

^s;:

yfOito

S;5'«

co'^ea

•O-^i-^

l^CiUti

S3SS

S*2

(O-^C^

S5:;:2

IO90C4

N^^

Sg^So

ooeoic

c30>co

egwr-

00 -00

•oeow

^ss

c3««.

t--«*eo

OOOOO

■<«<C>4e9

O^rif-i

S;g^8^

<0«?4

i-'«i«t-

S**

•^1-1 CO

to CO CO

^JSS

t^«r^

C0OJ.-»

•oxt»

^N^-lO

C^^f-i

SS^8

t-oc*

coa»i«-

eoaoto

eo -ec

l-i-l«0

^a;5

"^0»iO

t-04u:)

sss

»»N»0

»-l |i-H

ss^s

-^irt?o

S^2

s«a

« 'iM

tON-^f

SS2

og3»<3>

•Ol-H^

(3»a>o

^•00

00 |eo

ssg

ocot*

a;^;::

t-Oiao

»lOrH

-^•-100

io25

S*^

l-CJUtt

o>«eo

»-C030

Wr-lr-l

{bc^^

O4F-0O

«•*»

g^co

ICCMOO

-^CCi-l

asa

;2;";:i

Ni-irH

OJOOi

j-.u.rc

« JN

^ss

CO-^O*

t^eo-'ji

•ce^ec

OOtOOO

«O^04

Oifoeo

S"***

»^i-J j

t-'^ec

0404 '•

ass

'*C>4(N

0>i*iC

o»yit-

<!oeoeo

CONf-i

s-^s

j^^»«-

N "M

oaoQO

ao«e4

f-i-H •

1-04 00

i*CO^

e«rHi-i

cow j

•^rHSO

TfCOr^

i-<f-*

MCI j

•ococ^

l-« |rH

o»^^

TfWl-^

ri^ :

CJOSOO

w»«

(M^^

C^ JC4

ous •

o<o^

r^i-H •

eOi-iN

.-l"*t-

C^i-li-^

r-t -r-i

jH^r^

J-t-.^

'♦»'*

OOiOOO

citoto

«D-*C»

«^<o

«0'X>

oeocfl

f-*i-^ •

ss;2:

fiSS

"^eOrH

a;::;::

SG-^*

•^ ,«-<

5! Sis

Oiid*

ffjga

85S^

582

UJJOO^

ISS

gss

§8^S

S;!o$

?:^g5

©i«»0

sS«

Si$S

^ *'flS rJ '"S .~! »'Z .Jo's ^ "'fli ^"''5 MSB'S M "'^'tf M "'2 M "'is ^ "Is M* v'd

3^1 s£a 3-ia 3^1 3-2a 3-|a s^a l^e 3|fl j!|b 3^1 s-sa

H^&4 E-i^Pe( H25&4 H^^ HSPk, hSCeh hS;!e4 hSpc, hSbe* h;§pe( hSsm h:§(<4

•■

Digitized by

Google

166

c
o
O

S20

Si^SI

«j^;s

«D«eo

rfit-OO

s*s

:?«?:;

«•*©«

«0;^i-

S5S

3!^3

s-'-

«^C4

•ea<c

•oooo

sss;^

SS'*

«eoeo

S£S

^SS

jHWCO

0>QCr-l

;-«U,

OCdao

;j?5a

«-*«

0D-^<«

S?2g

ass

C9r«iA

»-lf-i 1

OiOO

ooioao

ss?s

<«>«C>4

5$5g

JoSS-

eo«cr-

^cOf^

«DaO<^

o-^to

^ss

^^t-

fWiO

^2!§

ssa

S*'-

usweo

t-«r-«

o«t^

gsis

OS'^O

0>«0'*

S^qg

?oS52

nooo

«>»-<io

0»i*i«

«ON'i*«

gs:5

•O jiO

O) 'C*

^5-3

ISS^g^

i^eoao

M J<N

W-^tO

0»eo«*

a;s2

OOf-il-

«09ieo

«5g5

S8^

eo«o

moieo

H«ao<o

OiOiO

8*5;

<om^

^^l«N j

82^'

S^S

. ©^oco»

-IrH 1

ass

aoccc>«

JoJ^a

weco

JS*'"*

S2S

ss5i

ejwo

loe^eo

"♦«©»

2-«.

s*-s

r- |i-

«esi'*

g o»o

w^®

Dl^OJ t^CQ^ "«l"C»3r-1 fCDU) t^<M>0 r-4<CiA e»W

S2S

0«0'«*" 1-1

eoooio coeai-H c^c^

8522^

r-«t-^ lOCi&i *^^l- «OC4^ t«9l*0

CO -CO i-H -H

■♦r-ico e* -w r-®f-* eOf^Q^ r^

t^-*eo c^ci

g^S^

ooicrt «o-«*ie« SNO-.co ot^co o>®eo t-wia i^-^e*

aga SS?? SSS !283 S«g? SSS3 «{g^ E?SS

• •■I ••• ..« ..« ..« . . m ..OR ..•

•;9 •■« ..«> ..«> ..« ..o ..« •••

^•38 ^-38 iS^a f-fg 5^1 ^^1 *^i <||

c « o o « o © • » O « O O * « O * © O * 5> c * o

HS&m HS&m EhSC«< HS&m HS^ HSat, HSs^ H^Sta

«
^

Digitized by

Google

I6i

as?s

a»<oe«

OKoeo

cj^r-

»*^«o

df-i-H

00 "^Tf

•

"♦f-I«

r>e«iO

§1

t--*co

§1

-J 1

eO^N

to>a \

S 1

i : i 2H

^ 1

»-ll-H •

§§

<o«eo

§g

i 1

toiAOl

! 1

ssa

5? 1
GO

3|S IS

o • • * •

Digitized by VjOOQIC

168

■-C

• O

G^l

1 ^•

1 ^

•MopiAl

•JftMOpij^

•P9UJ«W

•»I«ais

'aSi9ioj

'avoijomy

•pojoioo

•HRM

'aMoaifaQ

•J9A0

pa«06

S^g

iss

^2S

8SS sis iSS ^-- 8SS S2S 3^« §«§

OOMiA iSfi^ O-^tD «DOCO t^iAM <Daat« ICCOC^ lAC^CO

» is

SiS

Jg \^

CO :« gj ig

S :?§ « :• 53 153

SS i

ggS :

«D« :

'*'♦ : ss •*

coeg 1 oso> • «« •

&ss$

sss

gr^s

SSIS ssss

§SS 3SSS @i^^

^^^ ^fiS ^S» ^^^ ^ss ^^® ^^^ ^^^

•*»-iCO Ejt-^ »oe«« iO"*i-i NM

5;*-s

eoe4f-4 t«|oc4 ^-«Ot-l

■*«»^ ?i?et ft«rt"* QOi-it- o<o"* »*«■*

^e9e>4 gOAOa C*r-»rs »-ii-l r^

gSS gli MSS Sss §2S S2S 2^s gss

oa»f-i loooei eoe«i-H

8SS SSI sss s^«= mn mn s^» i^i

eo<ot« «"*« i-i '-^ i-*^

l-Hl-H • 01|M^4 r^rs

3S^ P^So SS53 *^^*^ S*S SS* '^"^ S^S

uaoot*

f:25

asis

lOi-l'*

;5«0.

SSS

JC«iAC4

ooet^

OtOiO

^5:^

ass

oO"*'*

00^'*

s*s

ooooj

«»»«-

■a « . . m ..« ••« •.« ''(B '*S

■sjl -11 -sli -»§ -s§ 5«S 3«| ill

Ui H£ SIpS I|£ ^s£ ^i£ ^IZ 5s£

H
H

•2

Digitized by

Google

Ififl

§^i i§g §^^ igg §is »§§ gs§ iss gsi MM ^gi iii

SSo^l

«Ot^O)

555«>

«5«o :

«r-»^

oavoo

coos-*

e*i-ii-«

tOC^i*

55^3

<©<N-*

t-ot-

8 js

s :n

^ •>

§S \^

^ :U

g jS

5g :§

3 is

5 |5J

g is

S^ :g^

§ is

co« 1

^8 i

J^Sh i

SS3 ;

S2 :

S2 i

^g :

s;3 :

SS :

^^ i

8S :

g?§? :

gss

gS8S

gsss

2E=J2

$5fe

a:8J2

gF=S

2S25

§IS

sssg

i3S

§S-

SSS

§a§

Si^

«5§S

sgi

§58

^SSlrS

§S.3

gSi

SgS8

iS*

^^^

SS5"

^t-^

eori.^

OOlOCO

«C'»»«C^

«r^»0

fCiOrl

«OCQCO

t-<N»0^

0"*«M

CMiOt-

^^ii

SS^

sss

t-«>rH

^-^eo

aa*

it^^g?

gj«3

ass

3§SJ5

£1^^

S83

gsg

i§§

iSI

gss

ii^

S§§ iSS

S^s

iii

iis

l^-s

eoi-i(M

S55aS

^C4e4

•Hi-H 1

l-H jf^

»«-«"*

CCC4rH

ocow

s«s

r-i :^

§§§

giS

§§3

3i§ iS§

iaS

ii§

SSI

'*CSS>J

w |c<i

cceo l

loc^eo

ICC^I-I

r-.-. i

r-i 'i-i

r-ii-t •

(MC^ 1

l-Hi-l '•

-««<MM

""•"^eo

eoCMf-H

COr-i-M

•^ :•"*

-*r-ieo

o^«

-^i-teo

diMr-i

i-HrH j

ga* S;:2 S*2 §5:2* ;::5" ^:::^ 5ga ^i::S {:;** ^SS ^** ^§5?,

a)<ooo |S«»^ ocooo Ois^t' .-ii:--^j« g^'^^ SSS eS

moj ©joc^ tr£^l«o ocooo i-tj

35;2:§? SSS ;5*'^ S^SSS ^"^ SS® S3S 55S23 ^;SS !t:j5::S i:;^*' ?c?32

■s

3|l 3|§ 3|§ l|i 3|i 5|i 3|i 5|i i|i 5|§ 2|§ 3|i

t-tS&< hSP4 EhSP>m HSCi< H^fe EhS^ h3^.&^ HS&h hS&u H55fc hSPm h5^&^

Digitized by

Google

170

c
o
O

Total
Males
and
Fe-
males.

iS§

!§§

gis

sss

§§s

Si§

eii

iS5

§S§

?s«s

•0«>>W3

co-^esi

oo«o

s^*-

e4«o<«

«o«eo

fr-Ob-

^«oo>

•MOpi,^

s; :>

.*5 it^

gs :§?

^ :«

fc >

St :st

O) at

S -'S

•jOMopiAV

SS :

SSi :

2S :

SS :

'*•'♦ j

eo« ;'

SS :

ccoo j

s^ :

•peuawre

S^S

SSS2

gg'^

^S??3

aS^;}:

Sffg

S§2

ggs

gStt

•oi»uig

|$So

ss§

gse

8SS

stgis?

SB!

iii

§=2

ggss

O-^i-i

o»io-«*«

t^'^tCO

o»co<o

•^'^ :

sooco

5355^

3>«CC

t- |t^

' -aSieioj

eoioao

RcSS

tr^t^oo

'4121:;

0»iA-^

sss«

Sg8J^

r— wco

C^t-tC

■u«.)u.iiny

i5s

SS§

?JS

Sc^sS

gSg

§i§ SIN- i§i

IHS

•pojoioo

»oc>ieo

sss

co»>*e^

i-Hr^ j

a*a

§?35«

r-. :^

OiO'*

•»^iqAv

§§§

siS

3SS

§i§

§§i

HSi iSi

SSH

l| *uiioa3{u;i

e« jc4

lOWW

(NC>< j

r^ jf-l

loeoc^

o»oec

tC'*^

-♦CflM

pu»06

e« jc^

W^Cl

eoco 1

r- :»-•

eooti-i

i-ec-*

<N«-ii-i

«ecec

S2g

23^

ai;:!?2

^22

S2S

i^aocs

S2;^

$2S?1

^x eo

S52

^3g

S*"®*"

55352

tOt-OO

?52"

iCOCt-

P»«cO

2f55S

oo«:

^xV:^

R2^

ceo 30

^US

CRCJt'

s'-a

SS"

S3S

2?^;=:

-^x-^

?;s2

CJ . i» .-0) . . Ci • -^ • ' ii . . ti . c ..«

' eS ^^ S c3 <-*

-^?:« -::S«s -S«S

3^1 5^3 s-^B 5-i 5-i f-i i-i 3-i i-

H-^ji, Httt:^ H<;Pfci H<;&^ H<«f;6s< H**.S^ H<<a^ ^«^5ui H«l

w^ 9

: .2 .5 * : : ' §

Digitized by

Google

171

§§s %m m,^ §ai nm ss^ §si %^^ ^ns iss 3»a m^

»«M^

t^aoo

s*-*

04940)

9«090

s^^

r*rHtO

mo«eo

ooaoo

s;2:«

or-eo

«oe«'*i»

^ :3

?5 its

So iSc

S :18

g :g

^ :^

^ :5S

IS :;2

gS :g5

s is

?3 :S^

5J \^

'*"* :

iO<0 1

SS :

S«& :

;ss :

;3^ :

SS :

•^■^ •

sa :

SS :

ag^ :

c^^ :

SS:;:

S§^:S

S$2

ggS

gssss

§SS

§1525

S^^

1^^

gs&

S;fe5l

gS&

§S'^

gSS

gs$

ggs§

3S8

g3;s

3B5

s^:;:

SS^

g^gg

S^$

ggg

«eo j

-♦rieo

r>i094

•^^^eo

•«eQi-i

ao3«<o

»o«o 1

»oe*eo

^04C4

fr-««(M

»neow

^CS|C<1

r-c«io

S-'S

«&>HlO

o»-«5

^jjr-t^

aas

ass

i^o««o

»oa»

3SS

8SS

OOWiO

8sa

§sS

SsM

SS5

SSS

SsS

5S?£

sss

iSS

lis

iSS

^-' :

Ol-^iO

Q0«DC4

• '•iC

^^'^

«OiOr-»

rHf-i' r

ass

«O^IO

i>-f-i»

sss

iSS

§23

sa§ gss

SS2

§§S

S^S

§S5

ISS

gB§

8§§

C<ie4 • eOC4i-H r-« ••-I C4C4 • C1C4 • r^r-i

-<re4C4 0'>*o 00 'CO to-^-M locseo

lO -lO 0 0»0 i-if^

fr-ofDOi ooectn ^•a»Xl

2S sj*s i;8?l s;:^* SS2 ss?i ;::*«^ 53::;s ^JSij;; 83* a^?3

0^ *-Ot^

J;2^ fi'-S gJ8i2 55S^ SS55^ S'-S s*^"^ l^;:!?:; '^S;? SS<* g«;2;

•coco cot>-'r> 3i!'«»o

'•o «oco oce-^ eooko> »e«t- &it«iA odioso eoo» ?D-*e* q«0'*

3-|a 5-2a 5-ii s^a 5-ii 3.|i 5-|i 3-|i l^a 5^1 3|s 3.fa

£H:gCL4 HS&^ hSse* hS&4 HSfs* t*SP"4 hScx* e^Spm hS5m hSsm hSn h5S^

a
2

Digitized by

Google

170

o
O

Total

Males

and

Fe-

maUs.

i§§

gg^

ssa

S5S

§§i

§i§

esi

§§5

ssg

H'K

ooooo

«oe>>(A

«0-*0J

oes«a

j3^t.

«00^

SS"

5^2*"

;5*C.

•MopiA^

S i^^

S5 ig

S5 :s?

5 :^

a is

lo ;?o

?: :it

o> o»

S -5

•J9M0piAV

-5;S :

SSi :

ooco j

■*■* •

S;5 :

SSS3 :

£S :

OQSO 1

ss) :

•pouaup^

z^^

SSf2

8Sg^

^55?

ssio^

5§sg

isa

gss

gSt?

•oi»aig

gsv;

§ss

SSf5

8SS

S5«S3

§S§

§§§

iSS

gs^

•HK

lO-^f-t

•«o-*

t-'^CO

OkCOCO

f^r^ •

»oeo

538;^

3i-J>W

1- jt-

•naiojoj

er>ioaD

{2S8

jot^-e

•41215

0»i.'5^l«

as~

SS^

»-'««CO

oai-u?

iSS

§s^

1^2

g$^

gsi

«§§ gsg |S§

ISS

j -pojoioo

OC<ICO

ssa

eor^c^

r^fM j

S"3

^^*

,-1 .^

OiO-*

i -o^lHAV

§§§ gii

3SS

§§g

§§l

sss

Isg

*uMoas[Uf^

w Jm

(Mf-ii-i

lowco

N-M '•

^ i^

oeooi

»<oec

0^—

-*C^N

j -MAO

« jc^

t-Ot-H

CO^<N

cort 1

'^ :^

«©«»-«

t-w-*

C««i-ii-i

«C«M

S2S

Oidt^

s;:52

gPccec

§5^2

lHjOOO

^2;:!

$s?^

.->x>«

^22

S58

C^irotr-

552:2

ot-00

SSS

iffflOt^

C4«OtC

5^-2

KOr^zC

Sl::;^

sse

fou'sao

l?us

SiC^t-

S'-a

S;:^'

^S::

S?8^

•^M-C

3^:2

—

• c

•J

«i

I H55&M

: o c : : : : 5

Digitized by

Google

171

sgs §gg iss §ii M% iss §§i i^"^ iis nu i§s gg§

t^eC"* r>co9) o«-* c«ooo> »«so oa«t« »-«-i«e lOMeo aoaoo ©"^^ ©r-eo oc^**

a :a S5 :§?

i;; :5o

S :!8

g jg

SS :JS

^ is

K» •iti

gS :g?

S :2

S is

g iql

SS : tS*^ :

SS :

SSS5 :

»« 1

SS :

1-t^H '•

Sa :

gg :

as i

SISJ i

SS:;:

ssss

S52

gi23

gss

§ss

3&!S

Sl^^

gas

gss

§^535

^Slo

gs$

gss

gS$

S§^

sss

gsc:s

§ss

S55J

g2?2

ggHS

^551

8g3§

ocoo 1

'^iMCO

r-«oc^

-♦-^co

"♦OOi-l

QDMCO

lOiO 1

>QC4eO

•<**04C4

t-iO(N

OWN

^CiC4

t-€<l»0

«:ioo

«-^iO

o»-r«

^•t-t^

ass

r^ejio

32*

^ass

8SS

aoco>o

usa

825

g§S

3^1-

feSE

sSS

a§l

^s^

SSI

iSS

ii§

ISs

1-.^ :

OJ-^iiO

0OCO(M

»'«#tC

i-»«0«0

(OiOr-l

i-Hi-l •

sss

cOphiO

C^l^«

i§S

USS

gS2

ss§ sss

3«S

sss

|f5«

iSS

sss

i§i

ri »#^eO r-»i-»

»-• CSIW . eOO«i-i f-< "^ C^Q* . C^C<I • r-lr-t • rl 'i-H

c»^»« oo -CO co-^C'i to^eo

lO 'tti 00«0 ^i-H • t— ♦«

»-O0O4

asia

J^S

5?8g3

OS— »

S552

a::?}

^u.«

53SS

:5iSif:;

S3«

a^'^

cjac*

r^ot-

8*-S

gsss

S£2^

SS^

S5*'2

j5«o

asJ:;

S32SS

g;:5«

s^^s

• ooo

ect«--r>

SSS

83SS

8SS

0C»O.

ss^

e4l>UD

SSS

§5S3

sss^

gS3

..W ..V ..V >•« ..« ..u ..V ••O ..« ••« .•« . . Of

3|1 ill ill 2|i 3|1 3|1 ill 3|1 5|l 3|i 3|l i|l

E-4SCe« ^S&4 hSPc» hSEm hS;s4 hSSee* E-»2Sci« E-»Spx4 E-»S&4 Eh^;^ E-i^»m hSEm

Digitized by

Google

a
o
O

H'X

•MopiM

•joiiopiM

'pOIJUBJ^

•oiauig

•HX

'IL819J0J

'atiouamy

•pajoioo

•»^TqAi

'aMoa^afi

•19A0

pa«

S2g

S28

esff

H
5^.

172

sss ss§ §s« siis ig8 iss

iJS PI SSS

,-7 cOfHi-i

s«^a

t^or-

»-«o»-

c5^^

j5«ao

^«»o

SS^

£$!3

b>WiO

2? :5

eo \n

S :3

S is

s is

Cfe j»

S :8

g;g

SS :S»

WW j

^S :

SJS :

^^ :

5J5 •

SS :

Sg i

SS i

i-HpH •

SS :

gs^

Sg^gi

gS^

2§^

8S5

i£S

SSI

SS2SI8

|s§ sffis sss IsS sS® SS^ §iS 51s S^®

<*— eo r-i«N T-t -r-i »-<o»c«« 2S^^ ^ooeo S9g3*A ScSS '^"^■^

sss 3S" s*" ass sste ""^^ sas |gs ssa

§PS gSS i§s ill' ggs gES iii g_^i^ g|3

e)t><0 rH -r-^ i-<rH • i-hi-h

r^iOW OOOOO

qp<PW ■^'TC^-l C4C«U>

2SJS ;^2;2 s:i^

§§§ §i§ igS ill g§s

W 'W yJr-iW ^ 'i-H wco

-"••COrH «D-^C4 in-^f-t lO-^rS rHi-H

MW j

^WW

WpHp^

w joi

'V CO 1-4

'* j-^

'*eOi-»

s^^;:

b-NlO

aO'<«>'4<

^S*

sss

^^^

!S;2;53

SS"*

sac;

gS2£

SS^

c5::!S JoS^" S-3^ SSS ^j^n SS^*^

3S* S5532 8S^ S5SS SJSS S*=^ ^SS 3fJ2S S*J:;

'3©* •aS* -3©* -io* -^S* "^S* •3£< -^S* -rS*

o " © c^ © o " © c ■ o o * © c * © o ■ © oJS © o * »
HSCn hS^^ H3%;iH HSBc^ hSem H^P^ H^b hSex^ H^b

5 5

Digitized by

Google

17.3

ISS iaS 8Ss lis saS B*^ iSS ^^^ sBS iSS 8sS iSS

or-«

eoiftoo

o®><«<

uch-oo

t-'^eo

■*

oo«oeo

iM^ :

0O"*if<

«0"*C««

ao«oc«

b>iOC4

s a

^i^

^ i^

§ jS

§? :§8

^ |5!

e« •G4

{s i^

S :S3

?5 :&

S :^

eceo •

s?: i

1— 1-, '.

^« :

r-r~- I

»nifl

SJS :

C4C4 1

t»t, :

2S :

88 :

^SS

gsg$

st?^

gsss

SS§!S

551:; J:;

sss

i^S*

£^s

^;s^

S;s:s

?25?o

gSfe

Sgs

2SS

g&iS

|S5:

?:§8^

2-5

•Atf>S)

gss

23^

gss

gsfs

ece^iM

t-«oc«»

eCM-^

t-«o«*

0)00 i-i

-"••eo^

(0-«C4

c^ jesi

t^eo-^i

ect-to

-«••>* \

co»coc

t^«p»-«

sss

aotoeo

CO tor-

eciMrfl

eect-

asa

ot-co

«O^C4

J:;;^*

g8SX

iS§ §Si gSi gSg iSS gss iss S2S3 s=a |ss |sg sgs

CO« • «aWC3 »OVH"^ C^r-lr-*

: ^

■*i-ieo ^H^^

isB is£ nm lis g2§ g^e ^s ssas |8g §32 g|s gs«

e<i-^^

COClr-l

CQC^f-l

'*weij

»M jpH

,HPH :

i*<eci-<

t-lt-l 1

(NO! j

Cvl "'Cl

^^eo

eoi-HCi

«CC^'*

00 n

l-H .'rH

I'-C^O

CO |co

M^^-H

toeccA

C^PH,-.

»»o

55S«

gJ2S

g8S5;3

5h2'^

0»Cirt

82;:l

aO'*r»«

QCi—t"-

lOOCt-

2*«

a^s

coo-*

5522

NI^iO

55222

5;;5«

« ;«0

8:2:2:

t-iOlM

c^to«o

GOQOO

8;s;3

QOl-j-J

l-^«

§5;5^

«o»o

Sc22

823

■^OICI

S5a^

Q0»OCC

1W>J«»»

eo-^O)

8^;::

82^

rs2< r:2* -TiS* TsS* r:g^ r: 2 * rs !

i|i 3|a 2|s 3|a i|i 5|i i|i Sla 3|i 3|a 3|a 3|8

HS;k4 H^b( hS;^ H^[^ hSEs4 hSem H^Pii HSPm E-iSp^ H^Pii hSpm H^b

Digitized by

Google

174

•MOpiAV

•JSAlOpiA^

SS •

23 : as : ^* i 5:;5:; :

SSS^ i

«« ■;

SJ2 :

lOlO j

•paijjuW

gss

S9% SSS3 S^g^g) SS^S^

2^fe

SS^

SSS

^s^

•ai»ais

gsg SSS l§i S«- iS§ §§1 gB gS2 S^s

eoootc

ss-*-

?::S'-

o»eoco

aoioeo

04 oc^

OiO-^

«094<«

S is

^ ifS

5S :^

S :£J

§§ :^

55 :«

^ :g^

55 :53

SSS SS^ ggS ?^^ ^SSS »SSS SSSS gSio SISS

e«e« i C4M • «-««»ft t^fO»M Mi-iix ^WM aoioeo e4»-<pH ^eOfH

*aJliajoj

^^ 3553S5 5SS S*'^ •*=• 2**^ 55^8

CDC4'<t* ^0404

'avauany

igE S8S III sss III |Sfe gsg gag sss

•pajojoo

^n^

O pH .rN MrHfM '<#r-ieO DIfHpH COeOCC

•»J!1M

gss SSS 55S 23- iSs lis gSg gSS S^^

'iiMoiii{aQ

pa«06

M»e09-1 Nrir-i '^•Or-I C^<M • 00 •« f-i»-l ; Wr-ir-l

§2g

I i^5s

-^fCOr-*

i-l 'r->

C^rlfH

•^ •»-•

e^i-i-^

«oooeo

«©«»«•

coioao

OOOQC

04^2

r.O^

S8c^;s

5;S2

^ss

82"

oocoio

oo^t-

SS'^

55*S

^^ :

^^t^

aw*

^;2;s

§33S

t-eo^

»^iO

sss

flooo*

OO '*'«♦■

SS»'

S32;--

a?3«

82*

QC«*"*'

5|i 3|i 3li 3|i 5|i 3|i 5|S i|i 5||

H:^aM hS&u h^I»^ HSfi^ h53&^ HSCm hS&* hS&4 hSP4

»•

Digitized by

Google

175

gs^ ssz %'SS3 n&n ssi ssss ssss gsg s!;:^ £37 |;

S2;::

oco«o

eqieco

aO'««ii*<

i2«<3>

J3253

83J*

lO'.*'^

«SS

CC»C x>

«eo ;

t^-^eo

3^**

S :355

J5 :55

a is

S :«

» is

S i^

S is

?3 [U

■* •■*

1 "1

a :§1

gg j

SS3 :

COCO 1

eoeo '.

gS§ :

eooo j

Sa i

SS^ i

a090 1

J— t* j

fr-S J

t<-t^ J

?2r!S 8SS SS?a i:«8 S&2 £$?:8 SSSS S?£28 S?§SS 8522

S§S

f2Sf-

|S8 |8i5 it$S SSS gg| gSI g;;S ggg 58^ ^22 5|| g?

rN QO'^'^ t-Hi-t • e^«o^- a-fr-c»i -^cooo eceo ■ 04900 eo 'CO loc^co ocoto t--* teo

SS® 822:2 SSa '^''^'' g$S J^*"** ^^""^ gSS^ '*'"'' *°*^'^ gSS S2^
2g§ g5J3il gsg Jgs!2 §?gS SSS Sf28 F^gS S5$J2 «8l8 Sgjg SJ:;S

g32^

■*l-t- leti-^-t TTflOr-i 0^(0

OoSSk

§S|s iS« ss^i Sss i5g 5^^ sts |2g isg PSS5S lis

CQt-iC»

C^Ol j

c^oi 1

«o«oo

«fH«

eOFHC«»

i-ic^jeo

rnrH I

COWf-l

^NC^l

-^Mf-l

rHi-l j

eo jrt

^'*C^

rH jt-H

'-' :^

«OOr-i

i-HfH 1

Oll-»1-H

»AiM'*

^ :-»

g5*S

^«ao

OiCsil:*

§5;:s

^g5^

«Dr^ lO

83S

?5§a

eci-«C

S^?3

OSiC-^

^-^t* ^aceo o®'* ^rrS! <5^'^ ^x«o sacS''^ t^«>i-« ■^c^cM e»-ac -^Qoo

eS^S c^®« ooaxo J7<X?^ °^5?'*' a'*"**

O)coco a»<Dcc

5SiJ5 S^

; ■
1 e

-3

"ei

13 ^

•3

HSSb hSS)

^ -I

CC OQ CO CQ

Digitized by

Google

176

•MOpiM

'jdj&opi^W

'paijjn]^

•©laaig

•U819J0J

'avoiJdiny

•paaoioo

•»^!qA\

== ,1-

uaAO
pa«06

S2g

,1 ^

155 sss =»* iii S2S i§i iSs s2='

a^S'^

•coot*

useoo*

'^^00

53 '^^S

^;:3

0<©">#

t-oauo

2 is

5 :5

a» |o>

S j^

S3 i§;3

g is

- i^

a :a

SS :

w« •

ocao •

S8 :

ooao :

5?3 i

SS :

ss ^

SSS §5SS 5Sa 255 55:S gS3 ?i5S SrsS

III 2^'^ ^^'-^ i^-® S^® SSS 2^^ S^^

r-^a* tCes-H '•••OOf-i tD-^e^ Mr-iC^ g5J2S '^'^ i t*"**^

gjgw oor^^ ^g^;* t-^w jDWg; ««>i- *DO>r«

i?S I2E ^-^ iSS lis ISs iSS3 S«i

$jS^ -^

SS*"

hQO^O

(o«Q •-•^t^ o-^oi 9£-!":!t SiJ3£:*i SSS ^SS

If:;* r:^^ «stf^ i2s s;5S s£2 ss;3

«QrH(M C"*--*!-" -^rtr-i

04C^t- COi-HG^

C^M • »-^X MC^

<c3»i- t:i^» n;:22 :3;i£!2

f^ CM'-*^^ '^"C?; CCr-n-t

^aS d5iS!S •^^^ 22* Ji^S L^^Scc SSS i::**

'KSi t--*"'^ Qo-T'* S^2 2^£ 2X2 Ei**® S^^iS

r;S« ^aj~ "^oj- *!!«

TSi" dis sjis tf«5 «i;| *£| 3®! gJS
HS&:; hS;2 H?5ji^ E-55S4 HSfa h:s&m h^Ssx. hssbm

H
X4

c . . •

: : '. S '• '' '

-g a •? = ci -^

Google

Digitized by

>8i

177

&!;$

r-ao

i:$S

B I

??3

-^ :^ e?3g

8SS g|

12~Bd. of Haalth.

Digitized by VjOOQIC

178

o
5

"< '\

•fiwq^opi

•SJ9q;«j

•pjaqjoj^

•Bjoq^wj

•saomoK

•sJoq^Bj

o
o

•B9itini3j

•sai^K

■Bdivoioj

•l«50x

'Baivnia.1

c^t- :ao© '"^SS*^ ^''S '■*

-:55

^'B'^^l

•-^sr^ss

*sa*;=

;: i'^-S

^g*'^a

^ : ;?S :

S :S=^S

1-CMO.ntO
rHrl !-•

2Sg?,:2S

c^ :r-r^»c

lo jSI^S

-SSSli

'•i'SoOlM

SSi8S

CM ts .0 23*0

gsllsg

MSii isisg

is?---

^f3

.-< ;c^r- r-< .l~

^IP.??5S

liSSs

e; o o -M 'M

§ISII 5iSsS SSIs^

■»r •-« O N •*

o> -- X I - o

•aaiBjv

3 05^«j'l1 iCl-tO©*?^

SEIS2

■^ Q tn 54 CM
D « 23 6l 'f"

M5oeo-^CM

§s§Si

uequidOdQ

'jaqinoAO]!^

lOOOOiOS C5-fOl«— 'CO iji'il^'^-*

5S .?5*§5'^^ S?i«!?l3

•jaqojOO

'aoqiaa;d3s^

28S gSV'^^^

•^snSnv

•.qnf

•oanp

ludy

•qoj«K

'iCjvnjqa<|{

'.(jvnuvf

0> 90 O CM O
eOriCl-^iO

S:?^^;?

S5SS22S S25S55;? SfkS

S:^^?^

^'{^2£c5??

S;:;s?iJ^

^?3?:i;?S

?J!^1S^S'^

33k?^?5

?SS^l?,^

5^S^?5

s^v^g;?^

^i^;;^§?

^'^^c^^

P-^'fllc?,

:;S?:3?^i^

S?82?g55

^5^2^J^

^:.?2i:f^o

S^srtss

J5!S^?^2?

Jii?i?1S^

f-5?i:?g

??*•-; v.^;<?

5.0 lo sj:

ce -,
is-:

*-.-r is-:: <

O O u w. -J ee.2 * i V,
w-^sQo^M ouees:.z ^J^kSSv
<<Kapq CQWo^u :^oqPQ

»^ a r. :► 15 rj<!_«j2'S

Digitized by

Google

179

lir^-"*

•»««- Tc^ : :o9oi--ri ocr^aATi

gfcl'

•^^353^' S2 :a : 52«*S

»-*ao r-Moo

^oaoxjso-f Iioo ;^^ c*»® :c^isc ^otot^o eoo«"*Qif: 9R2J'^t:»- o«0"*i-i I

"'^''

't-i'* '.ta 'iso*'*"*^* :t^ :««c>

I :§|- ^^ i'^ : -^ : i i

oDc^-MO^ oc>a»e4

oooftc^oo ;i-tootoeo a)r>C4«O90

:*5 S :fe2'' lg;S :»' • s^*-

%^m^ sisss iisis iiisn siMii 53|p ig§«i §§sii
si^gg iiBss Mmm i5S5§ s^ssi sssp sis^s s^ssi

i>-«o :« : .-•

oo-< Ion c«»^'«»i^

"^ i'vccio ri»

M :?!»«■» »-••?«

.vH ...

ssssa R^sis gs^??a g§sgs sgsss iiigp shiss ss^ss
ssi'ss si^is ssssi mmn %mm mwi ssiis ss-ss

%m,m mum mmn $mm smm

ssep

ilSis §g'=i§

SSS22 ?BSs£ SsggH gi^SS SigSS ^Sip SUSSS BS^SS
«ISSS I5§§S 2S?si g=HSs §§§2g sSgii g2§aS sl-ai

■"ssss ses^s s*s?5 sssssa sssss gss|s sst^isu ssj^ss
sssaa ssssi~iifisa"^sssa~aiaa3~^a5ga~'asiss~s?5=^

aa:;S'r3 $S$S5i! fcSS?S SSSSS affSSS^SSPgS SSSI5S5

z^^^n sins^s ^ssiu Sssssis c3ss;£«3

^'SpoSoc

i^assjs^ sseg^s ;i:sss2?s3 5:;sss53 asiss^

PHCO

Si^ssa s;?'^^;^

?5S?^fi?5 Uf^T^r^t^ 55?8?5?^ SS:;'58 §8f2?S53S *^gi?^ SSc^aSsS

o»»<-«oo

SS !?SSS^ 5S85SS?55 S^??»'?3

sss?g

«sgg^^

JhS;^^;: ^is'^^-s

^5:;sg^a :?rr$i5$|5 Sssg^^S ^;:

22rtg3s5S SS|g^ 5g5c5J:?5

;i?i^ss

sa??2g asi§:ss J?g8??5SS ssssss «?24i55 s?5Si;;? ;2;^as2

S^iS^S Sl::^^S SS^^^J? rr^3?SS ;::S?^

as??;??^ g3S2?$ 9ag;;5J *5;2i;j:;;5

^feS5n8 {bSScS8 ?og§'^5!^ S^fS^s"

^g;?**? SsS^gg:?

^^^^"^^ 3^gf-'« S;56U^?;? l«c5S?3S

:S22i§

cJi .
^ p c

«B « Oi

'.2 o I

^2
. o fl

;gp

•J? c

Sfi a

5c* iJccB** C-.2SC c-'o,-
i*JjJ ^»3SS5? SSSSS 5?:>:?5o

c m >hs p .Peg Lr<- ^ ;- a es ss ob.- o o o « a « « fc

H^i-^'-j^'-s ►^fcdUJJij K^j;%?S55 SS^.SS 5?5;2;coo

Digitized by

Google

180

i5o

55 a.

'8J9q)0I^

•saaqivj

*fa(Tfui.ij

^fotufV

'SdLvmnj

o
O

*MI*W

'|inu

'tain mil J

■MO}V\\

'j9quT»Aa(I

uaqinaAii'X

■j»qin»vl*b'

-l»nfnv

■linp

■liJ'JV

*qojfij^

'£jTnjiqa^{

'^4in>ti«f

I
I

s-e« : .r^

^ isgs ;t8^ i"

S-*"-**" .i^ir-«o

'^*Sg8 :3§!S i'" ^ :^''S ^^S^S

eo» *ffiw ^ : if-irN :<o :« : s£»rt .«'-'

S3^ ifias

c^tCi^O-^ O : leoiM :eOr-ir^i~i coo :o»c4
— . .. . _ ^^^ QQ ,^ .^

.$2S

S^iSI ill^S gl§SSS Siigg -|S§

SiSII sggss S|sg3 g^iig §§gg

:g? :S

Sgg|2

5|§|2 [3g|g^ i£S5gg sggs

I55S ^igsS ^§§1^

iSiSs

§ii§s iig§i mnm s^sii -ii§

sgggg 'SSis ^g§5g^ §£^S£ *is3

SSIS5 S|gS?

^SIS

SSSJJ:?: -•^^^SS ;=§5^t;'" ??^iJ«5 ^''tewi?

?SS;S85 2SS22 SJSSJS* 5^25?5 ''SS::?

SSeoSS

rH .-I t-ujiO

:S^^;5S SSJ::^?5 <^gs^s

S??§5§?J3 2§3:?2^ *ss;

O^J-^^O

•MJO"--^

SSf?

S^??^^: S2$s?i53 S??;::2S SS25255 ^§?5g3
52;:^c35S •SSSSJ SSSS'-S l2?Jg:jJ::iJ? ^2?555

<or?£j-ra «

?J3S "^SSSS SSS2« :£g5'^J5?; -^^{2

2t(?g5g5§8 *?«gSSS S?1S82

^s^ss^ 3??^?;^ ss^is^

^l^Sgi

0?5{^

i:;^?,25 SS?S??3S 2g3g3S;5 ^.^,i\P.^ ^^t^.B

^^^^^ ^S'^agJ ^§^§3:=!;: s?S;5^ft «^r^!2sg

?3S5S5

2?o^SS sg?2?J5S "=55S^

;s^

CoJ2

5 o
as a

s o

« SS-gl^ t2:2SiJ-g ^-^5^2 §|ad
•j5n=o§ a^J^J %^KS2 J?*^.&.& cS£.»

CuCUflNCUfiH P^PkffiffiK OQCCCQOCfQQ COOQCCHH ^>>'>

Digitized by

Google

181

g^grr

S'^sr: s

i-^a : ^^ r II

".^s : i5^

'c^-

sSsS il2s I

i^ss

s:2SS2 1?
1 2j

C4 »MrH CQp^^rH | »

gs§^ isi^

!_e»5_

g»^8 B5§5SS||

s!S§;^ ^^^n\

8Sc5^ Sg?SS||

s;:!:;ss ioS393 g

IS'^gS 5gS5:;S|^

353853 I2F5S3S g

SS^^^S :?§8:5a I

S82^ S

^ci^^ $S^^e3

:2s^s§a$ s^i^ig

iass &?2:s ^

Digitized by

Google

182

CO fe

0:1

ft:;

'paijod

19A0 pa«

•qineAaia

•qiaox

•q^uiM

VR'ia

■q)a9A8g

•q^xis

mjK-i

•qjjnoj

•PJRX

'paoDog

"I "Li

mox

ecact--*c^ -Ti-lr-if-iCvl OD

CO— »cec.-< eOr-iC4CiC4 s>

f-iO -^^w

eoi-4 r^ece0(O94

■^OOr-iC^SC ec •Cli-».-» tCC4r-i<Di"t o -oeo

o» — "^reo lOi— •<«*■* i-»«»-i'^io d

?c o •c "«<• cc -^o-^c^iio o50ioc«i-i t^ocMr^i-

§15;"

ssa*"" c^ooi^;* as-^ri* a*8gs

S2?S''55 g3^«2JS 55S»-^S S^^JSJ;

gJS^^J^SS S2;2;8S5 53^51:; SS55S3?^

sss^s^.' ;$S2«5S f:S?ssa asssfii

S53S8S? S?32^^3S gftfeSSSS 8J5$SS?S

Sft?2i?5? SS^Sl^ ;tS^S85 SSSI5S

*gS^§ I^^^S 2«^2^ Sr^gss

;::^'8f35g S53g8^ S;SSSS SS?S;5g5

i^'ri^ mfSM m%m igisi

-«;<s2aa« «p3:j;j-. :;^^oQa fieaoM

Digitized by

Google

183

•^

f-HOO

«ojo«oioec

©««f-H

«0«O0«CJ

:«

N 1 eo

sgi~

eQi««

««"

»-• «i^r-

(M--<

r-iW

cookc^n-^

CQC4CC

OO-^^CCr-

•tp

: ^^ss;-"

i-lrH

i-i-*i

t-i'^eoe^

ic«i-»eoi-«

oii-ii-iccio

laci^n

•'"••••♦•'N

1 <0'MOie»>C»

eOrHCO

^(M<£>

WCOfH

COOO."!-^-^

iftC^O^O^

O^lftC^^

C^C<l<N

j <©««

gs^

l-iO^O'*

iONrHCCTf

ao-^>oeo«D »oc^«oi- r-^D^o-^ec c<i«ci:^ec«o ««Dcoio«3 c^ior-^a»co c>9C4oo«dc4 «Oi-hc^co'o

•^joi^-^t- eo-^ooict- t-o»t^oD-< mot^cqic eococ^oao o>t-:>t^'^ oor-fOt-o> -^c

i—<o©!>ect^ r^MffJC*"^ -^osccii® spo>»-<eaa> occ«dc«io rr*5'*iO«o f-r-^»t- wic-inc^

S^SS:: s:fS^8 ^?3SS5S ?;*2»2;{:; ss?5;2;s ??«§g^ s:2g5S;s '-S'^^a

*=^c15355S 3?{::5^S ^?5??S^ SS2n?8S ?,g5??^^ ^^Si^ ^tiSt^^ ?;a^SS
^^85883 gfcS§SSS 5S?%8.1§S5 :2^1SS?5 §s?Bj5s;?5 S^ggS 2i;SP!^S 5?5:2?^?5

^5£^ggS $?S?gS8S $5:8a;S §?:5:8glc5 ^!95Jo^ fcJf5§5S :5S5S5 5lo«^?3J8

SSSSS ^sssgg rtrr^ss s^i;;^.^^? ^^ssss ^i5S5?trt si:5a;!S ^ss^

"^Ciirt— I MoO«Jt~t-

JJgg ;3SSa?S !>^SSS§ 5?S^§85 S^I2g^ g^Sf^s SSS8U

'm^m §mm nmnn mim siiii 'imm mm^ gi'-ii

Digitized by

Google

1S4

'pouod
-9H ION

C»--"*i-»CO •» 'r-i N»-l -f-i . «OC9<«C0^ -ectoo

j«A() pav

•^(00430 eoeoeoe^r-i

•q^aeAdia

f^t-^eo -lO ecw'*"!^

C^»MeOrH C3<M^Ht<>C>l

e4e«e<9 • t^ wi—eo

•q^aax

•m"!K

•vq«!a

•q^a»A»g

•qixis

•qui J

•q^jnoj

•p-»5qx

*pao,i3g

ISJIJ

•WOX

H
H

CCI-«0-^ -C^lift^i-I »-<■* -C^tH «ei-irHr-i'««< »H^ .00

f-Ni^i-'^c^ oo««^cc>-4 G^-^wi-e^ !-•-< •too* •ao<«<t^

O-i-C^IOOM -t-t^iCWt- rH-.*it^^C4 <MCvl"*0OQO

e!5r^»-H

90009494 O00O«-HrHiC COtOCC'"*'

cjoir-i-*-; z:SS''*S3 »-«cao»ftco »S«0':352S

r-r-" ^

c5^5?3^ ss^tis ;:£5J5S*^ s^ssg^s ^sas

i-ios*''*' Oiooo^" -faiirt-^tc c^f-H-^--t.2j cc^oio
c^.'Trt.-i' i-i-viH-^po ^u:rte!ir- «ecrH'^w O"*©

?!?5S?jS ;=2i^Sfg? ^s^'/;^ sssss ^§?«ss

i;?:^rr^'g t^sss^ ^s^SS 53r:^g3g ;:^.sS

I'T 1- 3C iTt 7^ yi-s-i^y.o -^^-rtoci xw55c^ci i-iqc3c«

utrooct- i-wM-rro ccx--ao» ooocaiO-M — cjo'*
cMMs^cMic r-iTiitrcci »--*c^^^i-( «crt»-^«« e3J»J35

JS^

ft e^ *3

^ 0

ea o

oJ'^-.i •s3o^' •'^5®S 2S®Sfl a»i«:

5&«iiS SS-gi?^ i5:2oiS-g ^siSSS o'gSo

Sfe^SS a^l^S 8JS5I Z-B'^S^a oSS^Sf

SHCuSUOia^ &iCUffiPdaQ X-COXCQCO CQKCCHH ^»r^

Digitized by

Google

1S5

S-S*^

• eo wco-^f-t

• e9 i-i.-<c^f-i

• eo eOf-iiHM

■•^^- e^t^iooo

<or<*akao i«»*»eooo

t^-^ajb- iAO^«0

\f^^^^

e««4«lf^

SSg^S $s$»s

S^^SSSSS l^$S5^

9g$9§3 SS3^

S^S3S S^SSS

0>A^tO CQOQOcO

g^^s §5ii

^ S S 2 « «^^

Digitized by

Google

186

<;j CO
O

J 5< —

*9|«aiaj

•oi«W

*9i«taaj

•3I«W

*3[V1IIVj

■s[i«K

'jsnidjf

UiiqiB^I

^£g u^Hlnj

85^1 'ien*^^

'^'^H1«W

•joq^«j

•Jeqiow

•jaq»«J

•jaqiojv

•jaqiBj

•jaq^OK

•wqi«J

•jaq^OK

•49qitij

H
O

• ift cceci^dio ®o

.-^ ecN . •«© oe«

mr-li-4i-HeO uo

• ■«* uii^cccCf-* o»o

*g-a* s

^h;» ««

•ftw 'Oi^ec

t»e« i-if^t-»-»i-j

•oi-i eo««»oc««-«

eOrH i-HGCO»«OiC

!-<« lAr^Vfeia

*" s ^ssa

^SS

■*o»«o-»«'-«« ^-e»5«cooo riO*'»oo

O iCtOOC^CC

SSgi^agJ SSS^S SSg?S55 SSfe^SR

ss^^ssso s^^^sis ^s§^ss :ss^&^3^

rHOQ^H I— I

^2^coc5

sSo^s:^

SiS^S i^^SS I^S^SS §Si§S

isiss siS5i si^is iassB

isi^s s^s-i ss^gs sisis

2!?PiS25 Si^SSS^ J£2gSS?5 §cg|3SSc

»o«c«0'»«>i-< cot-i-^i^ec o»'^';o«'* irc^i^wc^

a "tj

«±"tic5 obfcSt bcs>S gjiJS-sS

-<<mmm oq»u;^q ^o^oq qqoq»

Digitized by

Google

IS";

[eneot^eo

•^•otatOM

•**•«©

^•^•^O*!-!

co«»-*^

eoooi«2«

jpcrioo^

i-ii-i |mc^

C1»«iO |ift

o»ii>t^^-«

eo |oo

C<l

«Dt-4«oe4eo

«ooeoc4

eoiccDgm

|coco-«

c«i-t |c»ieo

|o»'*«eo

tcow-**

'^tO'^N'*

;3 :•«•«

is :•

«Or-i«^«

jiO j«»-

eOCO 'riN

e>iioe<ir-iu:>

0«tC<OtO

<44ietD

ioc«io»«o«

:!S«> : '

oeco<c^«c

]»OM9«t^

I-H • [««o

T^^« jco

eooOtAr^M

weot-

«OiO'*«0<?«

eoc»«oei

eoc^gjg'*

jt-lOOOf-

j 1 ;CC 1

^^« ''^

r-iCOOICq©

'•CO CO

cOfMa»*-i^

e9r;Ht-«

^^ass

;»aesiaOf-'

SSS*"^

T^JftOJjO**

«o jo>

^a^-^S

i'^Sffi

»^sss*

«i^ j-^s-:

"^ |o>i-ic^

«g >•

cDect«eO'<4t

o>««

sas«s

^^SS5

*SS5gS

:^«c.tao gj{55-o»:o

ll-l

• j • !»-<

: i*^*^

:«-t : :«

eqi^

r-iOQ

COrlCO

|cO«r-f

i-H

t-QO

rtriC^ 1

r-«i-l JMCO

«o j 1 1 1 :

'" :

N '• 'l-*

i i*^ i i

j-^oooBao

J^O

too*

■«f

«c»

25 ^^'^^

«Q«h-^

00 3"

S3««

!c«CQ0j2;»fi

iO»O©«00g

«;:sas 55?J5a55S asss??^ ^sss^s sg8?5ss gasg?s f^s^icS ?:;::''^s

«^5Sg3 gggf^g 5S??gS5& ?Sg?S^5c s^gs^* ssgss ^g^SS? 5^aS5SI

^^SS3^ g§^S$ S$89;S SS^^SoSS ;cS:ssss gssss; %^^^^^ ss^ssg

sssae ggggs sggsg gssjss g^fss gsgig sssgs ssssai

s«2S2 ?S|ggi iSiSs 2|SBS S§S2§ §S§§J SSSiS ssags

s^^ss* §iiis isi§i s^ss* «§§«?§ gss?j ss^gi ^i^gs

S9S^ SSSSS SSS^S %$;6»S SSSS^ 9!;SS3 »3SS!<3 g^sa-'^s^

»o»-^«©«9eo r«a»iOto-<^ i^ri« -co «Oi^oo^»-t -^^oodo •-'i-t:SC'* weC'Mooci rni-i . -o

:d0

Digitized by

Goosle

188

O H H

K •< as

'9I«in9j

•9l«W

• coa»i-4i-« 'eoooi-Hi-i r-i« • ■« m 'C^eoeo 'Otc^c

i-«"*l'.i-iG^ i-HCOiO'V

:— «> ^g-^S

•3l«ni3j

•oi«i^

«"*»«C»liO

i-HC^r— *o>

•0OC«i-ie4 C« -C^rH • <o

•■^t-eo • •C«<'*r-i^ oo

copq

O O

gSSB

■diBinoj

•»i«w

•j9qiOK

•jaqjuj

•jaq^«j

•aaqiBj

•Jaq^opi

f-^OC^^rH ©«« 'f-J*-! ooec»H>o^

»o •*cgeO'*»o -*©

'Si

00 i«eOr;j«i-< a»c*c

eC<i«>-< .r-l

•*"*»-t«OQ0

eo eoi;-eoNco

fcS^

352«S -"^SS^I^

•jaq^Bj

eooiiocook i;o-«a)r-^«o i-io«ooeo t-^MCJO^k^

•j»q^O|^

•jaq^oi^

•J9q?i»^^

aoi--'«#o»o -^i-uc^ec cosPt-«Or-i r^efif^ect-* «ctei--

•aaqjBj ^53??S:S 55?SS2^ *^55g S5j;5??^ ^g^Sg

^gs^^

S|g;€| sssfiss sgsg:; i^»^5S -§g|

•«q,o„ ssssg fegg??! ssgsss iiaag as?a

•49q;opf

•jeqi«j

5gS5c3§ *5.':*''^?J S5I2S* 5:SS8S ''SaS

0»iO'V94<-* ■^•u'3 C^ (OiArNi-4C>l '^ •C<li-i«0 •aOC4CO

I g o -jj

•2»
* * ® 2 a fl ®^

•2s

St:6S^ Sg|5x rfS-al 453II gfio
S£:2S5 -S^S^S gJSSi !]9'W.S flSS^

atOtOiCLiPU OnCltpCiKp^ aQOQOQQQQQ QQCQOQEhH P»>

Digitized by

Google

189

»-«co« i-eowi-i

N(M o |t- :

aON N jr^ j

•

C4C4 1 t- ;<e"^

(Mr-lt« j t-rHtO-*

g^iC>^<«< to ;»OW

«o

=5.

««S5 ^'^^'^

(Nil inr-l

0^00940 ^e>4C>-«^

S'^'^S^ S53S^

Sg5S3S5! ?:5I5S

S5gS2 g^S®

SS2?2 IggS

g^ss i§ss

gg|& g||g

gJ=8S S^SSSI

■^

CO \ CO'*

©»

1
^

•5

Digitized by

Google

190

•sapuQ

'smoojo

S
c

•Bopua

s
<

'smoojo

rp9jo|03

••IIHAV

■OOQ

•AOX

•VX)

•;<leg

•Sny

•Xinf

i§i« isig| nnm §iiS3

|»0^ jrH

:I5 :5gS

• -©-H j

i :^ -S

|c^ • I •

:^ :5^

: :-" i

: :-" :S

: i :SS

t- jt-eiec

1— oao jcj

<sp^icoi«

c :^j^g

gc^c.w

l-iOOOSC^g

Si§i2-i-isi

li=gl

iiesi

SIsIS

g^lgl

gSSgs

i§i*5

lOMi^ •

;:""§

-*^ jlMO

i-<riOO ; j

ISSss l^lgg S^I^S iSggS

SiSS5S?5 S-^-^S^J? SSSSSS ^SS'-^g

§538^^?:; SSi:;??^ lcS5::aS S3;53J:;S?

J:;£?SSS3 SS^

i^e»jc^5>--

l^e: ^S^^SS^

c^S^-'^'S S*'U;?}2? §«2?2?3 US^^^s?

r^ f-<C5

25 5;s?3S^

ic«ai«coo oiiCC'i'*

"ounf

•ludy

•qoj

•utif

Si-S'-^'"® ^3ia.c5t:j g>ac«t^co

^Wt** t-OOk.'Sj-O

SCaO(M(MT*'

S2i;S??

S-T^S'-J:; S^-2SS :?SS;:S?5 ???1i^2i5

•c go w -^ "M

Mt-iOC»^ OCeOtftSOCJ ^0(^5(^3

i^SS;::;2: ?;'^;f3si5 ^^S'^^s?! Si:;^;::?

r- <i-*i-»'MO eC — ^ — *■• — •

l^^i^^ ia?<g*^?J

o : I-

bS-5 3-*«^

S°'2-15 a^Z'-^ .•iS>.2-C «si2o^
•9*tiaS oStSi; 2?cE>S SjisJS-cS

•«nnpq cqpquwu oo-^Ps ppQQeq

Digitized by

Google

191

sSS5i mm^ ssiig asass smm ^rm s^ihs h^-b^

^P. : :S5

i-^^ >'

c^^

i '^ : i^ i

|« :

leot- \

^ :{g

fH •

•^

«^ : .S?

r^ :r

C^r-«

i : i i^ i

l«f^

leci- 1

^'^S

-' :

S55

r"*^^ :

^g^^^N

► ••H

<M C^OOMi-ir^

:^ : .58

[^^^

S^-^ r

■*<o j

T-lr^OOOOeO

^5juio«

rieo

j i-(Wdi->mfH

:g-g«

-jr-^o.

•*t- ;

§M§gi i§§§§ smm gssss s^sas isiiii si§^ h

Sg=22

§gi^i

HSiiS

isaass

§§^g§ gl§P

ss|S?S£

fff^ggg

«8 : : :

;Sg5-S?3

lOCOOiO ;

e>1 IrliO \

S'- : : :

--Sg:

J5^0>C^i-l

•f^ •»-< •

BSSSS

SiSSI SSggg 12855

S§SS§

SSSiJ

sgsis

sgsg^

ssf;<*s

at:isas

SSIiSS

!S;:»as

a8:$SS

g^sss^

,eggjotjj5

-*«»-S5»

:S&SS28

S$558S

SSisasB

5JSSSJ;

S^SS:::

sss^s

;=K;5g5S::

•J^to^t;^

^l^sst;

SSSS^SS

:ss»^s

as;as*

as?35cs

^^^^'^

SSR^S

;:S'-S8

?2S5SS?3

:S$Qt;8

?st;ags

a^ss;:

sas«§

^ip,^zn

^^sas

*^S'-SS

$??i8SS

S5?as;s

ssass

O^gjjOO

;r^8t«g

SsSS^g?^

*??S?JS5

icejwrjj^

'^SSSS

ssass

«^:=ass

St;8S*

a8J?5^S

SS5g2

iO«Ci-aoeO

*:::«S5!5

CCgCCC»;C

p:^sss

«sgss

gi^ss»-

=:s5a*5

fei'-SSU

'^;s^?;'=^

lOOs jeo^

3SS5^S

sa^jss

S*S2S

a«n8J«

*3sas5

a;5ggj:;

ost^ej^oo

eocic^iftoo

^$5SSS

SfcSSS

«»a>r-e«

OC4ICOO

?:Scj*s

Si^Sg?^

S?^S8*^

lOC^C^'MCO

*-5S5^;5

S5?ig5S

s'^aass

r^»« -o

?5*J5;:^

s;2:ss2

t-»OQO^QO

-^Ui^^sa

SSSSS S'^gg^S SSS3

fr> ce*»«ooi

e*»«ooi Jf^Oij-^gio *:;^*?S^ aceciooog

55SS??S SSSaSSS S5Sfe2tS SS8

s sassje a-^sicS •i^^f^s:: ss-^tiS

5-^ aJ« ■ "2

«c .= . ; .a

^ = 252 c.-§S5 S

^111 llPi |is|l II j| lilli tllll fiifl l|i|i

Pfauu^c.*;^^ 0-aS33 SWWWas ►;»5*»?»? .?««^4^ jjSSSS SSSSSS 5?;S!;oco

Digitized by

Google

102

o
O

*80pUg

'smoojo

'sapug

'Bcaooj{)

•sapug

euoojf)

p9ao[oo

•onRAV

•oea

•^8W

lutfy

•J»W

•q»j

•u«f

Saglg BfegCS 8§SS

^i^^

cctOMOjeo "^oa

iggis um

^SSSS c^§

'1=:^ S*^ :g5

r-«r^ IN'^M

•^lOOt*

ar-l w-Oi'-Oi

S siS«l gllsS «ggi

S sii^s iSliS «SSS

|gSa ISiSS *ls^i Islsl =^§=1

ss sssas sasss assssa •sss

•AOX

SSSSS

asg^^-j::

cog^cojg

SS:S55S

«i2Si::

•?oo

;2:ssss

s^asss

Sg^-'SJ

SSE=5S

X^^^

•^das

fc:52RS

«SS2S

X^5;^*«

g3?5«S?J

^^'-ti

•any

SSISSS

^S&iSS

•^sa^s

oooccgo*

^^a.^

•Xinf

tOt>(DC4g

aoeOjHOO*

t-ot>.»o»g

52^^^**

"SSS5

'aunf

ss;:^:*

OOJDNCO

^ss-**

8?3*S?:;

-S^g

«Dt-»ot^«o i^o»oo»t* eoocor-t* jcfc-occo^ *^S^*2

t^iQfr«C4R c4a»tDxao <oacQ-^eo eoo^toseo

QtAOttor* o>»-o>»oeo t^wooiAOk '^^'^S!25 ***!>:•■"

;s;j5*«S55 s^as''

.^oootoo •eoai'^oo r-j8JS««2

5SSSS ^JSai^S

s 5sas3 ^gS!S

5 §©5?

fl ss-^^

« £ fl fl aj"

k> S n r?>n f

ifciSj sS|l-= s£i|-§ ^iall Sfio
ISali -sls^s tslss -i"E.IS =56.?

o,CL,eL,o,a< a<«L<tfe(tf omoQcosg mooooHH 9>»

Digitized by

Google

193

i-S

^ .CJ

g^si gss§

8<»^8 . «»S):!I

as»^ S3ass

^^S:::^ SI2SS9

R^ssa ;3S*a

5}->55a ss;3a

a»-S9 8S*-a

s^sa aaaa

a*{:55 8S8?;5a

8 :29S S8aa;s;

S^loS «?;SS

a*-;3S asas

lill Nil ^

13-Bd. of Htalth.

Digitized by

Google

194

Bliss i^igi mmi siiss

pq
Eh

»5

-■5

ill

•iopua

^e^-^r-iio riu

3
^

'imooij^

•-HtHO* -lO

'Bopug

*Bmooj[{)

•adpug

'fmoojo

•eapua

•smoojo

'-a

i-liOiOrHeO to

•BOpUg

o>i« •!« eo

'snoojf)

C>9a)C«C4t> o>

'Sdpug

0»c3C^ •«© «0

"•SS

'Bmoojf)

'Bopug

8^55 '^S

'Binoojif)

9§;;rs!; s

'Bopug

^^5SeS S8

'BinoojK)

$^S^g s

'sapug

^S3SS 5S

*Binooj[{)

eo^eoc>i«D o>

1-1 .f-i eccio»-«NT-i i^«o

i-i«eo woo -eoi-i i>t»co

94a0t> ir3p-lf->4f-t • lAr^iO

lO-^eo cook'^OM oii-iao

co»-cj t-scoo»-iN «t«-cae*o>

*Sg §?S*'S?2 S2SS'«8

S^^So ^g^ISS^ 3S)SSS

^SS S:;?;:!:S3SS SlSS^^

sg| gggssg ssgfeg

S^Sg gS^i^^^ ^S)|{(iS

0(00) OCCO'^tO to^gic^io

S?ls-= V

<«m0Qpq pQAi^uo OOUQO QAQQH

I sis gJ^I:

Digitized by

Google

195

asass igM§n BMm mm^ mmn ^siis sishe ^s^sg

^gj ;r-i^ i***??*^ i '^J^'^ i*^ eo^c^^ • joo • | j eoeoc^t- • o ;gJg'-« ^ t'^^S

."S :**'* :*^J§*^ : : :^ : :^^ ; i**^ i •*'^«oeo j «d .'^•Q'^ "^ •'-• jjg

'.'.'.'.'. '.'.'.'.'. ,_i j

• e« • j •

i i i i ! i : i : i i i*^^ : ^ : i*^ : i i i i i "^ jf-ii-iw • • • j^^ :^ : i i

:^r-l |i^ M«N JC^C^ C^ jt«04i-l .C^(M '• r-« -eOr-l j C^i^OJCO"* ^r-« j ;•• • • -WW

j |tHf-lCI deO jtetN C«««Mi-i«Of-i ^^ jr^ ji^ j .NM 1 JC'IIOO'* ^cOf^rie* jri J Jci

^"^WN^ c^5^ |«CM «io.-«wua -^r-icofN.-* '^^ j-^iM j eo-^t-^mo vHr-itooito |e« Jiiw

c9<o«OC4i^ «»©'*«"* jccot—* •«csi,^c^c4 eoriioi^ 1 ^ectf^OM e>»w*eo^ |co j-^eo

C4W4CC4IO t^goCOO* i-I^C^fc^lA OOiOt-OOr-i '^JOIO© | *»®85»* ^"Ot-pJ^ JMOllOM

«SS«* *-;S9«S ^<^«=

jgto y"** :»- S;^*'* : 55"*JSI8*'* *^'^SS'* •^•* i'*^^

*ais«*?2

SS5S;2S

s;s£;ss

tj^eoooiAO

..aggr-t.

sssss

•a«ss

Mtocoo»eo

;s$8S^

S5;:a!3

a?4s;fs

g^ssaa

saisss

ssgsj^

SI;S885

"S»;s;5

SS^SoSSS

s;$^$^

s^^$;;^

9SSoS3SI

38SSS?=

saggs

ISSSS^S

sssss»

ssgss

sgsss

sagggg

1—1 r^

2§£-S

i^SSS

Sg85g

9g8SS

MS88

§s§s§

S5gSS

§2i2i5

s^isg

§§§8§

i^SSSS

Sgfi;8§

SS8&2S9

qjgSJSS?

s^s^g

s;9SS^^

%sssg

ggggri

SSSSSS

SI9SS89

<Dt««o«Oio 0;^;t«■t«<c eo^ic 'to «ocoo^'^ aot>o o oeoiosct* -ooo 'Ui diA 't-M

•^855^

•as

2a o-Sc* 5ooo« flJ$og Q ". ' 9 '

j»» „»ll I||l5 lllfl UllI ffi f

SQQSsqs »^^^,^^ »^tij;i$H^,j h)h)SSS aS^e^SSS $z;^ooo

Digitized by

Google

196

.£

'•♦3

fl
O

SggSS g§§S9 s§Se§ $SS§g H%%

-I

■WPHS

■•V00J9

8
S
8

a
D

•••pjjg

■•moai5

•••PMtt

*fmoai{)

F^eOMm 'Mr-I

•■•PHtt

'•aoojg

«-« #Hf-«e4

^ M^eo

•■•PTO

rH^f-tCOM -iOf^

•Bmoojo

eoao«D<D«o 9^fOto

•■•Plitt

«oo»«fr-<o c^A;:*

■tmoojf)

•WPHtt

asjssa "^sa

-iinoojf)

S593SS8 SSI8

•■•pwa

s§««s ««s

*imooj{)

SSSgS 8§§

•■•PHa

SSS^S ^9r:

*faooj{)

»-aBaoi-4<o M«*Jg

iM . >e9

<e <«ioeoMr> lo

'4^iO c«tr^«^

MM • •9-^r-4

tO^ ixiOMaD

« eoco<Dto«o

94 MCDtO-^ig tD-^i^l-iO e«IDlO«

lA f^t^oDMeo «g^«ot>«D e^ji^^fc;

cjQ-st. s**S* •^S'^SSI

8 ''SS-^S SSI^Sa *5*I5

« »99&8 38«382^ Sggig

« sgg^P ggsgx 8isg

a ^SS55S SS§g3 tegSS

8 8^889 g8S8g SgSg

f^ ^mevf^eo eO'<«>94e49Q p^e«^51

•id lais ism ^p^ lli?^

Digitized by

Google

197

*^ :S«5

i^»-ieo 1

- i«J5

t-* • • •

J J J«N : i : ;

j . : j c4*i4C4C4

^ I jr-i

^eoiHW

M • ••©

-*r-IOO«

^ : ':^

iO(NiOiO

C4C^00««<

rococo 00

s-^a^

00iOO>»C

51^55*

gt-flOt-

§8SSS

5?S?3S

5SSS

S5I855

g§2s

gSgis^

gS§8

gS§5

SS^SSg

«?2§85g

jlj«'»0>

aO'«<"Meo

|£-C2 |i55 ^

.X3 C b « >»3'*-'- t^
ee 4 « IS « tf^X

Digitized by

Google

Digitized by VjOOQIC

REVIEW OF MORTALITY STATISTICS

AND OF

PROGRESS IN STATE MEDICINE.

»99> Digitized by Google

Digitized by VjOOQIC

MORTALITY STATISTICS.

Correct mortality statistics have been collected by the State
Board of Health since October 1, 1899, and published monthly
with analysis. Up'to January 1, 1901, the statistical year ended
September 30 of each ye^r. From Januarj- 1, 1901, the statistical
year will correspond with the calendar year.

Diagram I gives a graphic presentation of the causes of death.

,Goo5le

Digitized by VnOOQ I

202

Diagram Showing the Principal Causes of Death for the Year End-
ing December, 1901, in the Order of their Importance.

<f Q^ fttmr
OtA^r ^ifcstii^e 27 tsetses

H e^teAro^S/fiTtai /?Zenfn^ih*^

■ WAoophfsr Cou§A

■ T/lecisfes

■ Sear/et Fryer

■ SAi'nJ?ise€ises

DIAGRAM I.

The total number of deaths reported for the year was 36,541,
making a rate for the State of 14 per 1,000 per year. The oily
death rate was 15 and the country 13.5. From important causes
we have to record as follows : ^ t

Digitized by VnOOQlC

203

Disease.

Pulmonary tnberonlosis . .
Other forms tuberculosis .

Typhoid fever

Diphtheria

Scarlet fever

Measles

Whooping cough

Pneumonia

Diarrhoeal diseases

Cerebro-spinal meningitis

Influenza

Puerx)eral fever

Oancer

Violence

Number
Deatlis.

State

Rate,

100,000.

City

Rate,

100,000.

3,164

126.7

152.1

1,277

50.7

46.2

1,431

56.8

48.6

666

26.4

33.6

152

6.1

6.4

3.4

3.8

287

11.6

11.8

2,644

110.0

126.0

2,047

81.6

85.0

377

19.1

31.9

426

16.4

15.4

172

6.3

6.0

1.034

44.9

56.8

1,536

60.2

58.1

Country
Rate,

100,000.

112.3

. 53.0

61.0

22.8

5.8

3.1
11.2
94.3
78.2

6.3
17.5

7.6
33.0
62.4

Digitized by

Google

204

TUBERCULOSIS.

Diagram Showincj Deaths from Pulmonaiiy Tuberculosis, by Aoes,
Year Ending December, 1901.

s I

Q
o

5-10

I0-/5

15-Zo

20-XS

2S-30

■

30-35

35-¥o

■

^0-^S

fS-50

50 is

55-60

■

60-65

65 70

■

70-75

■

75-90

80-90

9ot

■

unk\»>i^

c
o

o
o

DIAGRAM II.

I 8

Digitized by VjOOQIC

205

The terrible slaughter annually caused by tuberculosis makes
it always in order to discuss the prophylaxis of the scourge. In
our last report it was calculated that 1900 would record 4,584
deaths from tuberculosis, and so to be depended upon is this disease
to keep up its rate, that we have to record 4,441. In order that
Indiana may be abreast of the times, and in order that a duty would
be performed, it would be well for the Indiana State Medical
Society to take pronounced action and recommend to the people
and the Legislature prompt and positive actipn for the prevention
of tuberculosis. Many European countries and many States are
acting energetically in preventive lines against this disease. The
International Congress for the Study of the Best Way to Combat
Tuberculosis as a Disease of the Masses, convened at Berlin May
24-27, 1899. This congress was largely attended from all civil-
ized quarters of the globe, and much important work wais accom-
plished. Among the movements taken was the oflPer of 4,000 marks
for the best essay on the subject "Tuberculosis as a Disease of the
Masses and How to Combat It*' The competition was open to the
world and the prize was won by an American citizen, Dr. S. A.
Knopf, of New York. It seems there is no better way to bring this
matter before the people and the law-making power than for this
society to secure, if possible, from state or private sources, a reward
for the best essay upon "Tuberculosis Prevention in the State of
Indiana.*'

Digitized by VjOOQIC

206

DiAORAU SRowma Deaths from Pui,monart Tuberculosis, bt Months,
Year Ending December, 1901.

500 \ , , ■ ■ , ■ 1 1 1 1 1— I SOO

HOO

300

Xoo

lOO

CO
^0

■

■■

■

■i

■

■1

■

■1

■

■■

■

■1

■

■■

■

■■

■

■'

■

— 1

■

■^^

■

■.

■

■
■

■

HOO

ioo

200

JOG

80
Co

it « 1 r c ^

f5 «^

^
^

DIAGRAM III.

This being done, the society might each year continue its efforts
for prevention, and thus finally start the public into action. It is
true that the people, though believing that "An ounce of preven-
tion is worth a pound of cure," will not pay for prevention but will
pay liberally for cure; but medicine is a science and its prac-
titioners fully realize that the development of medicine as a science
is the true goal of their ambition. The money of it must certainly

Digitized by

Google

207

Diagram Showing Deaths from Tuberculosis, not Pulmonary, bt
Ages, Year Ending December, 1901.

0
J
1

6-10

iW Jo
^d5

csyo
70-70'
75'do

80-90

_ J

■

■■

■

_ J

^ _J

■■

■

^ $

DIAGRAMIIV.

Digitized by

Google

208

be looked after, but the first consideration is the science of it Be-
sides, it is plain that whatever uplifts or benefits the masaee will
also uplift and benefit the practioe of medicine. Indiana should
have private and public sanatoria for consumptives. It is plainly
the duty of the State to take care of indigent consumptives, and
this is being done in an extravagant manner in poorhouses and by
outdoor township relief. This method propagates the disease,
for there is no constant, intelligent teaching of the patients how to
care for the infection proceeding from them. The request of the
State Board of Health to the Ways and Means Committee of the
last Legislature, that a small specific sum be appropriated to make
a special fight against consumption, typhoid fever and diphtheria,
was refused. The members evidently did not understand the hu-
manity, economy and true statesmanship which the work involved.
This, future Legislatures must be made to understand, an(^ this
society can accomplish such an end.

Digitized by VjOOQIC

209

TYPHOID FB7VBR.

Diagram Showing Deaths from Typhoid Fever, by Ages, Year End-
ing December, 1901.

^ »» \i> 4^ ^
^ o o ^ c

I
%

-■!■

■HII

1 1

■

Jll

mil

III

mil

-<|i

mil

Jll

mil

Jll

■

111

—I II

III

■

■I

III

—

III

■

__J

■

; 1

■i

■1

IMI

V ^ c*. *^ ^
^ O « Ci o

DIAGRAM V.

14-Bd. of Health.

Digitized by

Google

210

The total deaths from this disease for the year was 1,431, a rate
of 56.8 per 100,000 annually. It is safe to say that for each
death there were fifteen cases, making 21,465. Of this number
of deaths, 784, or 54.7 per cent, of the wl\ple number, was of per-
sons between 15 and 35 years. Such unnecessary slaughter of
people in the prime of life is a subject wortihy of the attention
of this society. ' _

Diagram Showing Deaths from Typhoid Fever, by Months, Year
Ending December, 1901.

J<^0 , r — \ r \ 1 1 1 \ } 1 r 1 300

ZOO

lOO

80
CO
40
%o

■

!■«»■■■

■

~ ■

■

2.09

fOO

JIO

~ V *s ft*

DIAGRAM VI.

Digitized by VjOOQIC

211

DIPHTHERIA.

DlAOKAM SHOWINO DEATHS FROM DIPHTHERIA AND CROUP, BY MONTHS,

Year Ending '.Deoehber, 1901.
nS I 1 1 1 T r— T 1 1- — I 1 1 1 /^s

/oo

10
5

■

-j

■

1 i

■

1
1
1
!

1
1

* ^

? Ai *\ ^

/OO

/o
S

DIAGRAM All.

Seven hundred and forty-five deaths were reported during the
year from diphtheria. The deaths run according to months as
follows: January, 90; February, 70; March, 68; April, 30; May,
14 ; June, 1 3 ; July, 1 5 ; August, 40 ; Septenibor, 64 ; October,
111; November, 125; December, 105. There is no marked de-
crease in the mortality from diphtheria in the last year over the
preceding year, as appears from a comparison of the months of

Digitized by VjOOQ IC

212

October, November and December of the years 1899 and 1900.
During these periods accurate death returns were secured, and
hence bear comparison. For the first period there were reported
347 diphtheria deaths, and for the second, 341. This is a decrease
of 1.7 per cent only. Presumably antitoxine waa more freely used
in the last period, but such is not apparent in the figures.

Diagram Showing Deaths from Diphtheria and Croup, by Ages,
Year Ending December 1901.

■ to Se ^ **»
1 g^ o ^ O

'J.

L^i

/o/s

/S-20

U0-3S

%f-^0

30-i5

as-vo

^0H5

^-So

50-65

65-70

linkiioun

o Q «

DIAGRAM VIII.

Digitized by

Google

213

INFANTILE DIARRHCBA.

DiAGRAH Showing Deaths from Diarrhckal Diseases, Under Five
Years op Aoe, by Months, Year Ending December, 1901.

COO i — 1 — I — I — I — I — I — I — I — I — I — 1 — I ^00

fOO

^00

Joo

/oo

75
So
Air

■

500

Uoo

300

%oo

100

So
a.ar

DIAGRAM IX.

Infantile diarrhoea, under which term is included cholera in-
fantum and like disturbances of the intestinal tract, is one of the
most destructive of the preventable maladies. The deaths reported

Digitized by VjOOQIC

214:

from this cause in 1900, numbered 2,049. Of this number 1,276
were under 1 year of age, 564 under 2 years, 140 under 3 years,
39 under 4 years and 30 under 5 years. As this cause of disease
and death is due almost wholly to poisonous food and water, it is
deplorable that the poisoning can not be immediately stopped.

Diagram Showing Deaths from Diarrhceal Diseases, by Ages, Year
Ending December, 1901.

iXoo

/XQO

noo

iOOQ

900

800

600

50Q

200

■■

nimn^n i

™nm»nn^iii^n-

//Of>

^000

90O

800

700

coo

500

400

30L

200

/oo
50

0-nc^c5:^^^5S>lSSi^5'

•^^ '»^ "

DIAGRAM X.

Digitized by

Google

215

CANCER.

In our last report it was shown that the then existent rate
showed there would be 920 deaths from cancer in the coming
year. The actual figure is 1,034, a rate of 60.2 per 100,000 for
the State; the city rate being 58.1, and the country, 62.4. It is
true, therefore, that for this year, cancer has destroyed almost as
many as diphtheria and influenza combined; and also almost as
many as scarlet fever, oerebro-spinal meningitis, whooping cough,
measles and puerperal fever. It is a great pity that no prophy-
laxis is known for cancer.

Digitized by

GoogI(

216

PNEUMONIA.

Diagram Showing Deaths from Pneumonia, by Months, Year Ending

December, 1901.

100 I ^ ,—n ^ ^ ^^-^ r-. ^^ JOO

600

500

¥00

$00

200

100
75

r I I

■^^-^

■ ■ I ^^^^ F^^^^H ^^K^^ ^^^^B

COO

500

^00

300

200

too

15
50
%5

DIA(JRAM XI.

This infectious disease stands next in destructiveneas to tubercu-
losis, as 2,644 are credited to it for the last year. It seemed to be
the consensus of opinion in the Section of Hygiene of the Ameri-
can Medical Association, at Columbus, that pneumonia jaaost frer-

Digitized by VjOOQIC

217

quently had a history of overeating and drinking and afcer ex-
posure to vitiated air.

DiAcmAM Showin(* Deaths from Pxeumonia, by Ages, Year Ending

December, 1901.

0»

o
o

4
5-/0

10-15
15-20

25-30
30-35
is-to

^5-50
50 -55
5S-60
CO-CS
C5-70
70-75
7580
BO-90
90*

■

■■

■

DIAGRAM XII.

Digitized by VjOOQIC

218

INFLUENZA.

Diagram Showing Deaths from Influenza, by Months, Year Ending

December, 1901.

i^oo 1 — ^ — \ — I — I — \ — \ — \ — \ — \ — \ — m ^00

^> l< s: CS^^ -^ ^ v:3 ^ Q5 ^ ^

diagram xni

Lagrippo no longer calls forth jokes from the people and the
press. It is now known to be a highly dangerous disease. This
malady has Ix^en widespread the past fall and winter. It has been
reported by every one of the 700 odd Health Officers and deputies.
The deaths numl>ered 42 G in the war. This makes a State rate
of 16.4 per 100,000, a city rate of 15.4 and for the country, 17.5.

Digitized by

Google

219

Diagram Showing Deaths from Influenza, by Ages, Year Ending
December. 1901.

^^'

■

^^^^1

■

5-JO

•

/0-/5

it-20

20-2&

2S'S0

30-35

2S''/0

—

'm^

%-SO

SO'SS

■.

5S-C0

— ,

W-€5

iS'70

70-75

^P^^PP^

7$'80

MMH^tm

—

80^0

■■■■HHHHHI

90*

Uttkn^wn

9 <

§5

)IA(

5RA

i
M 1

ilV

Digitized by

Google

220

Influenza has apparently become domesticated with us. Its re-
striction seems possible, if early recognized. Positive early recog-
nition may be highly favored by bacteriological examination, and
great is the pity that for this and other diagnostic work, the last
Legislature denied the State Board of Health a Laboratory of
Hygiene.

SMALLPOX.

Since our last report smallpox has been constantly present in
the Stale. The number of cases reported to date from January 1st,
was 967. The deaths numbered 8, two in January in Allen
County, five in March, as follows: Allen County, 1; Dekalb
County, 1; iMadison County, 1; Tipton County, 1; Daviess
County, 1. April, Marion County, l.* Very few counties have
escaped having the disease. At new points of outbreak there is
almost always trouble in making people believe that smallpox
exists. This is because almost every community supports one or
more practitioners who have never seen smallpox and stand ready
to deny the disease is present. Business men are prone to look upon
a correct diagnosis as inimical to business interests. They fre-
quently are slow to realize that the disease must be attacked and
put out, and that it will not stop with the denying of its existence.
The physician or Health OflScer who tells the truth is quite apt to
be abused for the favor he has done, and the abuse becomes per-
manent, if, perchance, the disease is prevented from spreading,
because this fact is then pointed to as proof the disease was not
smallpox.

The statement is often heard from those who deny that the pres-
ent epidemic eruptive disease is smallpox, that vaccination does not
protect against it and that it does not prevent vaccination from
running a typical course. This may be true in a few instances, as
we all know, but it is very rare, and as a matter of fact, there is
yet to be found a single well-trained, well-educated practitioner
who will testify to actual experience to the effect as stated above.

It seems that some advance has been made in determining the
cause of vaccinia and variola, Fimck (Deutsch Med. Woch. Feb-
ruary 28, 1901) states that the protozoa described years ago by
Pfeiffer and others, have the greatest number of points in their

Digitized by VjOOQIC

221

favor as the cause. Funck gives new details conoeming the mor-
phology of the protozoa and contributes some additional points
concerning the method of demonstrating and spreading them. He
says: "The individual organisms are small and range from one to
three microns in diameter, large cystlike bodies, which have a di-
ameter as great as 25 microns, were often to be seen, and these were
filled with spores."

A culture, in a bacteriological sense, of these protozoa can not
be made, but Funck states that he took so-called sterile lymph
which omtained only a small number of protozoa, and was therefore
much more readily examined than the contents of pustules, snieared
this lymph over the surface of an ordinary agar plate and placed
it in the thermostat for twenty-four hours. Examination at the
end of this time, by means of a low power of microscope, enabled
him to pick out the large spore-containing cysts with readiness,
and by means of a fine platinum needle he isolated these cysts and
used them for purposes of injection. The injections produced
what he believed was a typical vaccinia and, after suffering from
this disease, the animals were immune to inoculation directly from
vaccinia pustules. He states that the protozoa can, by his more
complete and accurate methods of examination, be found in all
vaccinia pustules and in the immediately surrounding tissues, and
he considers that their constant preeence in the disease, together
with the fact that injection of the isolated sporoblasts produces
typical vaccinia, demonstrates conclusively that they are the cause
of vaccinia. He was also able to find protozoa of identical appear-
ance in a case of variola, and concludes from this that the two
diseases are due to the same cause, differences in the virulence
of the protozoa being the cause of the variations in the results of
infection produced by them. It has been quite thoroughly estab-
lished that oowpox is actually a modified form of smallpox, and
one can not reasonably object to Funck's conclusion that variola
and vaccinia are due to the same cause.

We have for the first time to make mortality comparisons of the
three sections of the State. These sections are divided into the
Northern, Central and Southern Sanitary Sections and are the
same as are adopted by the United States Weather Service for
weather comparisons. By referring to the chart it will be observed

Digitized by VjOOQIC

222

that the Southern Sanitary Section had, during the year, the
highest death rate for consumption, typhoid fever, diphtheria and
diarrhoeal diseases. In scarlet fever, the Central Sanitary Section
had the highest rate. This plainly indicates that much sanitary
work is necessary in the Southern Section in order to make it com-
pare in healthfulness with the other two sections. The Northern
Section has the lowest rate for consumption, typhoid fover, scarlet
fever and diarrlioeal diseases. The diphtheria rate of the sections
stands in the following order: Central, 17.2; Northern, 20.1;
Southern, 21.6. A careful study of this map by health officers is
warmly recommended.

STATE MEDICINE.

Of the laws relating to State Medicine existant in this State,
only the medical law has been amended since the 1900 report of
this committee. The amendments are thus described by Dr. W. N.
Wishard in the May number of the Indiana Medical Journal:

"The law recently passed by the Indiana Legislature amends
the laws passed in 1897 and 1899. The first section provides for
larger powers on the part of the State Board of Medical Registra-
tion and Examination in revoking licenses that have been obtained
by misrepresentation or fraud and gives the Board more direct
power in enforcement of the law through the prosecuting attorneys
of the various counties. It also provides that all persons applying
for license shall submit to a written examination as to their quali-
fications to practice medicine, and, in order to be eligible for exam-
ination, it is recjuired that all applicants hereafter shall be gradu-
ates of medical colleges that maintain the standard proscribed by
the Board. Heretofore the Board, under the advice of the Attorney-
General, has permitted all applicants to submit to a State examina-
tion who were not graduates of medical colleges, as the old law was
not suffieiently specific upon this point. The standard for medical
colleges adopted by the Board is that fixed by the American Medi-
cal College Association. An exception is made in favor of those
who have matriculated in reputable medical colleges within the
State of Indiana prior to January 1, 1901, and whose applications
shall be filed prior to Januarj' 1, 1905. Tlie Board is author-

Digitized by VjOOQIC

223

ized to grant new applicants temporary permits which authorize
them to practice medicine until the next regular meeting of the
Board, at which time applications can be finally decided upon.

"Section 2 of the law provides for the printing of 3,000 copies
of the annual report of the Board in the same manner as the reports
of the State Board of Health are printed.

"Section 3 defines the practice of medicine, and this section is
the one which met with the most bitter opposition on the part of
the Christian Scientists and others opposed to tlie bill. The courts
can certainly not make an error in determining what constitutes
the practice of medicine if they read this section. It is of such im-
portance that we give it verbatim: ^To open an office for such
purpose or to announce to the public in any way a readiness to
practice medicine in any county of the State, or to prescribe for, or
to give surgical assistance to, or to heal, cure or relieve, or to attempt
to heal, cure or relieve those suffering from injury or deformity, or
disease of mind or body, shall be to engage in the practice of medi-
cine within the meaning of this act: Provided, That nothing in
this act sliall be construed to apply to or limit, in any manner^ the
manufacture, advertisement or sale of proprietary medicines. It
shall also Ix^ regarded as practicing medicine witliin the meaning
of this act, if any one shall use in connection with his or her name
the words or letters "Dr.," "Doctor," "Professor," "J^I. D.," or
"Healer," or any other title, word, letter or designation intending
to imply or designate him or her as a practitioner of medicine or
surgery in any of its branches : Provided, That this act shall not
l)e construed to apply to non-itinerant opticians who are at this
time engaged in the practice of optometry in this State, nor to
professional or other nurses. In charging any person in an affi-
davit, information or indictment with a violation of this law by
practicing medicine, surgery or obstetrics without license, it shall
be sufficient to charge that he did, upon a certain day and in a
certain county, engage in the practice of medicine, he not having
any license to do so, without averring any further or more particu-
lar facts concerning the same.^ The amendments to the different
sections which were added by the I^islature are given in italics.

"Section 4 was introduced and passed in the Senate as an amend-
ment to the bill, and it was further amended in the House. It

Digitized by VjOOQIC

224

relates to osteopaths, and while it permits osteopaths, now prac-
ticing in this State with diplomas from any osteopath college, to
obtain a license, it provides such careful restrictions for those who
apply hereafter, that it is difficult to see how any friend of ad-
vanced medical legislation can object to this section, as far as it
relates to future applicants. It reads as follows : *The said board
may grant certificates which shall authorize the proper clerk to
issue to the holder thereof a license to practice osteopathy only.
Such certificate shall be issued on tlie same terms and conditions
as others, except that the applicant therefor shall not be required
to pass an examination in materia medica, nor shall the college
from which he presents a diploma be required to conform to the
standard fixed by said boards as to instructions in materia medica,
but such college shall so conform in all other branches of instruc-
tion. Such license shall not authorize the holder thereof to ad-
minister or prescribe or use on one other than himself any drugs
or medicines, and any such administration, prescription or use
of any drug or medicine by the person holding such limited li-
cense shall be practicing medicine without a license, and such
person shall be punished therefor as others are punished for prac-
ticing medicine without a license: Provided, further. That any
person now holding a diploma issued from any college of os-
teopathy in the United States and is a resident of the State of
Indiana, shall be granted a certificate and license to practice os-
teopathy upon presenting his diploma to said Board and clerk and
paying the fee required by this act'

"The bill has an emergency clause and became a law at half-past
ten o'clock on the closing evening of the Legislature, when the
Governor filed it with the Secretary of State and notified the S«nate
that he allowed it to become a law without signing it.

"Indiana now has a medical law which places it on a level with
other states having examination laws. The status of medical col-
leges is more clearly defined in that no one is eligible to examina-
tion who is not a graduate of a firstKdass medical college. All who
secure licenses must hereafter pass a State examination with the
temporary exception above noted, and the Board can more easily
revoke licenses obtained by fraud. While 160 to 200 osteopaths
now in the State are given licenses on their diplomas, it is provided

Digitized by VjOOQIC

225

that all osteopatlis who apply hereafter must be graduates of
schools maintaining the same standard in every particular as medi-
cal colleges and must pass an examination in everything that others
are examined in except materia medica,"

Litigation Under the Medical Law : The law has been decided
constitutional by the Supreme Court, State v. Webster, 150 Ind.
607.

In an appeal from a decision by the Board the State is the appel-
lee and must be represented by the Prosecuting Attorney. The
Board is not a party to the appeal.

In re Application of (^offin, 152 Ind. 439.

In a prosecution under this law, it is sufficient to charge the
offense in the language of the statute.

Eastman v. State, 109 Ind. 282 ;
Benham v. State, 116 Ind. 112.

The burden of proving the defendant was duly licensed to prac-
tice medicine is on the defendant.

Benham v. State, 116 Ind. 112.

In such prosecutions it is not necessary for the State to deny or
prove exceptions made by the statute.

Femer v. State, 151 Ind. 249.

Nor need the affidavit or indictment show that the State Board
or any member institutes! the prosecution.

Commonwealth v. Tobias, 141 Mass. 129 ;
CommonwealUi v. Murphy, 147 Mass. 577 ;
Commonwealth v. Gay, 153 Mass. 211 ;
Commonwealth v. McDonnell, 157 ^fass. p. 409;
Portland v. Kolfe, 37 Me. p. 402 ;
Stuart V. People, 42 Mich. p. 259.

Suit was brought against Dr. J. C. Driver, of Atlanta, Hamil-
ton County, for practicing medicine without a license. It was
shown that Dr. Driver had quite abandoned practice, but his*ign
still remained on the door of his office. Judgment for practicing
without a license was rendered.

J. B. Oliver, colored, practicing at Brazil, had a County Clerk's
license secured a few \veeks before the taking effect of the law of
1897. In order to secure this license oath w^as made by Oliver

15-Bd. of HeaUh.

Digitized by VjOOQIC

226

that he was a graduate in medicine. Upon the license thus secured
the Medical Board granted a license under the law of 1897. It
being discovered that Oliver was not a graduate, the Me<lical Board
revoked his license. The Clay County court gave judgment in
favor of Oliver, but the Appellate Court reversed the same.

Prof. Geoi^e P. Parks, magnetic healer, of Bedford, had him-
self arrested for practicing medicine without a license to make a
test case. Judgment went against him. Case is now appealed.

DENTAL LAW.

No amendments in this law since last report of this committee.
There is, however, an important decision to record. In the Grant
County court Timothy T. Overshiner was convicted of practicing
dentistry without a liciense. Case was appealed, plea being the
law was unconstitutional because under it the Indiana State Dental
Society appointed three members of the State Board of Dental Ex-
aminers, and the Legislature has no constitutional authority to
confer police powers on a private corporation. The Supreme Court
sustained tlie law.

PHARMACY LAW.

State, ex rel., v. Indiana Board of Pharmacy. In this case the
question involved was, should a mandamus bo issued requiring tlie
Pharmacy Board to issue an applicant a license witliout examina-
tion or diploma, under the provisions of the Phannacy Act of 1899,
who at Uie time of the taking effect of the act was the proprietor
or manager of a store or pharmacy in which physicians' preecrip-
tions were compounded, where the petition showed that tlie relator
became the owner of the pharmacy on June 19, 1899, when such
act took effect April 27, 1899. The point was, did the act take
effect in April or July 1, as the law contained a clause requir-
ing all applicants to be licensed without exajnination or di-
ploma to be made by July 1, 1899. It was decided this clause
had no bearing upon the time the act went into effect, as the con-
stitution provides on this question. Tliis judgment is of interest
to the medical profession of Indiana, because, had the decision
existed in 1897 the Medical Board could have refused to issue
licenses to many who now have them who are unworthy.

Digitized by VjOOQIC

227

Tliere were five acts passed by the Assembly of 1901 bearing
upon hygiene, namely: An act conferring powers upon the State
Board of Health to grant permits to industries to discharge refuse
into streams ; an act creating a State Embalmers' Board, control-
ling undertakers; an act creating a State Veterinarian, having con-
trol over infectious and contagious diseases among animals; an
act providing for the licensing of practitioners of veterinary
science, and an act, popularly termed the "Fish Law," pro-
hibiting the discharging into streams of any factory refuse in
sufficient quantities to kill fish. All of these laws are now in force,
but there are no judgments to record concerning them.

THE LABORATORY BILL.

The State Board of Health, being commanded by the food law
to enforce said la^v, recommended to the Legislature that a labora-
. tory be created to make enforcement possible. It was proposed
that the laboratory should be called the State Laboratory of Hy-
giene and should be used not only for making food and drug
analyses for the purpose of discovering adulteration and violation
of the law, but also for making sanitary analyses of all kinds, and
also pathological examinations for the purpose of aiding diagnosis.
The bill was very carefully prepared and presented to the Legisla-
ture which adjourned March 11, but it failed to become a law. It
passed the Senate and went smoothly to the third reading in the
House, but was never handed down for final passage. Strong in-
fluence was brought to bear upon the Speaker to induce him to
hand down the bill for passage, but he steadily refused to act.
Aften\^ard in explanation, the Speaker said from his desk, "I have
l)een accused of holding back the Laboratory Bill. This is not
true. It was placed in its regular order and the House adjourned
before reaching it and, besides, the gentleman who introduced it
into the Senate, Mr. Guthrie, requested me not to push it." It
will be observed the Speaker states he did not hold it back, but says
that Senator Guthrie requested him not to push it. It is a matter
of deep regret that the Legislature did not have the opportunity to
vote upon the bill. The State is a decided loser by this failure of
the Legislature to create a Laboratory which would, undoubtedly,
have saved, annually, large sums of money to the people, and which

Digitized by VjOOQIC

would have been an important factor in the matter of preventing
disease and saving life. Of course, a laboratory will some day be
created in Indiana, for we are certain to progress equally with
other states.

SMALLPOX- MONTHLY STATEMENTS.
January —

Smallpox was reported in the following counties during
January: Allen, 10 cases, 2 deaths; Dearborn, 2 cases; Deca-
tur, 3; Huntington, 6; Jefferson, 6; Jennings, 7; Lawrence, 18;
Marshall, 5 ; Monroe, 2 ; Ripley, 1 ; Fountain, 3 ; Benton, 1 ; Ham-
ilton, 4 ; Lake, 4 ; White, 2 ; Marion, 6.

February — I

There were 165 cases of smallpox and 2 deaths from the disease
reported in February, as follows : Randolph County, 1 ; Daviess,
10 cases, 1 death ; Monroe, 5 ; Marion, 17 ; Lake, 12 ; Dekalb, 18 ;
Vigo, 2 ; St. Joseph, 1 ; Elkhart, 2 ; Pike, 4 ; Dubois, 2 ; Perry, 2 ;
Newton, 3 ; Allen, 14 ; Lawrence, 70 cases, 1 death. The disease
is still mild and frequently mistaken for chickenpox. One doctor
in Lake County had the disease and he and two other physicians
regarded it as vaccinia, but now concede they were in error, be-
cause later the doctor's baby had unmistakable smallpox.

March —

There were 472 cases of smallpox and five deaths from the dis-
ease reported in March : One in Allen, 1 in Dekalb, 1 in Marion, 1
in Vermillion and 1 in Daviess counties.

The counties visited by the disease were Marion, 22 cases;
Steuben, 1; Pike, 4; Fulton, 12; Tipton, 6; Vanderburgh, 1;
Lake, 12; Posey, 6; Lawrence, 101; Vermillion, 16; Dekalb, 5;
Howard, 8 ; Perry, 1 ; Dearborn, 4 ; Wabash, 1 ; Ohio, 74 ; Switzer-
land, 200 ; Wayne, 1 ; Noble, 2. The cases are generally mild,
yet there are not a few severe cases. In the localities infected by
this smallpox, there are always found some uninformed doctors
who deny that the disease is smallpox, and they, of course, have
more or less of a following. This makes it difficult to maintain
quarantine and secure vaccination. Frequently the people are not
aroused to a proper appreciation of the situation until death occurs.
In Vermillion Countv was the last instance of this kind. There

Digitized by VjOOQIC

229

some doctors ridiculed the idea that the prevailing eruptive dis-
ease was smallpox. Certain newspapers made fun of it and many
careless and thoughtless people follow these leaders. On Thursday,
March 28, John White, living at Summit Grove, died of this dis-
ease. The neighborhood then became more serious.

April —

Smallpox prevailed in the following counties during April : De-
kalb, 30 cases; Vermillion, 6; Howard, 16; Hamilton, 6; Law-
rence, 22 ; Fulton, 15 ; Parke, 1 ; Clay, 27 ; Putnam, 1 ; Madison,
5; Dubois, 23; Clinton, 10; Delaware, 7; Switzerland, 36; Rip-
ley, 5 ; Marion, 34, and 1 death. We feel impelled to make the
usual statement that many physicians still fail to diagnose the
disease. Even typical cases are very frequently missed. Anti-
vaccination literature is widely distributed and vaccination is con-
siderably prevented thereby.

May —

Smallpox wafi reported from 19 counties, as follows: Dubois,
10 cases, 1 death; Madison, 15 cases, 1 death; Lawrence, 12 cases,
1 death; Perry, 10 cases; Howard, 6; Hancock, 4; Clay, 20;
Vanderbui^h, 17; Fulton, 2; Knox, 7; Union 1; Dekalb, 18;
Dearborn, 4 ; Lake had probably 60 ; Elkhart, probably 10 ; Jeffer-
son reported 5 ; Floyd, 3 ; Porter, 4 ; Switzerland probably had 10.
The disease is now more frequently reported in semi and confluent
form, with an occasional hemorrhagic case. These facts, together
\nth the deaths, show that even very mild smallpox is dangerous
and must not be played with. Many persons, not trained in medi-
cine, and who have never seen smallpox, and have not seen the
cases in dispute, unhesitatingly declare their belief that there is
no smallpox. Health Officers are advised to be patient and long-
suffering with such ignorance and viciousness, and simply to go
ahead and perform their duty according to the law and the rules.

June-
One hundred and twenty-three cases and three deaths from small-
pox were reported during June, as follows: Clinton County, 20
cases, 1 death ; Posey, 4 cases ; Cass, 3 ; Owen, 1 ; Jay, 1 ; Kos-
ciusko, 11; Allen, 12 cases, 1 death; Laporte, 6 cases, 1 death;
Tippecanoe, 32 cases; Montgomery, 1; Adams, 32; Marion, 12;

Digitized by VjOOQIC

230

Jackson, 1. A house-to-house inspection was made in the eastern
part of Adams Oounty the first week in July, and at many farm-
houses it was discove(red that smallpox had existed in mild and
severe forms, but there had been no deaths. Tliese cases were not
reported, as no physician was called. Some Adams Oounty phy-
sicians persist in declaring the disease is not smallpox, although it
certainly is.

July—

There was a marked decrease in smallpox for July as compared
with the previous month. It was reported from four counties only,
namely : Daviess, Dearborn, Spencer and Marion. An apology is
to be made for the imperfect smallpox report for this month. For a
variety of reasons, it proved impossible to secure the number of
cases. There were no deaths reported.

August —

There w^ere exactly 100 cases of smallpox reported from the fol-
lowing counties: Adams, 20 cases; Daviess, 28; Porter, 3;
Marion, 6; Randolph, 3; Dearborn, 4; Spencer, 12; Ohio, 6;
Switzerland, 11; Dekalb, 7.

September —

Smallpox was reported from the following counties : Dearborn,
5 cases; Wayne, 15; Tipton, 2; Wells, 3; Knox, 5; Daviess, 20;
Hendricks, 13; Jay, 1; Randolph, 4; Delaware, 1; Grant, 2;
Warrick, 3 ; Laporte, 6 ; total, 80 c^ses.

October —

There were two deaths from smallpox in October, one in Laporte
County and one in Daviess County. Cases were reported as fol-
lows: Laporte, 4 cases; Dearboni, 7; Warrick, 4; Adams, 17;
Wayne, 12; Vanderburgh, 14; Daviess, 41; Spencer, 12;
Marion, 2.

November —

There were 186 oases of smallpox with 2 deaths in the State in
November, as follovrs: Spencer, 54 cases, 1 death; Jefferson, 27
cases, 1 death; Randolph, 1 case; Switzerland, 10; Adams, 18;
Gibson, 13 ; Pike, 1 ; Dearborn, 6 ; Kosciusko, 5 ; Wabash, 6 ; Mar-
shall, 1; Warrick, 17; Marion, 3; Vanderburgh, 19; Perry, 15.
The State Board continues to tell the people that while quarantine

Digitized by VjOOQIC

231

and isolation will usually stop the spread of smallpox in any
locality, still it almost certainly will return again and again until
the greater proportion of the unvaecinated have it. Vaccination is
the only prophylaxis to be relied upon.

December —

The cases of smallpox reported numbered 465, in the following
counties: Vanderburgh, 40; Kosciusko, 26; Tippecanoe, 41;
White, 1 ; Union, 13 ; Lawrence, 1 ; Spencer, 31 ; Vigo, 1 ; Owen,
3 ; Scott, 12 ; Pike, 1 ; Marshall, 3 ; Switzerland, 1 ; Randolph, 3 ;
Dearborn, 9; Warren, 1; Knox, 4; Wabash, 19; Warrick, 41j
Shelby, 12 ; Jefferson, 80 ; Miami, 12 ; Wayne, 40 ; Daviess, 41 ;
Adams, 3; Madison, 2; Perry, 20; Delaware, 4. There was one
smallpox death in Warrick and one in Tippecanoe counties.

SICKNESS— MONTHLY STATEMENTS, 1901.

flanuary —

The reports indicate that the following diseases increased in
area of prevalence over the preceding month: Influenza, bron-
chitis, pneumonia, tonsilitis, plexiritis, whooping-cough, measles,
puerperal fever and cerebro-spinal meningitis. The diseases
which decreased in area of prevalence were : Rheumatism, scarlet
fever, typhoid fever, diarrhoea, diphtheria, intermittent fever, ery-
sipelas, dysentery, cholera infantum and cholera morbus.

February —

The usual morbidity reports show a decrease in sickness in
February as compared with the preceding month. The deaths also
were fewer. The diseases which increased in area of prevalence
were: Influenza, tonsilitis, rheumatism, pleuritis, scarlet fever,
measles, erysipelas, inflammation of bowels, cerebro-spinal men-
ingitis. The diseases which decreased in area of prevalence were :
Typhoid fever, diphtheria, intermittent fever, whooping-cough,
dysentery and cholera infantum. There were 166 cases of small-
pox reported and 2 deaths. The disease is still mild. Two deaths
occurred, one in Daviess and one in Lawrence counties.

March —

The usual morbidity reports show a decrease in sickness in
March as compared with the preceding month. The deaths also

Digitized by VjOOQIC

232

were fewer. The diseases which increased in area of prevalence
were: Influenza, rheumatism, measles, pleuritis, intermittent
fever, diphtheria, diarrhoea, whooping-oough, oerebro-spinal men-
ingitis and cholera morbus. The diseases which decreased in area
of prevalence were: Bronchitis, pneumonia, tonsilitis, typhoid
fever, inflammation of bowels, puerperal fever and dysentery.

April — *

Smallpox excepted, the general health was better during April
as compared with March. The order of disease prevalence was:
Rheumatism, tonsilitis, influenza, bronchitis, measles, pneumonia,
diarrhoea, typhoid fever, intermittent fever, pleuritis, whooping-
cough, scarlet fever, erysipelas, dysentery, inflammation of bowels,
diphtheria and croup, cholera morbus, puerperal fever, cerebro-
spinal meningitis, cholera infantum. The following diseases de-
creased in area of prevalence as compared with the preceding
month: Kheumatism, tosilitis, influenza, bronchitis, pneumonia,
cerebro-spinal meningitis. The diseases which increased in area of
prevalence were : Measles, diarrhoea, typhoid fever, intermittent
fever, whooping-cough, dysentery, inflammation of bowels.

May— (

Reports to the State Board from all counties show a decrease in
sickness during May. The following diseases materially decreased :
Tonsilitis, measles, pneumonia, influenza, intermittent fever, ty-
phoid fever, pleuritis, erysipelas, whooping-cough, cerebro-spinal
meningitis and dysentery. There was a very slight increase in
rheumatism, scarlet fever, inflammation of l)owel8, cholera morbus,
cholera infantum, diphtheria and puerperal fever. The mortality
reports corrolwrate the morbidity reports.

June —

The usual morbidity reports show a decrease in sickness as com-
pared with May. The deaths were fewer by 313. Diarrhoeal dis-
eases increased considerably, as shown by both mortality and mor-
bidity reports. Pneumonia, typhoid fever, diphtheria, scarlet
fever, whooping-oough, measles, bronchitis, influenza, pleuritis and
puerperal fever show a marked decrease. Cerebro-spinal meningi-
tis was not epidemic at any point. It was reported as present at
37 places and there were 7 deaths.

Digitized by VjOOQIC

2.33

July-
There was an increase in the area of prevalence in the following
diseases in July over the preceding month: Diarrhoea, cholera
morbus, cholera infantum, dysentery, rheumatism, intermittent
and typhoid fever, A decrease in area of prevalence appears for
the following diseases, compared with the preceding month : Ton-
silitis, inflammation of bowels, bronchitis, measles, diphtheria and
croup, scarlet fever, pleuritis, influenza, pneumonia. There was
undoubtedly an increase in the diarrhooal diseases for July over
the preceding month.

August —

The disease prevalence reports show the following diseases in-
creased in prevalence in August over July: Cholera infantum,
rheumatism, typhoid fever, dysentery, intermittent fever, bron-
chitis, influenza, pneumonia, diphtheria. The diseases which de-
creased in prevalence were : Cholera morbus, inflammation of bow-
els, whooping-cough, scarlet fever, measles, pleuritis, erysipelas,
puerperal fever.

September —

The disease prevalence reports indicate less sickness in Septem-
ber than existed in August. Tlie same condition is indicated by
the mortality figures. The following diseases increased in preva-
lence as compared with August: Typhoid fever, intermittent
fever, tonsilitis, bronchitis, diphtheria and croup, scarlet fever,
pleuritis, influenza, pneiunonia, erysipelas, oerebro-spinal men-
ingitis. A decrease in prevalence occurred in diarrhoea, rheuma-
tism, cholera infantum, dysentery, cholera morbus, inflammation
of bowels, whooping-cough, measles.

October —

The morbidity reports from 57 counties indicate an increase
in the following diseases over the preceding month: Typhoid
fever, rheumatism, tonsilitis, bronchitis, scarlet fever, diph-
theria and croup, influenza, pneimionia, pleuritis, erysipelas,
measles, puerperal fever. A decrease in the following diseases
is indicated: Intermittent fever, diarrhoea, dysentery, inflam-
mation of bowels, cholera infantum, whooping-cough, cholera
morbus, cerebro-spinal meningitis.

Digitized by VjOOQIC

234

November —

Keports from 67 countiee indicate that bronchitis was the most
prevalent disease during the month, then follow in the order
given: Tonsilitis, rheumatism, typhoid fever, influenza, inter-
mittent fever, pneumonia, diphtheria, scarlet fever, diarrhoea,
pleuritis, inflammation of bowels, measles, whooping-cough, oere-
bro-spinal meningitis.

December —

Reports from eighty observers indicate that tonsilitis was
the most prevalent disease in the month, then follow in the order
given: Bronchitis, influenza, rheumatism, pneumonia, typhoid
fever, intermittent fever, pleuritis, scarlet fever, diphtheria,
diairhoea, erysipelas, inflammation of bowels, measles, dysen-
tery, puerperal fever, whooping-cough, cerebro-spinal meningitis.

QUARANTINE.

An Act to provide for the restriction of dangerous communicable diseases,
prescribing penalties and repealing all conflicting acts.

Section 1. Be it enacted by the General Assembly of the State of In-
diana, That any physician called upon to attend a siclc person, and who
finds the cause of such sickness to be of a contagious or infectious char-
acter, or if the disease is ordered to be reported in the rules of the State
Board of Health, shall declare a quarantine of such person at once and re-
port the fact to the Secretary of the Board of Health having Jurisdiction.
Such quarantine shall continue in force until relieved or revolted by the
said Secretary.

Sec. 2. Whenever any person knows or has reason to believe that any
member of his family or household (boarder, roomer or yisitcHr) has either
smalpox, diphtheria, membranous croup, scarlet fever, typhoid fever,
measles, or any other communicable disease listed in the rules of the
State Board of Health, he shall, within twenty-four hours from the time
the existence of the disease is known, if no physician is In attendance,
give notice thereof to the local officer of the town or city in which the
disease occurs, or the County Health Officer, if the case is without the
corporation of cities or towns, and such notice shall be given either ver-
bally or by written communication mailed or delivered within the time
specified.

Sec. 3. The Health Officer having Jurisdiction, upon being notified of
the existence of either of the four diseases named in Section 2, or of other
diseases listed In the rules of the State Board of Health, shall immedi-
ately, in person or by deputy, quarantine the infected house, rooms or
premises, so as effectually to isolate the case, and the family, if necessary,
in such manner as to prevent transmission of the disease, and whenever
a house, tenement or room, is placed in quarantine, a placard shall be

Digitized by VjOOQIC

235

posted in a conspicuaus position, giving the name of the disease in letters
not less than two inches long and also containing the following quaran-
tine order: "All persons are forbidden to enter or leave these premises
without special permit from the Health Officer having jurisdiction, and
all persons are forbidden to remove this card without orders from said
Health Officer." The penalty for violating any of the provisions of this
section shall be ten dollars fine or imprisonment for ten days, or both, as
the court decides.

Sec. 4. Upon the appearance of either of the diseases named in Sec-
tion 2 in any county, town or city in the State, the Health Officer shall
make an immediate report to the State Board of Health upon blanlLS fur-
nished for that purpose, and shall thereafter make a weekly report as
long as the disease continues, stating number of cases, number of in-
fected houses, fatality, and such other facts as may be, required by the
State Board of Health.

Sec 5. As soon as possible after the recovery or death of any in-
fected person or persons, the Health Officer having jurisdiction shall cause
the infected premises to be thoroughly disinfected and cleansed acceding
to the method prescribed in the rules of the State Board of Health, after
which the said premises shall be released from quarantine.

Sec. 6. No parent, guardian, person or persons having the custody of
any child shall permit such child, if infected with any communicable dis-
ease, or if it has been exposed to such, to attend any public or private
school, or appear in public in any way, and all school teachers, public,
private or parochial, shall exclude from their schools all such children
unless a written permit is given by the Health Officer having jurisdiction.

Sec. 7. It shall be the duty of the secretary, or a representative of all
Boards of Health, to attend a meeting of the State Board of Health, when
requested by the latter, for consultation or conference concerning the re-
striction and prevention of contagious and infectious diseases, or for the
consideration of other Important sanitary matters, the expenses only of the
delegate shall be paid by his Board.

Sec. 8. The expenses incident to disease prevention shall be paid by
the cities and towns in which the work may become necessary, and when
without the corporation of cities and towns said expenses shall be borne
by the county. If at any time the authorities of any county, city or town
fail, neglect or refuse to enforce the statutes and the rules of the State
Board of Health for the restriction of dangerous communicable diseases,
then the State Board of Health, if in Its opinion it becomes necessary,
shall take charge and enforce the law and the rules, and all expenses inci-
dent to such enforcement of the laws and the rules shall be paid by
the county, city or town in which such enforcement becomes necessary.

Sec. 9. Any person who violates any provision of this act, or any rules
or regulations of the State Board of Health for the enforcement of this act
except as otherwise provided, shall be punished by a fine of not less than
ten nor more than one hundred dollars.

Sec. 10. All acts and parts of acts Inconsistent with this act are
hereby repealed.

Digitized by VjOOQIC

ABRIDGED ANNUAL REPORTS

COUNTY HEALTH OFFICERS

CONCERNINQ

SANITARY CONDITIONS AND HEALTH

IN THEIR RESPECTIVE COUNTIES.

19OI

(237)

Digitized by VjOOQIC

ABRIDGED ANNUAL REPORTS OF COUNTY HEALTH

OFFICERS^ 190^

ADAMS COUNTY.

As a summary of my iiisi)ectioiis and studies, I can confldcmtly say
the health of Adams County for 1901 has been fairly good. Typhoid fever
has existed to a slight degree and only a few cases of diphtheria have
been known. Scarlet fever has been rarely reported, but measles has
prevailed rather extensively. There were 130 cases of smallpox during
the year and no deaths. None of these cases were serious, all of them
being of a mild type. Many physicians denied that smallpox existed,
which I presume was the case in every coimty where this disease ap-
peared. Two doubting physicians contracted the disease, and, after re-
covery, were completely convinced that the malady from which they suf-
fered was smallpox.

The sanitary conditions of t)ie jaJl and court house are passable and
these Institutions are well kept. Many of the schoolhouses of Adams
County are unsanitary in their construction and most of them are well
kept. Our County Infirmary is a new building with a dry basement, well
lighted, heated and ventilated, and has accommodations for 72 Inmates.
There are three incorporated towns in the county, namely: Decatur, Gen-
eva and Berne. The Health Officers of these places report the absence
of epidemics, except of mild smallpox, and that the general health is good.
These officers recommend several sanitary improvements for their re-
spective towns, and it is hoped the recommendations will be adopted by
the authorities.

H. F. COSTELLO,

Health Officer.

ALLKN COUNTY.

I made a careful insiH'ction of the Allen County Infirmary, County
Orphans* Home, County Jail, Reformed Orphans' Home and Catholic Or-
phans and found all in good sanitary conditions. No sickness of any kind
prevailed in any of ^these institutions. We had an outbreak of small-
pox in the Feeble-Minded Homo, of about 15 cases, but by prompt isola-
tion and vaccination of all of the inmates, including all of the employes
of the institution, the disease was checked.

The general health of Allen County has been fairfi^ good, there being
more cases of typhoid fever, scarlet fever, measles and diphtheria than
ought to have been, but there was no epidemic of any kind. Smallpox
is still epidemic with us, every case is promptly isolated and quarantined,
and an extra smallpox physician is sent for treatment.

Digitized by VjOOQIC

240

Our schoolliouses are in a fair condition and a good many ncrw ones
are built. As a general rule the physicians of Allen County have informed
me of any contagious diseases and have sent in regularly their birth re-
ports. Contagious diseases in the city of Ft. Wayne are handled Just
the same as in the county. Two sanitary officers are doing quarantining

CARL PROBGLBR,

HeAlth Officer.

BARTHOLOMEW COUNTY.

Several nuisances have been abolished during the year. Two sloughs,
which. were the source of ill health, have been drained by ord^ of the
County Board of Health and much good has resulted. An outbreali of
scarlet fever occurred in Columbus, Hope and Elizabethtown in the
months of October, November and December. There were also a few
cases of diphtheria, but none ot malignant form. Typhoid fever prevailed
rather alarmingly, but the reports of cases are not sufficiently accurate
to warrant any positive conclusions. Sanitation is undoubtedly advancing
in the county for more and more people each j'ear apply to the Health
Department for advice and aid. An epidemic of measles spread over the
county in October and there were three deaths on account of this disease.
Usually, however, the cases were mild. Smallpox, in a mild form, appeared
in the city of Columbus in July, 1901. There were four persons affected
by the disease. Sanitary control was promptly imposed with the result
of preventing the spread of the contagion.

The schoolhousea throughout the county are frequently in bad sani-
tary condition. Some of them are new buildings, well Itept and satis-
factory In every way. School authorities everywhere have been exhorted
to Improve their schoolhouses and specific instructions have been given
how they may do so. The county asylum is in satisfactory sjinitary con-
dition. It is well kept, but some improvements have been recommended
to the authorities, and 1 think they will be adopted. The Orphans* Home
is a model of cleanliness and its surroundings are very attractive. Of
course, some sanitary improvements should be made and a few minor
ones have been recommended and they will probably be very soon sup-
plied. The courthouse and jail are comparatively new structures, are well
built and well kept They are reasonably well ventilated, but improve-
ments could be made in this respect. All of the city and town Health
Officers have reported to me and it appears that the general health of
their various jurisdictions has been quite satisfactory, with the excep-
tion of the ever-present typhoid. We hope very soon, by education, to lift
the people out and away from the cases of typhoid. It is undoubtedly
true that the draining of the land for agricultural purposes has more to
do with the improvement of the public health than any direct efforts for
that purpose.

J. S. ARWINB,
Health Officer.

Digitized by VjOOQIC

241

BENTON COUNTY.

Beuton County has been remarkably free from epidemic diseases dur-
ing the year. We had three eases of smallpox, one at Earl Park and two
at Fowler, with no fatalities. There has been no typhoid fever during;
the year. The Jail, located at the county, seat, Fowler, is in a very un-
sanitary condition, but will be renovated within the next three months.
A new poorhouse is at the present time being constructed, and from its
plans it is plain to be seen that it will be a fine building and appropriate
in every way for the purpose for which it is intended. The schodhouses
are as good as could be expected from buildings that are heated by stoves
and ventilated by windows and doors. Their location is very good. The
water supply is in every instance from deep driven wells and is excellent.
I know of no school buildings where the outhouses are not kept in good
condition. The town of Fowler will soon put in a complete sewer system,
which will, of course, improve the sanitary conditions of the town very
greatly.

D. E. MAVITY,
Health Officer.

BLACKFORD COUNTY.

There are only four townships, in this county, with 109 square miles
and 23,000 inhabitants. There are two incorporated cities and three vil-
lages. The county is pretty well drained. There are a number of small
streams, some of them receiving sewage and others pollution. The health
of the county has been good during the year. There were no epidemics.
Four cases of smallpox developed in one family in Jackson Township.
They were promptly placed under sanitary control and there was no
spread of the disease. There are forty-eight district schools in the county.
Forty-five are brick. As County Health Officer. I gave special atten-
tion to the cleaning of schoolhonses before school commenced in the fall.
I am sure much good was produced in this way. The county poorhouse
Is in very good condition. It is a new building of brick and stone with
most modern conveniences. It i.s well kept. The courthouse is a modern
structure and is in good sanitary condition. The same may be said of
the Jail. Some improvements have been suggested and have been fol-
lowed out.

Montpelier has 4,500 inhabitants and has a very active Board of
Health. Many improvements, in a sanitary way, have been put in dur-
ing the past year. In Hartford City a new sanitary and storm sewer is
being constructed in the western part of the city. This sewer will drain
a large section. The Health Officer has recommended a sewer for the east
side and his recommendation has been favorably received. He has also
recommended a garbage ordinance which It is hoped will be taken up by
the council very soon.

W. N. CRONIN,
Health Officer.

16-Bd. of Health. r^r-kr-vrrT/^

Digitized by VnOOQ IC

Digitized by VnOOQ I

242

BOONE COUNTY.

From the records and general ol>servatlon I am prepared to state
there has been less sickness of every kind this year, than In any other
year since the county was organized. There is much public interest
shown in sanitation, especially in regard to water supplies. The farmers
generally are thoroughly awalie to the necessity of having good, pure
drinking water. The dug wells are giving way to the driven wells, and,
of course, health improvement will follow. The schoolhouses through-
out the county are mostly of the old style, but none of them are in a di-
lapidated condition. Only a few have driven wells and some of them
have water supplies which should be condemned. All of the schoolhouses
in the county were thoroughly cleaned and disinfected before school
opened in September. We have had no epidemics during the year. Have
had some scarlet fever and diphtheria. The cases were all scattered.
There have not been to exceed ten cases of typhoid fever and investigation
proved the patients had all used water from dug wells. Our jail is in
fair condition. Certain sanitary improvements have been recommended
and will almost certainly be adopted by the Commissioners. Our poor-
house is in fine condition. It is new, is heated with hot air, and has all
the modcn^ improvements and conveniences. There are 28 male and 15
female inmates. There was not a death and no sickness of moment among
them during the year. No smallpox, although two counties bounding us
on the west have had it.

. A. P. FITCH.

Health Officer.

BROWN COUNTY.

Typhoid fever iK^-vailed in Brown County to a considerable degree dur-
ing the year. There were 8 deaths from this cause. In every instance,
bad drinking water was found where the disease existed. Scarlet fever
and diphtheria has been mild. There was one death from scarlet fever and
none from diphtheria. The high and rolling lands of Brown County gives
good drainage and so we have natural sanitary conditions of a high order.

The county poorliouse Is a new building, situated on high ground,
heated by a furnace, water supply from driven well, has 11 inmates, all
in good health. The poorhouse is well kept. The courthouse is an old
building, Is well kept, and is In only fair sanitary condition. The county
jail is a two-story log building, very unsanitary, but Is as well kept as
conditions will permit There are twenty-five schoolhouses in the county,
all frame. It can not be said that one of them is strictly sanitary and
some of them are dilapidated and so unsanitary th^ should be con-
demned. The water supply for many schoolhouses is from creeks and
branches and nearby neighboring wells. Despite the unsanitary school-
houses and surroundings, the health of the children seems to have been
passably good. All new school buildings hereafter erected in the county
shall conform to the sanitary requirements of the State Board of Health.

JAS. P. MOSER,

Health Officer.

Digitized by VjOOQIC

243

CARROLL COUNTY.

There were no epidemics duriug the year and less than the usual
amount of contagious diseases. There has been a number of scattered
cases of diphtheria and scarlet fever. Sanitary control was carefully ex-
ercised with all infectious troubles. The courthouse is in fair condition
but needs better sewerage. The jail is unsanitary on account of defect-
ive plumbing. These defects in the courthouse and jail will be very soon
remedied. The poorhouse is very well kept, but the building is old and
unsanitary conditions exist. There are many very unsanitary school-
houses in the county. As fast as new ones are constructed, the specifi-
cations of the State Board of Health are enforced.

J. J. SHULTZ,
Health Officer.

CASS COUNTY.

There were 51o deaths duriug the year In Cass County. Important
causes of death were as follows: Typhoid fever, 14; tuberculosis, 68; diph-
theria, 4; measles, 2. There were no epidemics during the year, and there
were no deaths from scarlet fever or smallpox. There were in all twelve
cases of the last named disease. I tliink the general health of the county
during the year may he rightly spoken of as good. The poorhouse is In
passable sanitary condition. Many improvements could be made and some
have been recommended. The courthouse is a fine building and Is sanitary
in every respect except In regard to ventilation. The jail is well kept,
but the ventilation is not what it should be. Several sewers have been
built during the year at I^gansport and several streets have been paved.
These are to be counted as sanitary improvements and no doubt will have
a good effect upon the health of the city.

DR. F. A. BUSHJAHN,

Health Officer.

CLARK COUNTY.

In my last report I was compelled to tell a sad story in regard to the
county jail. I am pleased to report that during the year a new jail has
been built and the drainage is now all that could be desired. The venti-
lation, however, is not what it should be. The jail is well kept. There has
been no material change in the Orphans' Home and its manage-
ment The place is well kept. There has been very little sick-
ness, and it was of a minor character. There were no deaths.
The two hospitals at .leffersonville are notable institutions, well
kept and sanitary. They are the Deaconess Hospital, located on the river
front, and the Mercer Hospital, located on Spring Hill. The Jefferson v ill e
pesthoUse Is a passable building and is well kept. The poorhouse is a
poorhouse indeed. It is a miserable building, is unsanitary, but Is well
kept. There Is a demand on the part of the people that a new county asy-
lum be built There are 33 inmates at this time, 23 males and 10 females.
Four new schoolhouses have been erected during the year, and all of them
are built with sanitary principles in view. They are good buildings and

Digitized by VjOOQIC

244

well kept. The majority of the school buildings in the county are not
what they should be and some of them are poorly cared for. The County
Superintendent is alive to the situation, and, as fast as new buildings are
constructed, they will be according to sanitary law. Several complaints
of nuisances have been made during the year and all .have been satis-
factorily answered without recourse to law. There have been no epi-
demics during the year, l^ut, of course, a few cases of scarlet fever and
di'^htheria have been reported.

Smallpox appeared in JelTersonville on the 21st of May. The patient
is said to have come from Louisville. He was sent to the pesthouse. On
May 27 another case appeared in one of our citizens who had returned
from the South. From that time it has existed every month, but at no
time has it assumed an epidemic form. All precautions have been taken
to prevent its spread. The whole number of cases of diphtheria reported
during the year were 38, with 3 deaths. Scarlet fever reported, 57 cases,
no deaths. Typhoid fever, 100 cases. 23 deaths. I believe the reports of
deaths are very accurate.

W. H. SHEETS,
Health Officer.

CLAY COUNTY.

This county enjoys the distinction of being one whose death rate Is
always below the average, as is proved by comparison with the tables
printed in the Monthly Bulletin. The county asylum is well kept, but its
construction is not as sanitary as should b^ There were 43 inmates dur-
ing the year, 30 males and 13 females. Nine of these were insane. Sev-
eral recommendations for improvements as to outhouses and other san-
itary conditions were made to the County Commissioners, and said im-
provements were promptly made. There were only two inmates in tlie Or-
phans* Asylum. The building is large, well constructed and passably
sanitary. The jail and courthouse are excellently kept, but are rather
old buildings and are not sanitary in every confitruction. Tliere seems
to be a woeful lack of taste and pride in the way school buildings and
premises are kept. There are signs of Improvement, however, and the
houses hereafter constructed will, undoubtedly, conform to right sanitary
conditions. Smallpox has been epidemic almost continually since the Clay
City experience of 1899, but has been conlQned to certain localities. The
cost to the county of fighting smallpox, was, for the year, $1,500. There
are six incorporated towns in Clay County and their Heaich Officers are
alive to their duties and deeply Interested in preventive medicine. There
have been no epidemics of diphtheria, scarlet fever or typhoid, yet a few
cases of these diseases have existed.

J. H. CARSON,
Health Officer.

Digitized by VjOOQIC

245

CLINTON COUNTY.

The health of the county has been very good during the year. There
have been a few cases of typhoid fever and a few isolated cases of diph-
theria and scarlet fever, but nothing Uke an epidemic. There was an epi-
demic of smallpox during the spring and earlier summer months. The
first cases were traceable to the return of infected persons from Olcla-
homa. Proper sanitary precautions were taken' to prevent spread. The
sanitary conditions of the county may be classed as good. There is very
little wet land and verj' few ponds. The principal roads are all in good
condition, being well graded and graveled. The school buildings are
mostly modern and up-to-date. The greater number are of brick. The
water supply is always from driven wells. The outhouses are widely
separated and have good walks leading to them with "rare exceptions.
The county poorhouse is kept as well as possible under the circumstances.
The location is very good and the drainage satisfactory. The main build-
ing is of brick, but was built several years ago and is without modern
conveniences and no sanitary principles were obser>'ed in its construction.
There is gi*eat need of more room. There is only one bath tub and that
is very badly arranged. The water supply is from a driven well and-very
satisfactory. The Jail is a brick structure, but is very old and is not mod-
ern. It is very dark, damp and unsanitary. There are two tiers of
cells. The sewerage is very poor and almost continually out of repair.
There is but one bath tub and that is for the men. The heating is by
steam and is not satisfactory. The courthouse is not a new Iniilding and
has no special system of ventilation. It is well kept.

BENSON RUDDELU

Health Officer.

CRAWFORD COUNTY.

The Crawford County jail is in very bad sanitary condition. The sexeA
are not kept separate; there are no closets and ventilation is very bad.
There is only one in the jail at present and he is sick. These conditions
have been brought to the attention of the Commissioners and I expect
proper action will very soon be taken. Tlie county asylum has 20 in-
mates and is well kept. The buildings were not constructed with any
sanitary Ideas in view. The schoolhouses of the county are all unsanitary.
Their construction Is not In accordance with sanitary requirements. Most
of them are well kept. At the last meeting of the county teachers, I ad-
dressed them and many promises were made that sanitation would be
looked after to the best of their ability. There have been no epidemics
during the year and only a very few cases of mild smallpox. 1 believe
that every death In the county has been reported. The physicians are In
harmony with the Health Officers.

C. D. LUCKETT,

Health Officer.

Digitized by VjOOQIC

246

DAVIESS COUNTY.

The wet lands in Daviess County are rapidly disappearing on account
of efficient tile draining beiilg put in. The health is improving. Dug
wells are being abandoned and driven wells put down. Typhoid fever
and diarrhoeal diseases are in continual evidence in the City of Washing-
ton, the county seat. This is because of lack of drainage and bad water
supply. This matter is under perpetual agitation. The public buildings
of the coimty are in passable condition except the county jail. This build-
ing is unsanitary and will remain so until it is entirely remodeled. It Is
kept clean as possible under the circumstances. There has been little
sickness in the jail during the year. The poor asylum is in passable con-
dition. No epidemic present duiing the yaer. The inmates are well fed ■
and properly clothed. Many improvements are demanded and its is ex-
pected these will be made within a few months. The Orphans* Home is
a good building and is well kept. There have been no epidemics during the
year. Three cases of diphtheria have appeared at different times; and two
of scarlet fever were reported. Measles have existed to some degree among
those inmates who had never had the disease before. The towns of Odon,
Elnora and Montgomery are in passable sanitary condition. Nuisances
were abated in all of the towns named and a general cleaning up was or-
dered and enforced during the summer months. No epidemics have existed.
There have been a few isolated cases of scarlet fever and diphtheria during
the year, also some typhoid and considerable measles. At no time has
there been an epidemic of any kind. The physicians of the county are
interested in sanitary matters and most of them promptly report births,
deaths and contagious diseases. The city schoolhouses are all first-class
and well kept. We have many country schoolhouses which are very un-
sanitary, some of them dilapidated and some of them are badly kept
Improvements, however, are apparent. In January, 1901. smallpox ap-
l)eared in a mining district known as South Washington. About fifteen
families in four school districts were infected. Exactly how many cases
occurred will never be known, for many of fhem were so mild as not to
require a physician and hence were never reported. The epidemic lasted
until the middle of September during which time the disease was prevail-
ing in Wasliington and surrounding country. Two hundred and two cases
in all were reported, but it is l>elieved that two or three times this num-
ber actually appeared. Vaccination, the only prophylaxis was offered to
all without charge, but very few took advantage of it. A few physicians
persist in calling the disease impetigo, cuban itch, etc. It is hoped they
will learn, in due time, how to diagnose smallpox. The cost of the small-
pox epidemic to tlie towusliip was $2.3r)8.25. The City of Washington had
also many lieavy bills to pay.

C. C. M'COWN,
Health Officer.

DEARBORN COUNTY.

The population of Dearborn County is 22,000, with 8 incorporated
towns, las schools and about 7,000 school children. The county school-
houses are in passal)le condition. Some are old and poorly lighted and
ventilated. All school buildings are thoroughly cleaned and disinfected

/Google

Digitized by VnOOQ I

247

every fall before school begins. Some schools are not provided with good
water. The county poorhouse Is brick and was built In 1882. It has 64
rooms. Water supply is from dug wells and two large cisterns. There
were 44 inmates during the year. The deaths numbered 7—6 male, 1 fe-
male. Causes of death were: Dropsy, 2; old age, 1; pneumonia, 1; tuber-
culosis, 1; hemorrhage, 1; general debility, 1. The building is heated by
steam, but the ventilation is poor. The county Jail is In good condition.
It was built In 1803 and has 20 cells, is heated by steam, water supply
from a driven well: The sewerage is satisfactory. There has been no
sickness nor deaths during the year among the inmates. The number
of contagious diseases reported for 1901 was greater than in the preced-
ing year. Measles were twice as epidemic. The number of cases of diph-
theria was 39; scarlet fever, 40; Bmalli>ox, 81; typhoid fever, 16; cerebro-
spinal meningitis, 1. These cases were spread all over the county, with
the exception of smallpox, which was mostly concentrated in Lawrence-
burg and Aurora. Lawrenceburg^ the county capital, has a population of
about 5,000. It is not completely sewered. It has three school buildings.
All are well kept and in passable sanitary condition. The courthouse is
a three-story stone building, built in 1872, well lighted and ventilated. The
sewerage is good. The building is warmed by steam. The health of the
city has been very good. .A large majority of the cases of smallpox have
been among the very poor.

A. T. FAGALY,
Health Officer.

DECATUR COUNTY.

Decatur County is located in the "Central Sanitary Section" of the
State and has a population of 19,518, of which the City of Greensburg
claims 5,034, the remainder, 14,484, we will call the rural population of
the county and will consider the vital statistics, as relates to that portion
of its citizens only, in this report, whether favorable or otherwise to its
people.

Judging from the increased death list of the county, for the year end-
ing December 31, 1901, it might be inferred that the sanitary condition
was less favorable than In the two preceding years; the average death rate
of which was 131, that of the year Just closed being 142.

Referring to the records of the last three years, we find that there has
been no epidemic of significance; that consumption still leads In the mor-
tality list as heretofore; intestinal diseases of children being next, with
an increased number of fatal accidents in 1901. Apoplexy and paralysis,
pneumonia and cancer give the usual propoi-tion of deaths of former years.
There were four deaths from typhoid fever, one from malarial fever, one
from diphtheria, none from scarlet fever, measles or membranous croup.
There was one case of smallpox, no death or additional infection.

Comparing the number of deaths In persons between the ages of 60
and 90, which was 64, we find 12 more deaths this year than the aver-
age of the two preceding years (52). Excluding this class and the In-
creased number of deaths from accidents, that occurred in the county, our
mortality list is less than in 1899 and 1900. We therefore think the in-
creased death rate was not due to a worse sanitary condition.

/Google

Digitized by VnOOQ I

248

There were 20 deaths iu persons over 40 years of age, from diseases
of heart, and the great majority of these over 60 years of age were classed
as senile "heart failure/*

The courthouse, jail, orphans' home and county asylum are In good
sanitary condition. There are at the latter place 14 males and 9 females.
There were 6 deaths, mostly the result of age. The Odd Fellows' Home,
re'cently built in the City of Green«burg, Is under the supervision of the
Grand Lodge of the State. There are at present 59 guests, of which 28
are children.

With the beginning of the school year, I sent to the Township Trus-
tees of the county a copy of the Health Order of 1898, issued by the State
Board of Health, relating to the renovation and cleaning the school-
houses. I have good reasons to believe that this order was generally en-
forced.

There are 88 schools In the county. Including those in Greensburg, in
charge of 145 teachers. There are four schoolhouses that are not occu-
pied in the districts. Isolated cases of contagious diseases caused the
dismissal of three schools for a short time. About <Hie^half of the township
schools have driven wells. In tw-o of the townships it is found that steps
will have to be talcen to provide better facilities, not only in the buildings,
but in changing the localities, and perhaps in consolidating school districts.
This, as it generally has done, will cause some dissatisfaction, and has
perhaps been deferred for this reason, to the injury of the pupils.

Two new school buildings have been added, or taken the place of
others. These were of brick and are favorably located.

The school buildings and surroundings, with the exceptions noted, are
in very fair condition from a sanitary point of view.

Dr. E. T. Riley, the Health Officer of the City of Greensburg will re-
port on the condition of the city schools and such other matters as are
required of him in the call for this report.

JNO. H. ALEXANDER,

Health Officer.

DEKALB COUNTY.

Our courthouse is an ancient structure, and is very unsanitary, but
is as well kept as the conditions will permit. The county jail is an old
structure and is unsanitary. It Is as well kept as conditions will permit
The poorhouse is old and unsanitary. We have 104 brick schoolhouses
in use in the county, all of which are in passable sanitary condition.
There are three frame schoolhouses which are in poor sanitary condition,
but they will be Improved next year. We have had 24 cases of smallpox
in the county, but no deatlis. Only a few cases of scarlet fever have been
reported and no deaths.

D. A. SEBRING,

Health Officer.

Digitized by VjOOQIC

249

DELAWARE COUNTY.

Smallpox appeared in February, near Muiicie. The disease had gained
considerable foothold before It was discovered. It was eradicated by the
most stringent measures. In the winter and spring of 1901 measles ap-
peared In epidemic form in Muncle and various other parts of the county.
About 1,000 cases appeared, with 2 deaths. The Jail Is Inadequate to meet
the demands made upon It. The sanitation Is very faulty. The one room,
which constitutes the woman's department, can not be ventilated. De-
moralizing Influence prevailed in the mal« department, as it Is Impossible
to separate young boys from hardened criminals. The jail Is not sani-
tary, but Is as well kept as possible under the conditions. Improvements
have been made in the children's home in the past year. Wash rooms and
closets have been provided. The county poorhouse Is of brick, and Is in
good sanitary condition. Sanitary principles were not fully consulted '
when it was constructed. A modern system of waterclosets has l)een
placed on the first floor of the courthouse. Both these buildings and the
Jail are now heated by steam. I have been making a special eflTort to Im-
prove the sanitary conditions of the schoolhouses of the county. Several
new buildings have been erected within the year and all sanitary features
have been Incorporated. The consolidation of schools In some of our
townships will probably cause the permanent abandonment of some un-
sanitary schoolhouses. I have had a form of report drawn up and dis-
tributed to all of the teachers and have been gratified to receive full re-
ports from every s<'hool In the county. In Muncle there was a severe
epidemic of measles in the sprlyg and one of smallpox in February, March,
April and May. There were 30 cases of smallpox In all, with no deaths.
All afillcted had never been successfully vaccinated. The county and the
City of Muncle, Jointly, own a contagious disease hospital. This Insti-
tution has been of great use in extinguishing smallpox. Effort has been
made to bring about more thorough cleanliness of our alleys and private
premises. Prompt return of diseases and births are made In Muncle.
The public health of Albany has been unusually good for the past year. No
cases of contagious diseases, except measles, have been reported. There
is much sanitary work to be done In the town. It Is without a compre-
hensive sewer system and there should be a garbage ordinance. There
were 3 cases of typhoid fever reported, 1 was fatal. Every spring we
have a general cleaning up which unquestionably does much to preserve
the public health. We have had no scarlet fever or diphtheria during the
year. Tul)erculo8l8 is ever present. Whenever a death occurs from this
disease, thorough disinfection of the premises Is practiced. A few cases
of pneumonia appeared during the winter at Albany, but no deaths.

H. A. COWING.
Health Officer.

DUBOIS COUNTY.

The health of the county during the year has been fairly good. There
has been some typhoid fever, but no epidemic of the malady. Several cases
of diphtheria were reported from various parts of the county with several
deaths. I have reported many instances where the parents refused to

Digitized by VjOOQIC

250

allow the use of antitoxin. We had 18 cases of smallpox from one town-
ship, most of them being mild eases, with one death. In the spring there
was an epidemic of meask^s. Dubois County is generally rolling and the
drainage is, therefore, good. All new schoolhouses In the county are well
located, but the improvement along the line of heating and ventilation
does not keep step with the march of other school work. There should
lie a statute controlling the sanitary features which all schoolhouses
should contain. The County Superintendent suggests that the truancy
law causes more sickness in the schools than was formerly the case.
Children from homes which are very poor are now forced into schoolrooms
and very *of ten carry disease. Jasper, the capital, had 28 deaths and 59
births during the year. There were 5 cases of typhoid fever and 3 cases
of diphtheria. Sewerage and the garbage question should be speedily at-
tended to. The sanitary conditions at Huntingburg are only passable.
School buildings are very satisfactory. There was an epidemic of diph-
theria in mild form during the year. Fifty cases were reported, with 2
deaths. Huntingburg needs a more efficient sewer system.

J. F. MIOELOILS,

Health Officer.

KIvKHART COUNTY.

From my inspections and studies I conclude this county is in passa-
ble sanitary condition with the exception of a i>6rtion of the City of Elk-
hart. The schoolhouses throughout the county, with very few exceptions,
are modem in construction and sanitary principles have been applied.
Tlie sanitation of the school buildings will be carefully looked after. The
jail is in bad sanitary condition. The plumbing is defective and also the
sewerage. This matter has been brought to the attention of the Commis-
sioners and County Council. The poorhouse is in passable condition. It
has recently been repaired and modern heating and excellent sewerage
provided. The courthouse is in passable sanitary condition. The court-
room is not properly ventilated, but this can be corrected with very little
expense. There was an- epidemic of smallpox during the summer months
of July and August. There were 20 cases in all reported, with no deaths.
T\w disease was of mild typo. At the present time there is an epidemic of
mumps all over the county. There has been some scarlet fever and diph-
theria, but no epidemic. E. R. ASH,

Health Officer.

FAYETTE COUNTY.

Tliore was a little scarlet fever during the year, l)ut it was of a mild
type. The school l)uildinjrs in the county are mostly in good condition.
There are some which are very unsanitary and others which should be
condemned. As fast as new ones are l)uilt, the Health Department sees
to it that they contain tlie niodern sanitary improvements. The country,
in general, is rolling and this insures good drainage, a point which favors
the public health. The poorhouse is old and not modem. It is as well
kept as is possible under the circumstances. The authorities contemplate
building a now poorhouse. There were two cases of smallpox during the

Digitized by VjOOQIC

251

year. Vaccination procee<ls slowly. The sanitary conditions of Conners-
vilie are fairly good. Schoolhouses are satisfactory from a sanitary stand-
point. The courthouse and jail are well kept and In good sanitary condi-
tion. Connersville needs a more extended sewer system, which will prob-
ably come in due time. There were 52 cases of smallpox reported during
the year and nearly all were of a very mild type. There were 2 deaths.
Seventeen cases of diphtheria and no deaths, 2 cases bf smallpox occurred
in the city during the year. E. DERBiSHIRBX

Health Officer.

FLOYD COUNTY.

The death rate of Floyd County was 1.2 higher In 1901 than In 1900.
The marriages numbered 308, births, 206. There was no smallpox dur-
ing the year. One hundred cases of diphtheria were reported, 20 cases of
scarlet fever, 22 cases of tjTphoid fever. Measles prevailed to a consid-
erable degree. The New Albany schools were closed for two weelts in
October, on account of diphtheria. The disease subsided to reappear when
school was resumed, and It continued more or less until late In the spring.
I met with the County Council six different times to discuss the im-
provement of the county jail. At the February meeting the building was
condemned as a shame and disgrace to civilization and I was appointed
to see an architect and have plans made for Improvement and also plans
for a n-ew building. The council has taken no action upon my recom-
mendations and the plans offered. The Sheriff keeps the Jail as clean and
neat as he can under the circumstances. The poorhouse Is well kept,
but is unsanitary in many particulars. The unsanitary conditions have
all been reported to the authorities with recommendations. The Orphans'
Home is well kept and is satisfactorily sanitary. The school buildings of
this county are not what they should be; with rare exceptions they arc
unsanitary, many of them are dilapidated and some of the better ones sad-
ly need modern repairs. In October I visited the school buildings in La-
fayette Township and found they had not been swept since the previous
session of school had closed. Upon my demand this neglect w^as cor-
rected. An order has now been issued by the County Board of Health
governing this matter.

^ The town of Georgetown is only passably sanitary. Some improve-
ments were made during the year, such as the removal of pig pens, clean-
ing of alleys and emptying of vaults. The schoolhouse In that town is in
passable condition. It needs some improvements. The town of Green-
ville has been put in very good sanitary condition. A general cleaning
up has effected this end. The school house is not what it should be from
a sanitary standpoint and improvements in this regard will be made
during the next vacation. There were a few cases of scarlet fever during
the year at (ireenvllle, but no deaths.

New Albany Is a very old city. There are too many dilapidated build-
ings. The sewerage Is not what It should be and the city is not clean as
proper santltatlon demands. Progress, however. Is being made.

R. W. HARRIS.
Health Officer.

Digitized by VjOOQIC

252

FOUNTAIN COUNTY.

There were no epidemics in Fountain County during tlie year. No
smallpox to record, although this disease infected adjoining counties.
The courthouse is not sanitary and is only passably Icept The same is
to be recorded in regard to the poor farm. The sanitary condition of the
Jail is only passable and I contend that better sewerage and better drain-
age are demanded. All deficiencies have been brought to the attention of
the County Board of Health with recommendations, but no action, so far,
has been taken. The school buildings of the county are not what they
should be. Some of them are very old, dilapidated and very unsanitary.
A few meet modem requirements. There is probably not a schoolhouse in
the county that could not be Improved in some particulars. The water sup-
ply for school buildings could be bettered in many instances.

GEORGE ROWL.AND,

Health Officer.

FRANKLIN COUNTY.

The entire area of Franltlin County is rolling and, therefore, drain-
age is usually good. Measles was the only epidemic disease that has ap-
peared during the year. The death rate was 14.4, which is 1.3 higher than
the preceding year. I think this largely due to the extreme dry and hot
weather, which, of course, impose severe conditions upon infants. The
school buildings are, many of them, old and dilapidated. There are also
a goodlly number which are new and well built. Very few of them,
however, were built with any idea of sanitation in view. The vault
nuisance is always with us, and certainly Is the cause of not a little dis-
ease. The county poorhouse Is In good shape. There are 50 Inmates at
pi"esent. The buildings are brick and heated by steam. The water sup-
ply is plentiful and of good quality. The vault system of disposal is used.
The Childrens' Home Is in good condition. It Is a good, substantial brick
buildings with 13 rooms, heated by stoves. Ventilation is by windows and
doors and is closely watched by the Superintendent. A bathroom Is
needed at this institution. The jail Is a brick structure with stone corri-
dors and cells. It is heated with stoves. It is damp and unsanitary. The
vault disposal is used. GEO. B. SQUIER.

Health Officer.

FULTON COUNTY.

Fulton County has an excellent water supply, which is secured from
driven wells. Tliere are very few dug wells In the county. Of the 207
total deaths during the year, only 7 were from typhoid fever; 20 were
from tuberculosis; 4 from diphtheria and 1 from scarlet fever. The school-
houses are old and unsanitary. As fast as new ones are constructed
they are built in conformity with modern ideas and modem sanitary de-
mand.s. Instructions have been issued to trustees and school authorities
in regard to the necessity of cleanliness and in regard to the necessity of
pure water. The ventilation of a schoolhouse. which must depend for
ventilation upon windows and doors, is entirely in the bands of the

Digitized by VjOOQIC

253

teticher. It is true that it is impossible to properly ventilate schoolhouses
by windows and doors. The courthouse at Rochester is a new structure
and is generally up-to-date, but there Is no special arrangement for ven-
tilation as there should be. The jail Is well kept and is passably sanitary.
Rochester has put in some sewers which will, of course, greatly Improve
matters, and contemplates, next year, the disposal of sewage by filtration
beds. There has been no epidemic of diphtheria or scarlet fever, but
measles has been epidemic twfce. The county has been invaded by 0
cases of smallpox.

CHAS. K. GOULD,

Health Officer.

GIBSON COUNTY.

I believe the sanitary condition of this county, for 1901, is better than
in previous years. Many recommendations have been made to the peo-
ple, and, in many Instances, these recommendations have been carried
out. The school buildings are not all satisfactory. Some of them are very
poor and should be condemned. A few are excellent and meet all modern
sanitary requirements. This matter has been brought to the attention
of the County Board of Health with recommendations, but no action has
been taken to this date. There has been some contagion in the county,
two schools were closed for a short time, on account of smallpox. There
have been no epidemics of scarlet fever or diphtheria. Whooping cough
was epidemic during the entire year.

J. S. CRITCHFIBLD,

Health Officer.

GRANT COUNTY.

There have been no epidemics during the year and the general health
has been what might b^ termed good. It will be remembered that ty-
phoid fever was very prevalent in Marion in 1900, but there were only
a few cases this year. Measles was epidemic In several portions of the
county during the earlier part of the year. This disease should be looked
after more carefully for it is quite as dangerous to the lives of children
and as fruitful of deleterious after-effecis as scarlet fever. Tuberculosis
is always present with us and reaps its harvests of death each year. It
Is a comment upon our bad management that nothing is being done toward
the prevention of this disease.

The total number of school buildings in the county is 114. Most of
them are frame and all too many are in a dilapidated and unsanitary
condition. We have, however, many very excellent schoolhouses. Of
the 114 buildings, 76 have their water supply from driven wells, 8 from
dug wells and 11 have no wells at all. All of the dug wells should be con-
demned, and I have no doubt, analyses would prove that some of the
driven wells do not furnish pure water. The outhouses are generally in
very bad sanitary condition. Strict supervision should be made of the
schools in this regard. Next year closer attention will be given to the
sanitation of the schools in this county. Several buildings have been con-
structed in various parts of the county, and, in rare Instances, sanitary

Digitized by VjOOQIC

254

features have been carefully looked after. The Orphans' Asylum is an
excellent building and is passably sanitary. It is excellently liept. There
is practically no fire protection. I have made several recommendations
concerning this building, which I hope will be heeded. One jail was
built in 18(59. The county now has three times the population it had when
the present jail was built. There were committed to the jail of this
county during the year 1JX)1, 1,934 persons, 1,873 being males and 61 fe-
males. This gives an average number each day of over 50 men being
confined in a jail built for 11. This is, of course, all wrong, and this bad
sanitary feature, in addition to many others, has been carefully presented,
with recommendations, to the authorities. A new jail is necessary, and,
undoubtedly, will very soon be built. The poorhouse, from a sanitary
standpoint, is much improved over what it was last year. New
waterclosets and bath-tul>s have been installed in the main building.
Complete separation of the sexes is now provided for. The institution
is well Ivopt. Many recommendations concerning the management of the
poorhouse and the improvements which are necessary, have been made
to the proi)er authorities, and we hope next year to be able to report still
further improvoment. I have visited all subordinate Health Officers and
inspected their boolis. I find the said subordinate Health OflScers to be
attentive to their wovk and their 1>oo1js are in good condition. With one
exception, liowever, tliey have failed to file any report with this office.
This is due more to misunderstanding than to any other cause. The
Health Otficer at Fairmount has fll«jd a report to his Board that is a
model.

During the year we have had two outbreaits of smallpox. The first
consisted of a single case in Pleasant Township. The second outbrealt
was in the village of Sweetzer. There were 14 cases in all. The source
of contagion was from .Tacivson County, the result of a visit of a family
living in Sweetzer to friends. There were no deaths and no severe cases.
None of those who were attacited were ever vaccinated. A family going
from Sweetzer, l)efore the epidemic was reported, to Pleasant Mills, in
Adams County, carried the disease with them, for smallpox developed at
the last named place. Much good sanitary work has been done in the un-
incorporated town of Matthews. The streets have l>een cleaned, vaults
emptied and the people instructed in sanitation.

A. E. POWELL.

Health . Officer.

GREENE COI^NTY.

This cM)unty has an area of 54<> sijuare miles, is hilly and undulating,
and hence the drainage is very good. There are numerous springs of pure
water. In late years many drains have l)een built and with the abolish-
ing of wet and marsliy land the general health has improved. I think
the gravel rojids. of which 100 miles have l>eon l)uilt, have also added
somewhat to the liealth of the county. The nunil>er of schoolhouses is
140. The sanitary condition of most of them is fairly good. Ventilation,
however, is not what it should be. There is much improvement to be
made along the line of sanitation in tiie schoolhouses. Recommendations
have already gone forth to the school authorities in regard to this mat-

Digitized by VjOOQIC

255

ter. No schools were closed during the year on account of infectious dis-
eases. Smallpox appeared in one family in the eastern part of the county.
Diphtheria, in one family, was traced directly to the disease in cats. Tu-
berculosis is the dreaded scourge of this county. The people should be
instructed in regard to this disease, but funds for that purpose are very
hard to secure. The county poorhouse is a two-story brick building on
a high ridge. It is bcfautifully located. There are 16 rooms and it is in
fair sanitary condition. The water supply Is from, two cisterns, and it
is heated by a furnace. There was no serious sickness during the year.
There are some chronic cases. There was one death in the institution from
old age and debility. The jail is built of brick, has 2 rooms and C cells.
It is heated by stoves, the water supply is from cisterns, which some-
times go dry. The sewage disposal is very faulty. Recommendations have
been made to the proper authorities in regard to this Institution and also
in regard to the schoolhouses, the poorhouse and the courthouse.

W. H. COLE,
Health Officer..

HAMILTON COUNTY.

Three hundred and seventy-one cases of infectious diseases were re-
ported during the year. This is nearly 200 more than were reported for
1900. The increase was largely due to measles. We have some school-
houses which are in very poor sanitai-y condition, but there is steady im-
provement in this line. Two schoolhouse wells have been condemned dur-
ing the year and pure water supplies furnished. There is an improve-
ment in the sanitary condition of the county Jail over last year. Painting
has been done and the sewer system repaired. The poorhouse is in better
condition than last year. An additional building will be erected before tlu^
year is out, as $6,000 have been appropriated for that purpose. There
was one case of smallpox reported during the year.

E. C. LOEHR,

Health Officer.

HANCOCK COUNTY.

Population of the county, 19,189. The incorporated towns are Green-
field, population, 5,000; Fortville, population, 1,000; New Palestine, popu-
lation, 600. GreenAeld has flrst-class sanitary arrangements. There is an
excellent system of sewers and an abundant supply of water obtained
from wells 400 feet deep. The courthouse is a new and modern building.
All sanitary conveniences exist in the building. The county jail is a brick
building and has twenty-four cells. The sexes are thoroughly separated.
Sewerage is good, the ventilation passable; but it is heated with stoves.
There has been no sickness and no deaths in the Jail during the year.
The poorhouse is a hrick building; it w^as erected in 1884. The inmates
number twenty-seven— males fourteen, females thirteen. The building is
heated by natural gas. Water supply is from dug wells. Sewerage is very
good. The building is not modern. The bathtubs, two in number, are in
bad condition. The building is very well kept. There are eighty-seven
schoolhouses In the county, all but a few in good sanitary condition. No

Digitized by VjOOQIC

256

schools closed during the year on account of infectious diseases. On May
6, a case of smallpox was reported six miles south of Greenfield. All
well persons In the family were immediately vaccinated. In ten days, the
oldest girl, age seventeen, developed the disease, but at no time was con-
fined to her bed. Both cases made rapid recovery and no other cases
occurred. There were eleven in the family. These were all the cases
which occurred during the year. J. W. SKLMAN,

Health Officer.

HARRISON COUNTY.

There was no marked epidemic in Harrison County in 1901. The cases
of typhoid seem fewer than in the preceding year, and this may also be
said of scarlet fever and diphtheria. It may also be said that all cases
of these diseases were, as a rule, of mild tyi)e. The total deaths numbered
290 during the year, which makes a death rate lower than that of the
State. The sanitary condition of the county asylum is, at this time,
better than ever before in its history, and the* same may be said of the
county jail. Progress has undoubtedly been made in sanitation in Har-
rison County in 1901. WM. DANIEi;

Health Officer.

HENDRICKS COUNTY.

We have had three outbreaks of smallpox during the year; two of these
did not spread beyond the families in which they were discovered. We
unfortunately got hold of some worthless vaccine, and a second outbreak
was not so easily controlled. There were twenty-three cases in the second
outbreak— all recovered. There were thirty' eases of typhoid fever at the
Reform School during the year. The source of the disease was traced
to the bathing pool. This pool was formed by damming the creek.
Analyses of the spring water supplied to the school shows that it is
pure. After the abandonment of the bathing pool no more cases oc-
curred. There were seven deaths in this outbreak. There were a few
scattered cases of scarlet fever and diphtheria during the year. Two
schools were dismissed for a short time to prevent the spread of this dis-
ease. Measles have existed quite extensively during the year. Most
of our schoolhouses are in passable sanitary condition. Some are dilapi-
dated and very unsanitary. Slow improvement is being made. The water
supply of schoolhouses is universally good, being from driven wells. I
know of twelve schoolhouses which should have a new water supply.
The courthouse is well kept, but is an old building and was not con-
structed with sanitary ideas in view. The Orphans* Home is an old build-
ing and is kept as well as possible under the circumstances. It is not
sanitary in many particulars. The jail Is faulty in its sanitary characters.

W. J. HOADLKY.

Health Officer.

Digitized by VjOOQIC

251

HENKY COUNTY.

Tliere were few cases of eommniiicable diseases during the year in
Henry (.'ounty. but there was no outbreak which could be truthfully called
an epidemic. Consumption, of course, was with us, but this disease is al-
ways epidemic. A few cases of smallpox in different parts of the coun-
ty are to \w mentioned, but all of them were very mild. The various
Health Otticers of the county have l)een very active and have faithfully
performed their duties. I made 10 sanitary inspections during? the year
and in each instance the unsanitary conditions complained of were put
to rights. The county asylum is not an old building and is fairly sani-
tary. It is well kept. The jail and courthouse are of recent construc-
tion, are well kept and passably sanitary. We liave many schoolhouses
which are very unsanitary, but the new ones which are built conform
to tlM» best sanitary conditions. The city of Newcastle, the capital of the
county, is situated on high ground and has excellent drainage. The pub-
lic water supply is good and there are no ei>idemics to record for the
year. E. T. MENDENHALL,

Health Officer.

HOWARD COUNTY.

The school buildings of Howard County are. many of them, passably
satisfactory from a sanitary standi)oint. There are many, however, which
are old and dilapidated and sliould be condemned. The water supply at
every schoolhouse is from driven wells and presumably good. Inspe<!tions
and rerommeiulations in regard to schoolhouses are constantly being made.
The county poorhouse was erecte<l in 1873. It is brick and stone with slate
roof. It is heated by hot air, but there Is no special provision made for
ventilation. The sewerage Is good. There was very little sickness during
the year, but there were 5 deaths, all of them on account of old decrepi-
tude. The institution is very well kept. Tiie Orphans* Home is con-
structed of brick and stone with shingle roof. It has a basement with
cement floor and Is heated Ijy gas stoves. Tlie water supply is from the
Kokomo City Water Works. The building is eciuipped with sanitary
closets. The building is old and not first-class. The County Council has
made an appropriation for remodeling. There were 50 inmates during the
year, with one deatli, and a very limitiHl amount of sickness. The jail
was erected in 1881!. Tlie sanitary conditions are not Hrst-class. The
sewerage is bad, the closets are not modern and there is no bathroom.
No special provision for ventilation. Kemodeling of tlie jail is under con-
sideration. There were (MM prisoners during the year, but no serious sick-
ness and no deaths. There was an epidemic of measles during tlie year,
l)ut no other infectious diseases unless the 1*2 cases of smallpox we had
may be called an epidemic. No smalliM)X deaths occurred. Complaints
have been receiveil in regard to adulteratcnl food, and one complainant
presented canned goods which certainly were spoiled and of poor qual-
ity. Complaints were also made of adulterated milk, lard, butter, vine-
gars and syrups. There is no i)ossibiiity of enforcing tlie i)ure food law
unless a laboratory is established by the State. There wete 54(1 births

17-Bd.bf Health.

/Google

Digitized by VnOOQ I

258

duriug the year— 275 males and 271 females. The number of deaths were
:i(i5; of these 48 were from consumption, 19 from cancer, 11 from typhoid
fever, 5 from lagrlppe, 15 from pneumonia. Diphtheria was reported as
causing but one death. There were ;5:i2 marriages during the year.

R. H. SMITH,

Health Officer.

HUNTINGTON COUNTY.

None of our public buildings were constructed with sanitary principles
in mind. They are all, however, well kept and all need repairs and im-
provements. No deaths from diphtheria, scarlet fever or measles are to
be recorded for the inlirmary, jail or Orphans* Home durjng the year.
Most of the school liouses were constructed without considering sanita-
tion. ^\11 but a few are well kept and inii)rovenient is apparent each year.
We had thnv cases of smallpox during the year, but the disease has not
been epidemic. No epidemic of diphtheria or scarlet fever has occurred,
but there have been a few isolated cases. Typhoid fever is rarely heard
of in Huntington County. CHAS, L. WUIGHT,

Health Officer.

JA( KSON COITNTY.

Jackson County contains about 5<H) square miles. It Is drained by
Wliite Kiver and a few small streams. Ordinary drainage lias improvetl
the health in Jackson County very materially. The water is good and is
obtained by driven wolls. There are a few dug wells which are being
abolished as rapidly as possible. The courthouse, jail and poor asylum
are in passable sanitary condition. They are all well lighted, heated and
ventilated except the jail. The sewerage of the jail is not what it should
be. There were (m inmates in the i)oor asylum during the year- -38 males-
and 27 femalt*s. There were 7 deaths, all of tlieni among people of ad-
vanced years. There are very few strictly sanitary sclu>ol buildings in
the county. 1 do not know of one single building of this character which
is all it should be. There is well-directed and intelligent effort on the
part of the teachers to ventilate properly and to furnish uniform tempera-
ture. These conditions, however, can be secured only to a limited de-
gree In many instances. Improvements in the sanitation of schooihouses
is not as rapid as might be hoped for. Then^ were 12 cases of smallpox
during the year, 8 in one family. There were no smallpox deaths. Not
one of the persons attacked had ever l>een vaccinated and all the exposed
people who were vaccinated and in whom successful "takes" were se-
cur(Hl. did not take the disease.

The sanitary conditions of the city of Seymour have been much im-
proved. Drainage and sewerage has been extended and streets have been
paved. There have been a few cases of typhoid fever, but no deaths,
lirownstown, the capital, has natural excellent sanitary conditions. It is
situattHl on high, rolling, sandy ground. The water supply is obtained
from driven wells. There Is no sewer system. There was an epidemic of
measles ant^whooi)iug (ough at Brownstown during the year. There has

Digitized by VjOOQIC

259

been a marked advaucement in sanitary matters In Crothersville in tlie
last year. The attention of the town authorities has been called to the
Importance of sanitation and many good things have been ordered, such
as cleaning alleys, emptying vaults, etc.

D. J. CUMMINGS.

Health Officer.

JASPER COUNTY.

There have been no epidemics during the year. There were a few
cases of scarlet fever and diphtheria, but all were in isolated places and
the disease has not be«en allowed to spread in any instance. The water
supply of the county is usually from deep driven wells. This may prob-
ably be the reason why we have so very few cases of typhoid fever.
There were 16 ca-ses of smallpox during the year, with no deaths. In one
family, where 8 of the cases occurred, only 1 member escaped, and she
had been successfully vaccinated at school. The coimty poorhouse is
old and not constructeil with sanitary principles in vicrw. Better sewerage
is needed. Closets and bathrooms should also be supplied. Nunber of in-
mates during the year. 12: no deaths, and very little illness. The county
jail is heated by a furnace. Water closets need repairing, and ventila-
tion should be improved. The sew^er system of Kensselaer is passably
good, but many improvements are necessary. It Is hoped this will be made
v(Ty soon in the future. The schoolhouses of the county are mostly in
poor sanitaiy condition. With few exceptions, they are well kept. The
new buildings l)eiug constructed generally comply with the proper sanitary
laws. E. C. ENGLISH,

Health Officer.

JAY COUNTY.

There are llIO scluwlhouses in this county— 09 brick and 21 frame.
Most of them are heateil by stoves, ventilated by windows and doors.
The cross-light system of liglitlng has been adopted in most of our school
liuildings. The outhouses are generally bad. The water supply is from
driven wells. Recommendations as to sanitary nee<is have been made to
the proper authorities where called for. There is an improvement to re-
cord at the county poorhouse. A new Superintendent has been installeil
and keeps the i)remises in much better sanitary condition. The building,
however, is old, and many recommendations were made. Our Jail is a
new and modern building with all sanitary improvements as to light, heat,
ventilation, bathing, sewerage, isolation of sick persons and the treatment
for women prisoners. Our courthouse is an old structure. The Salamonia
River runs through .lay County from southeast to northwest. Its flow
Is obstructed in numerous places by driftwood and willows, and, after
verj^ heavy rains, considi'rable areas of land are covered. This is not
conducive to good health. The river flows through the coriwrate lim-
its of Portland, the county seat. It is a very shallow body, and is stag-
nant and receives the sewerage of the town. This river should be im-
proved for sanitary as well as for farming reasons. Jay County is well
drained with tile and open ditches and there are V(M-y few stagnant ponds.
There were reported 53S births- 'M4 males and 2<)0 females. Six hundred

/Google

Digitized by VjOOQ I

260

and forty cases of infectious and contagious diseases were reported. Of
this numl)er oJM) cases were measles. There were 9 cases of diphtheria, 17
of scarh^t fever, 11 of tyi»Iioid fever and 4 of smallpox. There were no
deaths from smallpox. * J. G. ROSS,

Health Officer.

JKFFEUSON C'OUNTY.

From p:eneral oliservation and a review of records, I am able to say
that the general health of the people of Jeflrer.son County was good during
the year 11K)1. The general sanitary conditions are fair. Of course,
there are to be found many homes which are very unsanitary. ETxcept-
ing smallpox we have had no epidemic of contagious disease. Of this
disease there have been IKS cases during the year, distributed as follows,
by months: January, 1: .\pril, (i: May, 2; June, 4; Novembet, 25; Decem-
ber. <)(>. Most of these cases have been in the country and In little ham-
lets. In the city of Madison there have been very few cases and easily
controlled because they were immediately sent to the pesthouse, and the
homes of the pati(>nts immediately disinfected. It has been more diffi-
cult to handle the disease in the country thari In the city and I l)elieve that
if the county had a contagious disease hospital, as the city has, we could
much more successfully combat the disease.

The health in our public institutions has been quite good. During the
year improvements were made in the jail, Orphans' Home and poor asy-
lum. These improvements have greatly l>ettered the sanitary conditions.
All new sch(H)lliouses in this county are built to conform to sanitary de-
mands. All the old sch(K>Ihouses are vei-y unsanitary.

H. S. HATCH,

Health Officer.

JKNNIXCJS COUNTY.

No (epidemics have occurred during the year. The general sickness
has bren very little. There have been a few cases of typhoid, scarlet
fever and diphtheria. The peoi)l(^ generally are discovering that it is pos-
sil)le to i)revent certain diseases, and this is very encouraging. There were
li cases of smallpox during the year, all occurring in one family. The
gi-eater proportion of our schoolhouses are unsanitary and should be con-
demned. Our County SupcTintendeiit, M. W. Deputy, is tireless in his
efforts to secure l>etter sclioolhouses. Four new sanitary schoolhouses
have b<'en erected (luring the year. The county jail is very unsanitary.
It should be entin'ly aI>olisluHl an^l a new one constructed. Our county
peorhouse is in only fair condition. I have made recommendations to
tlie autliorlties in regard to I)etter sanitation of all school buildings, the
.ail and the poorliouse. W. J. MITCHELL,

Health Officer.

JOHNSON COUNTY.

There have l>een no epidemic outbreaks of infectious diseases during
the yea I". Two county schools have I>een dismissed on account of scarl?t
fever. 1»ut in neither of these instances was there an epidemic and the
selDoIs were dismissed out of al)undant caution. Most of our country

Digitized by VjOOQIC

2G1

srhoollioiises are unsanitary. The warminp, the ventilation and tlie
U^rhting is wrong in every respect. We hope gradually to get this matter
righted. The Orphans' Home has 22 Inmates and the general health has
been unusually good. The building is heated with a furnace and the
general sanitation has been much improved. Further improvements have
been recommended. The poor farm is in better sanitary condition than
last year. In accordance with the recommendations of the Health De-
partment, better drainage has been supplied to this institution and bath-
tubs have been put in. The heating facilities are still not what they
should be, but will be correctcni in a short time. There are 18 inmates,
1() of them epileptic or of unsound mind. The county jail has received »
new coat of paint. It is kept scrupulously clean and provided with good
drainage, but the ventilation is not satisfactory. Tlie courthouse is in
only passable sanitary c^onditiou.

C LARENCK PROVINCE,

Health Officer.

KNOX COUNTY.

The sclioolhouses of Knox County are generally very unsanitary. In-
deed, there are very few that are even passably sanitary. Some of the
new buildings are built according to modern ideas. I am sorry to say that
some schoolhouses are badly Icept, but the most of them I believe to be
well kept. JNIany suggestions have been made to school authorities and
some of these suggestions have been followed out. The county has about
;i3.r)()0 inhabitants and there were 511 deaths last year. Some important
causes of death were typhoid fever, 25: tuberculosis, 54; diphtheria, 8;
scarlet fever. 2; meiisles, 3. There was an epidemic of diphtheria at Vin-
cennes and also in the southern part of the county during the year.
Prompt quarantine and proper sanitary precautions seem to have limited
its spread. A few cases of smallpox appeared, but all were mild, and there
have been no deaths to date. The exact number can not be stated be-
cause some of the cases were so mild that physicians wei'e not called.
The Jail is an abomination. It is unnecessary to describe it in detail. The
Board of Authorities has condemned the structure, and a new building
will be efected within another year. The courthouse is an old build-
ing with no special precisions for ventilation. The water supply of Vin-
cennes is taken from the Wal)ash River. Last year it developed a very
l)ad odor and taste and could not be used for household puri>oses. By
investigation it was shown that this odor was due to the decomposition
of putrefactive decay of masses of algae. The occurrence seemed to have
no effect upon the pulUic health.

The VIncennes Water Company has an excellent filter plant, where
all the water furnished to the city Is filtered. This, however, did not pre-
vent the growth of plants in the mains which, upon decaying, gave forth
the bad odors. VIncennes sadly needs sewers and paving. These are
talked about almost every j'ear, but it remains to be seen whether any-
thing will be done. LYMAN BECKES,

Health Officer.

Digitized by VjOOQIC

262

KOSCIUSKO COUNTY.

It may in j?eneral be said that the sanitary conditions of Kosciusko
County are fairly good. We have some old time schoolhouses which are
very unsanitary, and only a few of the school buildings are provided with
special ventilating methods. The new school buildings are provided with
all needed sanitary improveTuents. The county infirmary Is a new build-
ing and up-to-date in every respect It is well ventilated and is heated by
steam. The water supply is from deep wells and the sewer system is very
good. The house is well kept. The city of Warsaw Is in good sanitary
condition. A new sewerage system has just been completed. The jail
and the courthouse are stone buildings, having the latest sanitary improve-
ments. Both are connected with the new sewer. There was very little
sickness throughout the county during the year and no epidemics of any
kind. Smallpox appeared Novenil)er 20. Thercr were 64 cases in all.
ihere was much difficulty experienced in inducing the people to be vac-
tinated. A county pcsthouse was established and by means of it good
prevention work was accomplished. The business men gave •their hearty
supjwrt to extinguishing a smallpox outbreak.

J. M. BASH,

Health Officer.

r.ACJKANGE COUNTY.

The number of deaths in Lagrange County In 1JK>1 was 207, making a
death rale of i;^5, which is one less than the rate for the whote State.
Eight per cent, of the total deaths were of infants under one year. Con-
sumption caused 20 deaths; cancer, 14; pneumonia, 15; heart diseases, 26;
apoplexy and paralysis, 18. There were reported during the year 20 cases
of diphtheria, all in the south part of the county, and during the year 82
cases of scarlet fever were reported. There were 28 cases of typhoid fever
and the usual minor contagious diseases prevailed in moderate degree.

Most of tlio schoolhouses of the county are unsanitary and it is only a
few tliat are not well kept. Only in about half of the cases are the
wells a part of the school property, and in the other half, the water is
secured from adjoining private wells. The heating of schoolhouses is
done by stoves and the ventilation by windows and doors. This is, of
course, unsanitary, but the new school buildings which are being con-
structed from this time one will conform to sanitary conditions. The
courthouse has reccnitly been renovated and supplied with new sanitary
arrangements. The county jail is well kept, but badly needs better sani-
taries. The main building of the county infirmary is in good condition
and very well kept, l)ut there is urgent need for improved sanitary
features in the outside buildings. The Orphans' Home is well kept, but
when constructe<i sanitai*>' principles were not fully included.

1). W. DRYER,

Health Officer.

Digitized by VjOOQIC

263

LAKE COUNTY.

1 have made a careful survey of Lake Countj', having visited all of
its town and villages. A general order to local health officers resulted
in cleaning up all of the towns of the county. The county is well drained
and there are'fiow very few swampy places to be found. The county jail
and courthouse are in fairly good sanitary condition and are well kept.
The sewerage for these institutions is not what it should be, and recom-
mendations have been made in this respect and also in- respect to better
ventilation. They are well kept. At the poorhouse no patient is taken
until it is certain he or she is free from transmissible diseases. I visited
a number of schoolhouses and lectured to the school children on "Hygiene
and the Prevention of Infectious Diseases." I found the schoolhouses not
to be sanitary structures. Those who built them evidently had no ideas in
regard to sanitation. Schoolhouses are generally w^ell kept. Many im-
provements have been recommended to the proper authorities. The city
of Hammond needs many sanitary improvements. The river at this point
is badly polluted and surely is not a source of health. Our public build-
ings contain the latest sanitary improvements, and are passa-
bly well kept. There is a force continually at work cleaning the streets
and alleys. There were four cases of smallpox during the year at Ham-
mond, with no deaths. There were a few cases of diphtheria and no
deaths. At East Chicago there is no sewer system. The town is kept
passably clean. There is much, however, to be done from a sanitary
standpoint. A sewer system, with public water plant, is under contempla-
tion. B^our cases of smallpox occurred during the year, no deaths. There
were two cases of diphtheria and scarlet fever. Sanitary conditions at
Whiting have greatly improved during the year. A main sewer has been
built with several laterals. Some of the streets have been graded with
cinders and the main street is stone-paved and has asphalt guttering.
Several miles of new sidewalk have been constructed. The water supply
is from Lake Michigan and is believed to be good. Occasionally, how-
ever, it is probably polluted by sewerage from Chicago and the Standard
Oil Company plant. The sanitary conditions of the town hall and town
Jail are bad. The sanitary situation at Lowell is very good. The streets
are clean and recently authorities have ordered the vaults cleaned and dis-
infected. There is no sewer system. The public school building is well
lighted and ventilated and is well kept. There has been no smallpox in
this town. A few cases of diphtheria and 10 cases of typhoid fever dur-
ing the past year, but po deaths from other diseases. Ther were ovei"*
300 cases of malaria with no fatalities.

JOSEPH VON OSINSKI,

Health Officer.

LAPORTE COUNTY.

No extended outbreaks of epidemic diseases during the year. There
have been a few widely separated cases of diphtheria. Scarlet fever has
prevailed somewhat in a few localities and generally in light form. Diph-
theria and scarlet fever each caused one death during the year. There
were 17 cases of smallpox during the year, with no deaths. Afalaria in-

Digitized by VjOOQIC

264

ci-eased oven* the preceding year and typhoid decreased. The jail Is an
old one aud-4?honld be replaced with a new structure. It is kept In as
clean a condition an possiljle. The poorhonse is a new building and a
model of neatness and cleanliness. There are GO inmates. It is well
ventilated and well sewered and has a ffood water supply. The Old
Ladies' Home has 20 inmates. It is well kept, but is not built with all
sanitary principles included. Some of the school houses are unsanitary and
a few are old and dilapidated. There are only a few school buildings in
the county in which sanitary conditions have been followed. The water
supply of the county building is from deep wells and the water is excel-
lent. Laporte has a good sewer system and public buildings are connected
therewith. Garbage is cremated. The slaughter houses, which heretofore
have been a source of much trouble, are now under control and little or
no complaint is heard concerning them. There is less ti'ouble in collecting
re<-ords of births and contagious diseases than formerly.

(). L. SUTHERLAND,

Health Officer.

MADISON COUNTY.

The population of Madison County is about 75.000. There are many
foreigners being attracted by the factories. These foreigners are disre-
gardful of sanitary laws, and most of them have an antipathy toward
cleanliness. There were 1,027 deatlis in the county during the year, mak-
ing a death rate of 12 per 1,(KK). The greatest morality was from tuber-
culosis, namely, 184: 125 of the>«e were of the pulmonary type. Diarrhoea!
diseases caused 88 deaths, most of the cases occurring among infants
and children. There were 71) deaths from pneumonia during the year, 72
still-births, 51) from violence, 30 from typhoid fever, 20 from diphtherial
17 from scarlet fever, 21 from meningitis, (i from whooping-cough, 18 from
influenza, 1 from measles and 2 from smallpox. There were reported 99
cases of diphtheria, 11)5 cases of scarlet fever, 42 of smallpox, 01 of typhoid
fever. I believe a number of typhoid cases were not reported. Smallpox
api»eared in the county In March at Ingalls. Tliirty-six c*ases were directly
traceable to one man. who traveled in the county considerable in the
eruptive stage of the disease. This man's trip through the county, leav-
ing, as described, a trail of smallpox, entailed an expense of about $3,200.
The natural drainage of the county is very good. Many of the factories
lK)llute the streams with their refuse. The American Tin Plate Works de-
]H)slts into a small creek which, in turn, runs into White River, several
tons of copi)eras daily. This co]>peras is calUni "spent pickle" and is
formed by dii>ping the steel iilate into dilute sulphuric acid. All of the
sewage of the city of Anderson is depositetl in White River, also the
refuse from the American Strawboard Co., an enormous concern,
which pumps 2,(HM),{H)0 gallons of water daily. The river is undoubtedly
IK>llute<l at this iioint. The courthouse is a good building, but the sewer-
age is bad. This will soon be remedied. The sanitary condition of the
l)uilding is g(K)d. The c(mnty jail is unsanitary on account of poor venti-
lation and Inid plumlilng. The building has been frequently cleaned.
whitewasluHl and disinfecttnl. It is too small for the immber of prison-
ers <'ontined there. A new and more commodious building will probably

Digitized by VjOOQIC

265

be very soon constructed. The sheriflf keeps tbe jail In as good condition
as he can possibly do under the circumstances. The poorhouse Is a model
Institution. It is roomy, well lighted and ventilated and splendidly kept.
The Orphans' Home is In fair sanitary condition and well kept, but Is too
small for the number of Inmates. The building will very soon be en-
larged. Most of the school buildings in the county are constructed of
brick and are heated by natural gas. In the cities of Anderson, Blwood
and Alexandria are well lighted and well ventilated. This can not be said
of the country schoolhouses. S. C. NBWLIN,

Health Officer.

MARION COUXTY.

This Is my fourth (innual reiK)rt, and I am happy to be able to state
that better sanitary conditions exist in Marion County than at any previ-
ous time. That the people are arousing to the Importance of sanitation is
proved by the fact that frequent letters and frequent calls are made upon
me on account of health matters. During the year there were 217 cases
of diphtheria, S'll scarlet fever, 138 smallpox, 2,162 measles, 180 typhoid
fever reported. The county Jail is a new structure and when built all
new modern sanitary conditions were incorporated. It is splendidly kept.
The worlf house is in good sanitary condition. The drainage Is excellent;
baths, closets and other sanitary surroundings are all that should be ex-
pected in such a place. A new hospital has been erected a short distance
from the main building, at a cost of about $5,000. It will accommodate
alwut 15 patients. The hospital is not perfect In Its sanitary arrange-
ments, but it is passably so. The old bathtubs have been abolished and
shower baths substituted. The poorhouse has 188 inmates— 151 males
and 37 females. The sanitary condition is not good, and under the present
condition of things It is impossible to make it even passably sanitary.
The building Is old, not properly constructed and is entirely out of date.
A new building must very soon be erected. The Orphans' Home is scrupu-
lously clean and admirably conducted. The sanitary arrangements are
very good. The building Is supplied with good drainage, closets and bath-
rooms. The Institution for the incurable insane is located at Julietta.
This Is a new building and contains all sanitary Improvements. There are
113 patients. The German Orphans' Home, under the management of
Mr. Roesner, is well conducted. This institution, unfortunately, has no
connection with the city sewer system. The ordinary dug closets are used
and must be cleaned several times a year. Better ventilation should be pro-
vided. There is an Improvement to be recorded in the dairies of the coun-
ty over a few years ago. Constant Inspections will be made and I will have
to record still greater improvement next year. One by one the old school
biiildings of the county are giving away to more modern structures. There
are yet too many old-time, llly-ventllated, poorly-warmed and wrongly
lighted schoolhouses. There were 427 deaths reported as caused by tuber-
culoi^ls in Marion County during the year. There is probably no decrease
in this disease and it is possible there Is an Increase. It is to be hoped
that the Health Officers will, ere long, be permitted to take proper steps
in the line of preventing consumption, A great deal of education will be
necessary before this admirable end Is accomplished. We go to enormous

Digitized by VjOOQIC

266

expense to properly prepare for the insane; we abundantly care for the
poor, and even the criminal receives our sympathetic consideration, but
the unfortunate sufferer from chronic tuberculosis finds no place but the
open grave, and in his hopeless condition he often prays that he may be
allowed to go and rest there in peace.

H. W. RIDPATH,

Health Officer.

MARSHALL COUNTY.

I have inspected or had inspected by deputies all of the schoolhouses
in the county. Very few of them are what they should be. Very few
have been built with any sanitary idea in view. In only two Instances
were poorly kept schoolhouses found. The water supply was found good
and in every instance driven wells are used. Recommendations have been
made to the proper authorities where sanitary deficiencies were found.
The {janitary conditions of the courthouse are passably good. The build-
ing is brick and stone and is well kept. The ventilation is by windows and
doors, no special ventilating system having been installed. The sanitary
conditions of the jail are passably good. The drainage is not exactly what
it should be, but the place is well kept. The health at the poorhouse
might be termed good, as there has been no serious sickness during the
year. The sanitary conditions are passable. A better system of abolish-
ing closets is to be desired, and the same has been recommended. There
have been no infectious diseases at the Orphans' Home. The sanitary con-
ditions are passable. No epidemics have prevailed in the county during
tlie year. There were a few cases of diphtheria at the town of Bourbon
during the winter. This disease also prevailed slightly at Culver. Diph-
theria has been reported from four points in the county besides those
named, but they were all single cases. No scarlet fcfver reported for the
year. There wore 23 cases of smallpox during the year. About four
miles west of Plymouth, 4 cases appeared In one family. Nine persons,
were exposed to the first case. All nine were promptly vaccinated and six
developed good vaccination and went free without coming down with the
disease. The other three vaccinations did not take and these three cam^
down with smallpox in modified form. No deaths from smallpox during
the year. The County Board of Health has passed special rules concern-
ing sanitary conditions at Lake Maxinkuckee. These rules aimed at pre-
serving the lake and immediate surrounding grounds from infection of any
kind. L. D. BLBY,

Health Officer.

MARTIN COUNTY.

Malarial fever has been less in the last year than for several preceding
years. Typhoid fever was altogether too prevalent. Twenty-five cases
of dysentery were reported from the various sections of tlie county, with
very few fatalities. There were only a few cases of scarlet fever and
diphtheria throughout the whole year. All houses visited by infectious dis-
eases are promptly disinfected at proper time. In one instance, where
diphtheria had existed in a log hut, the said hut and contents were

/Google

Digitized by VnOOQ I

267

burned. It was Impossible to affect a disinfection and burning was the
only remedy. The reports of teachers show the health of school children
to have been exceedingly good. Our schoolhouses are kept passably clean,
but the heating and ventilation is bad, inasmuch as the buildings were not
constructed with the intention of furnishing a uniformity of heat and air.
The high school building at Shoals is new and is built in accora with sani-
tary requirements. The water supply is from a drilled well, 150 feet deep,
and the water is of excellent quality. The di-ainage is excellent, as the
building is located on a high bluff on the river bank. The jail is in very
good condition. The drainage is excellent, but the building is not con-
structed in conformity with sanitary principles. Disinfectants are lib-
rally used and the inmates are compelled to admit abundant air. The
courthouse is well kept, but is not a modern building. The poor asylum is
a large two-story frame structure, is rather old and In bad repair. Every
effort is made to keep it as clean as possible. It was repainted last fall
and thoroughly cleaned and the grounds ditched and tiled. There were 8
deaths at this place in the past year, but they were all old persons who
died of general debility. The inmates have a change of clothes and bed
clothes twice a week and are required to take a bath once a week. The
house is well ventilated, as the heating is accomplished by means of large
fireplaces. , E. E. LONG,

Health Officer.

MIAMI COUNTY.

The sanitary conditions are much improved over last j'ear. During
the month of October there was an epidemic of diphtheria, 25 cases were
rei)orted, with 2 deaths. During the. other eleven months 28 cases were
reported, with 4 deaths. Antitoxin is pretty generally used. One school
building was closed for about two weeks on account of diphtheria. This
was in the city of Peru. There were 27 cases of scarlet fever reported
during the year, with 2 deaths. Measles existed for a greater part of the
year and over 300 cases are reported. Of course, many cases were not
reported.

The schoolhouses of Miami County are In passable sanitary condition.
There are a few which sadly need repairs and renovation, but this will
be attended to for 1902. On several occasions the schools of Peru were
closed for want of sufficient heat to make the rooms comfortable. I can
secure no good explanation why the rooms are not properly heated. There
has been no smallpox in Miami County during the year. There were sev-
eral cases of typhoid fever in the city of Peru, but no deaths. Peru is
well drained and most of the inhabitants are supplied with water from
the city waterworks. This public supply Is from deep wells drilled into
limestone for a depth of 350 to 3t>5 feet. Twenty-one of these wells now
supply the city. There Is certainly progress in sanitary matters in Miami
County. We have a new Jail, which is modern in ervery respect. Our old
courthouse is not sanitary. The poorhouse is not all that it should be, but
is as well kept as the circumstances will permit.

A. H. KALBFLEISCH,

Health Officer.

Digitized by VjOOQIC

2G8

MONROE COUNTY.

Monroe County has about 22,000 Inhabitants and there were 295 deaths
during tlie year. Some important causes of death were: Typhoid fever,
11; tubercuiosis. aC; diphtheria, 2; scarlet fever, 1; measles, 1. There was
a small epidemic of smallpox during the year at Bloomington. There
were 12 cnses in all, but no deatlis. While there were a few cases of scar-
let fever and of diphtheria, nothing like an epidemic occurred. The court-
house is an old and dilapidated structure, is unsanitary and is badly kept.
The public scliool at Bloomington presents bad conditions. The hitching
rack whtre farmers* horses are tied, brings an enormous amount of filth
to the square, and in addition, there is a noisome closet close by the court-
house. Thire should be a new courthouse in this county and sewers
should be constructed for Bloomington. The disposal of sewage in Bloom-
ington at the present time is by means of vaults and the water supply is
from driven wells into the same earth. The Bloomington jail is a bad
structure. l)ut a new one is soon to l)e constructed. The poorhouse is
unsanitary, but well kept, and recommendations have been made for Its
improvement. Tlie general health of the community during the year has
l)een good. V. F. TOURNER,

Health Officer.

MONT(iOMERY COUNTY.

1 am confident there is an improvement In sanitary affairs in Mont-
gomery County. With rare exceptions all new jirivate dwellings are bet-
ter built than formerly and all the public luiildings rigidly conform to
sanitary laws. Five cases of smallpox were reported during the year, 'X\
of typhoid fever, J) of .scarlet fever and 2 of diphtheria. Our courthouse
and Jail are in good sanitary condition and are well kept. The same may
be said of the poorhouse. Dr. Taylor, Health Officer, of Crawfordsvllle.
has been untiring In his efforts to Improve sanitary conditions in his city.
A comprehensive sewer system has been constructed and an ordinance
passed controlling the meat supply. This ordinance abolished several
nasty old slaughterhouses and now a modern abattoir has sprung up in-
stead. PAUL J. BARCUS,

Health Officer.

MORGAN COUNTY.

Excepting typhoid fever, we have not had many cases of transmissible
diseases in this county. No smallpox has been reported. Sanitary condi-
tions throughout the whole county have been greatly improved in the last
year, especially in tlie city of Martinsville. This city has put in a complete
system of sewers and has an excellent water supply. The heating of the
courthouse Is with steam and the Jail with furnaces. A sanitary method
of garbage disix)sal is much needed in Martinsville. The public hall is
])oorly heated and ventilation Is bad. It is dirty and not a fit place for
a public gathering. The county poorhouse is well situated. The building
Is of brick, heated by hot-air furnaces. New furniture has recently been
supplied and paint and papering has been pretty general. Cement floors

Digitized by VjOOQIC

2(59

have been recentlj-' put In the basement. The much needed repairs to
the bathrooms have not been made. T^vo deaths occurred during 1901.
Thrte are 107 sclioolhouses In ^rorpan County— 71) brick and 28 frame. All
are in. fair condition. excei)t 5, and these will be placed in condition before
they are used next year. A new school building In Martinsville was
erected this year at a <'ost of $18,000. It Hs modern in every respect. A
$0,000 four-room schoolhouse is in course of erection in Adams Township.
The plans for it show that all sanitary conditions are complied with. In
August I visited Alorgantown where typhoid has prevailed unusually. I
found 0 cases in different stages. The water supply is from shallow dug
wells. There are but two driven wells in the town. Every township in
the county has been visited by this disease. The total number reported
was 59. A. S. TILFOUD.

Health OtHcer.

NOBLE COUNTY.

Noble County, by the last census, has 25,533 inhabitants and there
were, during the year, .*i(K) deaths. This is an annual rate of 12.7. The
annual death rate for the whole State was 14.5. Smallpox prevailed to a
consideTa!)le degr€>e, but the exact number of cases will never be known.
This is because many physicians were unable to diagnose the disease, or
at least they continually called it chickenpox, impetigo, etc. There have
been no deaths to record from smallpox. Typhoid fever has prevaile<l
about as usual, and this means that it has been all too prevalent. I>ii)h-
theria and scarlet fever and the minor contagious diseases, namely:
mumps, measles, etc., have been somewhat in evidence, but have not
proved very destructive to life. The health of the county, with the ex-
ception of smallpox, has not varied over the preceding year.

The sanitation of Sylvan Lake, at Rome City, has received considerable
attention from the Hoard. Complaint had been received from there to
the effect that unsanitary conditions prevailed and an Inspection proved
this to be true. Rules and regulations were issued by ilie Board which
were very si)ecific In their requirements as to the disposal of excreta and
garbage. Much opiK)sition was developed among certain dwellers at th«»
lake, but on the whole, satisfactory results were obtained. We hope to
secure l)etter results next year.

Most of the schoolhouses of Noble County are unsanitary. They are
heated by stoves, ventilated by windows and doors and lighted on two
sides. In some Instances the water supply is not what it should be, and
in other instances is absolutely unusable. In all but two instances the
sanitaries are unde.scribable and wholly bad. The courthouse and jail
are new structures, are constructed with modern sanitary arrangements
and are well kept. The poorhouse and the Orphans' Asylum are well kept,
but are far from being as sanitary as they should be. The County Board
of Health is alive to defective conditions and improvements will be made
as rapidly as possible. There were 377 births rei>orted during the year,
92 cases of infectious diseases, 1*S0 marriages and 300 deaths.

K(>ndallville.— This city of Noble County has 4,(KK) inhabitants, and a
review of the records shows it to be very healthful. The city has a com-
plete sewer system and vaults are l)elng gradually abolished. In oight

Digitized by VjOOQIC

270

years there has not been a case of typhoid fe\'er in any home supplied with
city water. This spealis well for the public water supply. There were 37
deaths during the year, and of contagious diseases there were reported:
Scarlet fever, 9; measles, «: diphtheria, 2; typhoid fever, 2. There were
40 births. The North Ward schoolhouse, finished last year, Is a model
building in every way. The Health Department is provided with a for-
maldehyde generator and thorough disinfection of all houses visited by in-
fectious diseases? is practiced.

Ligouier.— There were two slight visitations of diphtheria and one
death during 19C)1. There was one case of scarlet fever. During the pre-
vious year there were 21) cases and no deaths. There were 4 cases of ty-
phoid fever, mild in tyi)e, excepting one case, when death occurred. Sani-
tary conditions ai-e being inipr6ved t*ontinually. People are learning the
benefits of sanitation and applying their knowledge.

Albion.— There has been no epidemic of infectious diseases in Albion
during the year. There have l)een a few Isolated cases, however: measles,
1; scarlet fever, 2. The water supply of Albion is excellent, but the drain-
age is not what it should be. The same is certain to be Improved very
soon. B. E. MliiLPm,

Health Officer.

OHIO COUNTY.

The health of Ohio County during the year has been fairly good.
There have been only a few cases of scarlet and typhoid fever, but no
deaths. Ten cases of smallpox were reporttni. two of them being con-
fluent. There were no deaths from this cause. The county asylum is in
fair sanitary condition. The inmates are all in good health. The building,
however, is not what it should be. The county Jail is not sanitary, but is
well kept. The courthouses is a very old building, and is not as clean as
it should be. The schoolhouses are not all well kept and very few of
them are .sanitary, but improvement and advancement are apparent in
this respect. G. A. STEVENSON,

Health Officer.

ORANGE COUNTY.

No epidemic of any kind has visited Orange County during the year.
There have been a fv^v cases of typhoid fever, but a less number than
usual. Not a case of diphtheria was reiH)rted and I know of no physician
that had a case. Scarlet fever has existed in very light forni at one or
two points. Only one ease of smallpox was reported from Orleans. There
was no spread of the disease. Many of the schoolhouses in the county
are new and all such are in good sanitiiry condition. The remainder are
well kept, but are not sanitary, because they are not properly warmed,
light»Hl and ventilated. The courthouse is in good condition and Is well
kept. The county jail has been repaired since my last report and is now
fairly sanitary. It is lighted by electric lights and supplied with satis-
factory closets. Our new county asylum is almost finished. It is a good
structure and is supplied with all modern sanitary requirements. Health
Officers of the towns of Orleans and Paoli report the sanitary condition

Digitized by VjOOQIC

271

of tlieir respective forporations as fair. The towns of French Licli and
West Badeu have recently l)cen incorporated. They are not, as y.et, in
first-class sanitary condition. The new method of collecting death re-
ports ift a great improvement over the old way.

C. L. BOYD,

Health Officer.

OWEN COUNTY.

The (>Aven Connty poorhouse is a 'brick structure, two stories high,
and has 'M) rooms. There is a basement under about one-half of the build-
ing, basement and building being well ventilated. The facilities for bath-
ing are a malveT?hift, and the heating is by stoves. There is an average of
20 inmates in the infirmary all the time. There are two incurable In-
sane. The Imilding is well kept and clean. Iron bedsteads are used, but
a system of water supply, bathrooms and furnace heat are needed. The
jail is attached to the sheritt's residence. Both buildings are 50 years
old and have no sanitary conveniences. The jail is unhealthy, being badly
ventilated, poorly lighted and the sewerage dangerous. It Is as well
kept as the conditions will permit. There are 88 country schoolhouses—
.1 frame and one brick— in the county. The brick schoolhouse is three
years old and is sanitary in every particular. The frame buildings, as a
rule, are old. with three windows on a side and stoves in the center, and
a few only have cloakrooms. All new^ schoolhouses which are built are
according to the plans and specifications furnished from the? State Board
of Health. Many of the schools are overcrowded and this is a very bad
unsanitary feature. The water supply is generally good. I know of no
instances where it is bad. Outhouses at one-room houses are generally
very imi)erfect and unsatisfactory. White River, which enters Owen
County near Gosport and traverses the greater portion of the county, is
badly polluted. It receives its pollution from the city of Indianapolis
and this, undoubtedly, has an effect uix)n the health of the people along
the stream. It is a cesspool during the summer and in low stages of
water. Within the past two years Owen County has built 130 miles of
pike roads at a cost of about $200,000. I think this a sanitary feature of
no small moment. Transmissible diseases have not prevailed in epidemic
form, except smallpox. There Avas an outbreak of this disease at Patricks-
Imrg and neighborhood which was very hard to control. There was also
an epidemic at Freedom, 8 cases in all appearing there. Physicians of
Freedom failed to recognize the disease, even when the cases were in
pustular stage and well marked. None of the victims of smallpox had ever
l)een vaccinated. Dr. W. A. Hodges, of Freedom, who had been exposed,
left the town with his family at the time he was breaking out with the
disease. He returned to Freedom on a passenger train which was well
filled with people, still covered with pustules. A brakeman on that train
developed smallpox in about two weeks thereafter. The County Board
of Health furnished free vaccination and employed a physician to vac-
cinate. A large number availed themselves of this protection. Scarlet
fever In mild form has prevailed to some degree. On account of mildness
the disease disarmed all fear and there was little successful effort put
forth to prevent spread. At Gosport, scarlet fever got quite a start The

Digitized by VjOOQIC

, 272

situation hecanio nlarminjr. and Instead of fiprhting the disease in a rational
way ;n its incipiency. schools were closed and the disease allowed to run
riot. Evei-y effort was made to enlist the citizens, health authorities and
all the physicians in a warfare against the contagion. One doctor who is
practicing medicine, l)y the grace of a ten years' license, was particularly
hostile against all efforts to control, and in a public meeting denounced
the County Secretary as a crank and a meddler. With some of the
l)hysicians fighting all attempts to suppress the disease, no wonder it
spread to different parts of the county. It can not be told how many chil-
dren are maimed and crippled for life. Of the 41) cases reported in three
months, 4(> occurred in Gosport. There have been 44 deaths from tubercu-
l(»sis during the year. A State Sanatorium should be constructed for the
purpose of lighting this disease, and the people should be thoroughly In-
structed in regard to its many dangers. Forty-five cases of typhoid fever
were reported, with 7 deaths. In instances it Is hard to make people be-
lieve how it is they acquire tyi>hoid fever. There were 14 deaths from
diarrhoeal diseases among infants, (-irculars concerning diarrhoeal dis-
eases have been mailed freely over the county. Measles and whooping-
cough have i)revailed about as usual with only one fatal case from
measles.

The County Board of Health has been alive to the health interests
of the county and has given full supi)ort to the Health Officer. I have
written and answen»d over r>(K) letters connected with the busin€*ss of the
office during tlio year and made numerous visits to various parts of the
county. Health i)aniphlets have been generously distributed and monthly
reports of mortality and quarterly I'ei'orts of other vital statistics
promptly made. I hturfi attended the annual meetings of the State Health
Officers and have read three papers. N. T). COX,

Health Officer.

rAKKE COUNTY.

The health of this county has been fairly good during the year. No
epidemics have been rei)ort(Ml. l)ut there have been slight outbreaks of
diphtheria and scarlet fever. Measles has prevailed quite extensively.
Smallpox ai)i)eared at two i)laces during the year, but it was in mild form,
and some cases, undoubtedly, occurred which were not reported. There
were no deaths from this cause. There were 14 typhoid deaths, which in-
dicates that there must have been about 140 cases of the disease and it
further indicates tliat the water supply of the county is not
what it should he. Recommendations have gone forth repeatedly
to the people in regard to their drinking water and it is to l>e
iioped that good results will follow in time. The tuberculosis
di^aths numbered 41. The schoolhouses of the county are by
no means what they should be. Most of them are old structures ven-
tilated by windows and doors and heated by stoves. Such schoolhouses
can not l>e sanitary. The new schoolhouses all conform to the require-
ments of sanitary science. The courthouse is an old building and is not
well kept. There are no extra provisions for ventilation, and the drain-
age is far from what it should Ihj. The jail is not sanitary, for its con-

Digitized by VjOOQIC

273

sti'uctiou pi-evcntB proper Hnuitation. The drainage is very bad and the
ventilntlou Is not adequate. The general health of the county could have
been better. W. H. GILLUM,

Health Officer.

PERRY COUNTY.

There were 255 deaths, 335 births, 243 marriages and 141 cases of con-
tagious diseases reported in Perry County in 1901. Reports are much bet-
ter than last year. Smallpox broke out in the county In March. There
were 37 cases, but it was stamped out with no deaths. Tell City phy-
sicians had cases of diphtheria, scarlet fever and smallpox all at the same
time. General vaccination has been ordered and all cases of smallpox are
promptly quarantined. Our schoolhouse is new, is built of stone and sani-
tary requirements are fairly met Bathrooms are badly needed by the
county poor asylum, otherwise sanitary conditions are pretty satisfactory
there. There are thre«e incorpoated towns in this county: Cannelton,
Tell City and Troy. There were no contagious diseases reported from Troy.
On account of 8malli>ox at Tell City several metings were held by the
Troy Board of Health. At the first of these meetings, general vaccination
was ordered and the town authorities agreed to furnish the virus free
to physicians, who In turn were to collect 25 cents from each person vac-^
cinated If financially able to pay. Otherwise the work was to be done at
the expense of the town. Despite this order and the provisions made,
very few vaccinations were aflfected. The streets- and alleys of Troy are
fairly clean, but a few complaints were received, during the hot months,
of pig pens and outhouses. These complaints were promptly attended to.
The schoolhouse at Cannelton Is heated by steam and the ventilation Is
by windows and doors. It Is well kept, but Is not what It should be from
a sanitary standpoint.

There are 102 schoolhouses In the county. Ninety-two of these are un-
sanitary. Fevr of the schoolhouses are painted and many have shed tlieir
past coat of plaster and some are unfit for human habitation. The poor-
house contains 33 rooms, 2G of which are used for inmates. Of these 8
are occupied at present. The grounds are well drained, building heated
by coal stoves and ventilated by windows and doors. There Is great need
of bathing facilities. C. T. HENDERSHOT,

Health Officer.

PIKE COUNTY.

Pike County can not be said to be In good sanitary condition. The
lowlands are being ditched and tiled, but It will be some time before this
work is finished. There were 31 cases of smallpox during thef year, but
no deaths. There were reported 60 cases of typhoid fever, 14 cases of
diphtheria, 9 cases of measles and 3 cases of scarlet fever. Only two of
the individuals who had smallpox had ever been vaccinated. In both
these instances, the vaccination was in youth, some 30 or 40 years ago.
Many citizens refused to be vaccinated, claiming that they prefer to have
smallpox. The poor asylum Is In fairly good sanitary condition. Many
improvements are needed, however, but the place Is well kept. The

18-Bd. of Health. Digitized by CnOOgle

274

Orphans' Home is under excellent management and well kept. The
courthouse and county jail are not kept clean and are not sanitary build-
ings. The town of Petersburg is in poor sanitary condition and always
will be until a system of sewerage is put in. The public school buildings
are in a very unsanitary condition. The greatest difficulty Is that there is
not room enough to properly accommodate the pupils. The lighting is
bad. There is not a room in the building that has the required window
space. The buildings are at present being plumbed and waterclosets
placed in the basement. We hope for better things from a sanitary stand-
point in Pike County. T. W. BASINGER,

Health Officer.

PORTER COUNTY.

There were no time epidemics of infectious diseases in Porter County
in lfK)l. There were 21 cases of smallpox reported, all discreet and no
fatalities. Sixteen cases of diphtheria were reported, with 5 deaths,
which is certainly a very high rate of mortality. There were 7 cases of
typhoid fever and 2 deaths.

TTiere are 102 schoolhouses in the county and a minority are strictly
sanitary. Some of them, however, are passable In this respect and others
should be condemned. The water supply is most invariably from driven
wells. One schoolhouse in the northern part of Center Township was.
from its photographs, plans and descriptions, awarded the prize at the
Paris Exposition as the best schoolhouse in the world. The county poor-
house is dilapidated, unsanitary, wretched and in every way a disgrace to
the county. A. P. LETHERMAN,

Health Officer.

POSEY COUNTY.

The soil of Posey County is generally underlaid with gravel and the
drainage is therefore good. A great deal of tiling Is being done annually
and this Improves sanitary conditions very perceptibly. We have had one
epidemic during the year. There have been several cases of typhoid fever,
but no fatalities. Our jail is badly constructed, the ventilation is not
sufficient. It is kept In passable condition. We are proud of our In-
firmary. The house is new, is well kept, the inmates are well fed, and,
altogether, the place is very satisfactory. The schoolhousee are generally
in passable condition, but sanitary criticism may apply to every school-
house in the county. We hope for better things in this respect for the
future. As a poor physician, I have found, in many instances^ deplorable
conditions, not only poverty, but filthy surroundings. A filter plant is be-
ing put in the waterworks of the city of Mt Vernon. We expect hereafter
to have an ample water supply. R. L#. HARDWICK,

Health Officer.

Digitized by VjOOQIC

276

PULASKI COUNTY.

From personal observation and best information at hand, I find the
county schools to be in passably good sanitary condition, with few ex-
ceptions. There have been no complaints in regard to schools. The pub-
lic school building at Winamac is sanitary in every respect. It is new
and is well kept. There are 101 school buildings in the county. The
county asylum is a brick building, contains 40 rooms and has 21 inmates.
The hot water system is used for heating and is in good working order.
There are bathrooms and closets; all are well kept and in good order. The
sewerage is tirst-class. There were 7 deaths during the year; all were
old people. This county has no jail and bnt little use for one. There has
lnH-Mi no epidemic during the year. A few cases of diphtheria have been
reported at or near Monterey. They were promptly quarantined and
spread was prevented. There we're 144 patients in the county during the
>ear. J. J. THOMAS,

Health Officer.

PUTNAM COUNTY.

This county has been free from epidemics during the last year. Small-
pox developed live different times and each time through a different
source of infection. Prompt quarantine and general vaccination has pre-
vented the spread of the disease. One case was diagnosed nettle rash
by the attending physician. There were 40 exposures, but every exposed
person was vaccinated and not one developed the disease, ex-
cept the Immediate members of the family, who were in the,
beginning in close contact with it. Ignorant i)h3'sicians still call
it Cuban itch, neverth€»less, and when one was reported, prompt
quarantine was instituted and the smallpox flag put up. There
was an epidemic of scarlet fevei* in the school at Raccoon. The
first cases were diagnosed nettle rash and there were 35 in all, with 2
deaths. The school was closed, and the building thoroughly disinfected.
After this the epidemic subsided. Th^re were only a vei'y few cases of
typhoid reported during the year, with 9 deaths. The courthouse is an
old dilapidated affair and unsanitary. A new one will very soon be built.
The jail is not sanitary, but it will be renovated very soon. The poorhouse
is well kept, but is not a sanitary building, (ieneral health of the county
is good. G. W. BENCE,

Health Ofllcer.

RANDOLPH COUNTY.

Our schoolhouses are in far bettor condition than in any previous year.
The sanitai'y survey which I m;ide last year of every schoolhouse In
the county has awakened an interest in sanitation. Township trustees
are this winter discussing the proper sanitation of schoolhouses. This
certainly indicates advancement. Our local Health Oflicers are doing far
better work than heretofore. They are becoming more Interested and
have a fuller information in regard to sanitation. The county infirmary
is well sewered and is well kept. It is passably sanitary. The ventila-

Digitized by VjOOQIC

276

tion is very good, for the building is supplied with ventilating shafts and
all of them worlv well. There has been no sickness in the Jail. We had
only 2 persons in 11H>1. The jail is heated by hot water and it is kept
in good sanitary condition and is lighted by electricity. The courthouse
is a new building, well ventilated by ducts in tlie walls, and Is heated by
steam. The Orphans' Home was built and endowed by a wealthy person
of our town, Mr. James Moorman. It is a sanitary building and is well
managed. There were 9G4 cases of measles reported, with 11 deaths;
scarlet fever, \) cases, no deaths; tuljerculosis, 28 deaths; typhoid fever,
0 deaths. There were 4 cases of smallpox reported during the year.

Dr. (/ommona, the efficient Health Officer at Union City, r^)ort8 as
follows: There have been no epidemics in Union City during the year.
There have been, however, a very few cases of scarlet fever and diph-
theria at different times. There \vere 3 cases of smallpox, all in the same
house. Our schoolhouse is modern and is well kept. The ventilation and
lighting are satisfactory.

The Health Officer of Uidgeville reports fairly good sanitary condi-
tions. During the year the dug well In the basement of the school build-
ing was condemned and a drilled well built outside of the building.
Measles was the only epidemic disease we had. Three cases of typhoid
fever, 1 of scarlet fever and 2 of smallpox, but no deaths.

Farmland Is In the best sanitary condition it has ever been. There Is
much room for imiirovement, and that Is occuri'ing rapidly.

Parker.— The schoolhouse is in fair condition, but needs some improve-
ments. Tlie drainage of the town is good. Two large tile sewers run
through the corporation. The water supply is largely from'^drlven wells.
Dug wells are discouraged. Excepting measles, there were no contagious
diseases during the year. We hoi>e to remove the pig pens from the town
tre long. Streets and alleys are kept fairly clean. The population is 1,200,
and the total deaths were 12, making a very low rate.

lAJsantvUle. -There are no ix)nds or stagnant water w^lthln the limits
of the town. The town has no si)ecial sewerage. There Is no schoolhouse
wltliin the corporate limits of the town. Drilled wells are largely taking
tl»e place of the old-fashioned dug well, this being much to the health of
the town.

Lynn.— The water supply is from deep driven wells, and the town is in
good sanitary condition. The alleys are clean and pig pens are not al-
lowed. Not a case of typhoid fever was re|K>rted during the year. There
were a few cases of measles and a few cases of chickenpox. A new
school building is inking constructed and it will conform with every sani-
tary condition. R. BOSWORTH.

Health Officer.

RIPI.BY COUNTY.

I lierewith sul>mlt my report of the sanitary condition of Ripley Coun-
ty for the year IJM)!. The county buildings, including infirmary, are in
passable sanitary condition. There has been no sickness among the prls-
onei*s in jail and but little in the infirmary. There has been no smallpox
in the county this year. A few cases of measles, a few cases of scarlatina
and a very few cases of very mild diphtheria. Typhoid has been less this
year than usual, notwithstanding the dry w^eather and low water.

Digitized by VjOOQIC

Versailhs has? put in an electric light plant, has improved the streets
nud planted many shade trees. A new school bnlldinjx is badly needed.
Milan has made mucli needed improvements and so also has Batesville.

Osj^ood sadly needs to improve its streets and put in sewers. The
town should be lighted. This will probably be done this coming year.

R. T. OLMSTED,

Health Olticer.

RUSH COUNTY.

The sanitary history of Rush County for 1001 may be classed as fairly
good. There were VM cases of contagious and infectious diseases re-
ported. Tills is an increase over the preceding year of 47 cases. Measles
we have always with us. There were 21) cases of typhoid fever, which is
an Improvement ovtr IIKM), wlien (>5 cases were rei)orted. The sanitary
condition of the county poor farm is i)assable'. The building is not what
it should be, but is well kept and the inmates have good health. There
were no contagious or infectious diseases at the poor farm in 1901. The
jail is not a sanitary structure, but is well kept. The ventilation and
sewerage is not what it should be. The public school buildings are, many
of them, unsanitary and it is only rarely that one is found which is not
well kept. All the country schools are supplied with water from deep
driv( n wells. There was no smallpox in Rush County in 1901.

LOT GREEN,

Health Officer.

SCOTT (X)T^NTY.

There were no epidemics of infectious diseases during the year. There
were, however, a few isolated cases. No complaints of nuisances, dan-
gerous to the pul)lic health, have been received. Twenty-two cases of ty-
phoid were rci)orted. witli 1 death: threi* cases of diphtheria, with no
deaths; 21 cases of scarlet fever, with 3 deaths. Total number of deaths
during tht* year was 120. The total births were 1(57. There were 8 cases
of smallpox, with no deaths.

The county poor asylum Is In passable sanitary condition. The court-
house and jail are old, but are well kept. Neither are built with any of
the modern sanitary conveniences. The schoolhouses built during the
year conform to sanltai*>' laws, but the old buildings are all of them un-
sanitary. WM. McCLAIN,

Health Officer.

SHELBY COUNTY.

Tlie sanitary condition of Shelby County is passably good. The coun-
try is well drained by streams, open ditches and tiled drains.- SmalliK)x
invaded the county during the year. There were many cases of the dis-
ease, but so many were of mild form that they never were reported. There
were no deaths. Diphtheria and scarlet fever appeared once during the
year in epidemic form. The nundK»r of deaths from diphtheria was 5.
and none from scarlet fever. Fnnn all causes, the num])er of deaths was
1,:W(». The OrpliJins' Home is a three story brick building, located on high

Digitized by VjOOQIC

278

land, is heated by a furnace and supplied with good drainage. It is well
kept. The county poorhouse was remodeled two years ago, and is partly
heated by a furnace and partly by stoves. It is well kept. The county
jail is in passable sanitary condition, but needs some repairs. The public
school buildings are mostly brick and are well kept. Ventilation is rarely
what It should be and outhouses are not always what they should be.

J. B. STEWART,

Health Officer.

SPENCER COUNTY.

There was a slight epidemic of scarlet fever and a few Isolated cases
of diphtheria during the year in Spencer county. Smallpox prevailed In
mild form in the fall. The actual number of cases can not be given,
but I estimate they had not less than 200. Tuberculosis is always in
evidence. The county jail is passably sanitary. It is well sewered and
pasasbly well kept. The courthouse is a brick structure, lighted by elec-
tricity, heated by stoves and supplied with water from the public water
works. It is not kept clean nor is it in as good state of repair as it should
\w. The Orphan's Home has been rebuilt. It is very comfortable and
is well kept. It has thirty-five inmates. The sleeping rooms and dining-
room are hardly suitable for such an institution. The house needs water-
works, bathrooms, sick room, better bedrooms and proper ventilation.
The matron is a conscientious and competent woman who keeps the
house clean and tidy. The county poor asylum is in poor condition. All
the buildings are old, dilapidated and dirty. Wall paper and plastering
are off in many places. Some rooms are fairly clean. The Superin-
tendent is doing as well as possible under the circumstances. The beds
are of straw and the sexes are separated at night, but not in the day-
time. The building is lighted by oil, is heated by grates and ventilated
by doors, windows and cracks. The physicians are generally reporting
their contagious diseases and birth as is required by law.

J. H. JOHNSON,

Health Officer.

STARKH COUNTY.

There were only 4 cases of typhoid fever reported during the year,
and no cases of smallpox. Dysentery has not been heard of. In the last
half of the year we had 2 outbreaks of diphtheria. There were 4 deaths.
Antitoxin was used In every case. The courthouse of this county is new.
is of stone and is sanitary in every particular. The poorhouse is an old
and dilapidated aiTair, and a new one is needed. It is Impossible to se-
cure sanitary conditions in such a building as we have at present. The
public schoolhouses are genei*ally in passable sanitary condition. There
are a few. however, which should be condemned. As in many instances
new buildings will shortly be constructed, steps will be taken to make
certain that tnery sanitary condition will be observed. The drainage
of Starke County has been extended materially In the last year, with an
improvement so far as malaria is concerned.

M. R. WRIGHT,

Health Officer.

/Google

Digitized by VnOOQ I

279

STEUBEN COUNTY.

1 have visited or had a report from every Health Officer in the county .
during the year. Satisfactory improvement in the sanitary conditions
of the county is to be noted. The Health Officers of the county have
been active in instructing the people in a better understanding of sani-
tation and of the statutes and the rul^ of the State Board of Health.
Regular inspection has been made during almost every month of the
y(wr. In this inspection close attention has been given to the public
and district school buildings, and decided improvement has been secured.
Most of the trustees and all of the teachers are eager to help in all
sanitary worl£. The county Infirmary, Jail and courthouse are in really
excellent sanitary conditions. All are clean and well kept; heating, light-
ing, drainage and ventilation, good. There were a few cases of diarrhoea
and lagrippe among the inmates of the poorhouse during the year. There
were only three deaths in this institution, one person 83, one 87 and
one C8 years of^ge. Complications following lagrippe caused the deaths.
Scarlet fever in very mild form, 10 case« in all, was reported from one
part of the county, but no deaths occurred. Measles have prevailed in
all parts of the county. Five cases of typhoid fever were reported, but
these were scattered and were not localized so as to suggest any common
source of infection. Three cases of cerebro-spinal meningitis, resulting
in death of the 3, occurred. The cases were all in one family. Smallpox
appeared in January in the southwest part of the county. The disease
was promptly discovered and isolation and vaccination of all the ex-
posed was enforced. The cases were among the unvaccinated exclusively.
No fatalities occurred. Disinfection with formaldehyde, isolation and
vaccination have been efficient in restricting the spread of the disease.
Smallpox has prevailed extensively in Williams County, Ohio, which
bounds Steuben County on the east. The County Board of Health has
given the fullest support to the Health Officer and advanced sanitation
in Steuben County under such conditions is only a question of time.

The total number of deaths during the year, was 163. The oldest
decedent was 94 years. Total number of births, 140—60 females and 86
males. The number of marriages were 161. A number of complaints
of nuisances have been received. All have been inspected and looked
after according to my best judgment. W. H. LANE,

Health Officer.

ST. JOSEPH COUNTY.

During the year 1901 St. Joseph County was exceptionally free from
all epidemics; although from time to time throughout the county there
were sporadic cases of smallpox, scarlet fever and diphtheria; but at no
time during the history of the year did any of these diseases approach
anything like an epidemic.

The mortality for the year, throughout the county, was a trifle over
13 per cent, from all causes. I visited most of the schools in the county
during the year, and in some found defects, which, by calling the atten-
tion of the trustees to same, were corrected. In one instance it was
necessary to condemn a schoolhouse. Most of the newer buildings that

Digitized by VjOOQIC

280

have been built during the past two years are in very good shape as to
the cUrection of ligrht, ventiUition and heating for the comfort and health
.of the pupils.

The county jail is a comparatively new structure, it Is well ventilated
and the plumbing is first-class. The health of the inmates has been
\ery good. ^

Within St. Joseph County we have one public institution, the Orphans'
Home, which is situated upon the banks of the river in a very salubrious
neighborhood. They have had 100 children. During the year they had
an epidemics of diphtheria, with 30 cases and only 1 death.

The County Asylum: The buildings are old and are not built upon
modern plans. The ventilation is defective, there is no system of sewer-
age worth the name, the buildings are crowded and are not adapted for
public purposes. The County Commissioners have had plans drawn for
new and commodious buildings to be built with modern ideas, but owing
to laclv of funds, contract has not lyecn let for the new buildings, which
probal)ly will be begun and completed in the near futifte.

Owing to the geological formation in the county our water is free
from surface contamination and typhoid fever has been very rare.

The police station, where tramps and prisoners from the city were
huddled indiscriminately, was certainly a "lilack hole of Calcutta;" for-
timately this has been remedied by the city building, a new and com-
modious city hall, and with it a new police station, where the prisoners
can be separated, tlie sanitary condition has been improved, and fear of
contagion from that source has been lessened.

J. W. HILL.

Health Officer.
SULLIVAN COUNTY.

Sullivan County has a large population of miners and very few of
them live in a sanitary way. Nevertheless the sick rate seems not to
be any higher among them than where people live closer to the laws of
lr*kgiene. There were 0 deaths from typhoid fever during the year and
probably 100 cases. It is evident an improvement could be made in this
direction. The tuberculosis deaths number 62. The diphtheria deaths
number 8 and there were 2 epidemics during the year. There were no
deaths from scarlet fever and none from smallpox, although the latter
disease prevailed to some degree. All of the cases were in mild form.
There were I'.i deaths from measles, which tells of a fierce epidemic
which actually existed. The Sullivan County courthouse and jail are not
what they should be from a sanitary standpoint. I have recommended
improvements every year, but no action has been taken to date. The
school houses are most of them ventilated simply by windows and doors
and heated by stoves. Th(*5\ of course, are not . sanitary. The water
supply of the schools is not what it should be in many instances. This
fact has been called to the attention of school authorities and recom-
mendations made in otlier respects. It is hoped that improvements will
appear in time. The drainage area is increasing each year and this
means that malaria and that order of diseases will decrease.

E. D. THIXTUN,

Health Officer.

/Google

Digitized by VnOOQ I

2S1

SWITZERLAND COUNTY.

During the winter an epidemic of mild smallpox visited this county.
Some difficulty was experienced in awakening the people, as well as some
of the physicians, to a full realization of the situation. Owing to edu-
cation in regard to sanitary matters, the public is becoming more alive
to their health interests and are exhibiting a greater willingness to aid
Health Officers in their worlc. The county asylum and jail are well kept,
but are old buildings and are not sanitary. The courthouse is also an
old building. Progress in sanitation is satisfactory in Switzerland County.

J. W. SMITH,

Health Officer.

TIPPECANOE COUNTY.

Tippecanoe County, being well drained by the Wabash River and its
tributaries, enjoys luiusually good sanitary conditions in this respect.
There are a few ponds and swampy places in the county and these will
disappear in all probability within another year, for the people are awak-
ened to the necessity of thorough drainage. A gi-eat ditch is being con-
structed along the southern portion of the county. When this is in
operation an improvement in regard to malarial diseases will undoubtedly
be noticed. The city of Lafayette has a complete sewer system and is
pretty well iw^ved. The city crematory is a valuable adjunct in main-
taining the public health. The system of garl>age collection and dls-
iwsal in this city is very successful and satisfactory. The majority of
our school buildings are modern, but thtre are many which should be
condemned. They are usually well kept. The county asylum is well
kept, but the building itself is not sanitary as it should be. Improvements
will unciurstionably soon Ih' ordered. The courthouse is a new one and
ample in every resi)ect. The jail is satisfactorj- from a sanitary stand-
point. There has been no epidemic during the year. Diphtheria has
prevailed to a little extent, but nowhere has it assumetl epidemic pro-
portions. Smallpox in mild form infected the county in March, but there
has been no fatality so far and the people and officials are alive to the
necessity of suppn*ssing it. Only a very few cases of typhoid fever have
been reported. J, V. LITTELL,

Health Officer.

TIPTON COUNTY.

No serious epidemics occurred in Tipton County in IIKH. Tuberculosis
and typhoid fever iirevailed about as usual and there seems to have been
less of diphtheria and scarlet fever than is usual. There were two cases
of smallpox in Tipton County during the year.

Our schoolhouses are not in a single instance up to a high sanitary
standing. Seven schoolhouses are in good condition, 12 are bad and the
remainder fair. Each new building constructed meets all modern sani-
tary requirements. The condition of the county infirmary is not im-
proved over the y*ir lu'ecediug and the same may l)e said of the jail
althougli neither institution suffers very bad sanitation.

A. S. DICKEY,

Health Officer.

Digitized by VjOOQIC

282

UNION COUNTY.

A sanitary survey of this county discovers sanitary conditions to be
above fair. Tlie citizens are certainly taking on advanced ideas in re-
gard to sanitation. There were no epidemics in 1901, and the general
sickness was very little. The physicians here are a little slow in making
their reports of contagious diseases, but they have been given to under-
stand that reports must come in promptly. There are 38 schoolhouses
in our county, 8 of them are heated by furnaces, 2 by steam, and rest
by stoves. Tlie ventilation is by windows and doors. The new school
buildings which are being constructed have all the late improvements
and are up-to-date. Only driven wells are used for water supply at
schools. Gradually the dug wells at private residences are being abol-
ished and drilled wells substituted. The county infirmary, built in 1899,
is of brick. 2 stories, 42 rooms, is heated by steam and the sewerage is
satisfactory. At the present time there are 13 inmates. There were 2
deaths during the year, both from old age. The health of the inmates
is very good. No consumptives are on the list. The county jail, built
in 1884, is passably sanitary, is well kept and the sewerage is satisfactory.
There has l)een no occupant for 18 months.

S. D KELL,
Health Officer.

VANDERBURGH COUNTY.

The courthouse and jail of Vanderburgh County are new and sanitary
and well kept. The infirmary and Orphans' Asylum are only In fairly
good sanitary condition. The plumbing at the county asylum will be torn
out in a few months and new supplied. Our city schools are in fairly
good sanitary conditions. One hundred and three rooms are most satis-
factory, but 102 rooms are yet to be much improved. The fan system of
heating and ventilating Is used for 80 rooms in all. The rural school
buildings are only is passable condition. Twenty per cent, are of brick
and are heated by furnaces, and the remainder are frame structures and
heated by coal and wood stoves. Not a few of the rural school buildings
should be condemned. The Southern Indiana Hospital for. the Insane,
situated in this county. Is in fairly good sanitary condition. The build-
ing itself is open to severe criticism in many respects, l^he plumbing
and sewers are in good order, there has l)een very little sickness in the
past year and none of the (contagious and infectious character excepting
tuberculosis. . W. S. PRITCHETT,

Health Officer.

VERMILLION COUNTY.

The basis of this annual report is my quarterly reports to the County
Commissioners, commencing .Tanuary 2, 1001. Diphtheria and scarlet
fever have prevailed to some degree during the year. Prompt notification
has been required of the physicians and sanitary measures promptly com-
menced to prevent spread of the infection. The deaths have been fewer
than usual and the severity of the cases has been less than usual. There
has been one Illegal burial, with disinterment and inquest, as the law

Digitized by VjOOQIC

283

foniraands. There have been several cases of smallpox, exactly how many
oan not be positively stated, because? all have not been reported. This
was because tlie diajruosis has been different in many instances and also
because people have had the disease and never employed physicians.
There was 1 death. Tlie dead man's name was John White, was 40
years old and lived near Summit Grove. Cancer seems to exist to a
greater degree than formerly, but exact records of cases can not be given.
1 have been called upon during the year, personally, to attend to 11 cases,
and I have record of 9 others. On July 10, smallpox was discovered
on an island in the Wabash River, about one mile east and one mile
south of Hillsdalt^. The population of the island consisted of 3 women
and .•? men, living together in a town. Quarantine was promptly estab-
lished, l)ut men wlio had been exposed to the contagion were promptly
arrested, sent to the island and kept there* under guard for 14 days. Four
more cjises developed, one of them was of confluent form. Two men had
l)een successfully vaccinated a few years before and escaped the disease.
The island is claimed by no county, l)ut the Attorney-General rendered
the opinion that Vermillion was legally responsible for the expense and
the same was therefore promptly obeyed. There was very little dysentery
during tlie summer. A few cases appeared in August, but no deaths
were reported. Several nuisances were abated during the year, notably
a slaughterhouse at Cayuga. On November 25 I inspected the sanitary
conditions of the poorhouse, jail and courthouse. The superintendents
of tliese buildings took pride in keeping them in first-class condition, but
I found the closets of the courthouse untidy. This defect was immediately
remedied ui)on notice being called to the same. The reports from the
incorporated towns of the county are all favorable. No epidemics, and
the general health good, with many sanitary improvements made and in
process. . E. C. LOOMIS,

Health Officer.

VIGO COUNTY

1 can report the general sanitary condition of Vigo ('ounty as only
fair to good. There is improvement of surface drainage by open and
sewer ditches. There is also improvement of public highways. The gen-
eral sanitary conditions of scliool buildings throughout the county shows
an enooM?*aglng degree of improvement. The new buildings constructed
are carefully looked after as far as sanitary conditions are concerned.
Driven and bored wells only are allowed at schoolhouses from which to
furnish water supplies. Many teachers have been induced to study hy-
giene and at times present points in regard to the subject to their pupils*.
The county Jail is in bad sanitary condition, but Is now undergoing re-
pairs and additions which will correct most of the faults. The county
infirmary and Orphans' Asylum are in excellent condition. The manage-
ment of these institutions is first-class. It is possible, of course, to make
improvements in places. The disposal of garbage has enlisted the careful
attention of tlie Health Board of Terre Haute. A good system exists,
for, in the last six months, 25.000 barrels of garbage, besides 189 dead
animals, have been cremated. During the year we have had the usual
infectious diseases among the children. Scarlet fever, diphtheria, measles

Digitized by VjOOQIC

284

aiifl whooping-couRli Imvo prevailed to some degi-oe. Smallpox has also
existed, the fii'st cases appearing In Fel)niary. There were 27 well-marked
cases during the year, liiit no deaths. Quarantine, disinfection and vac-
cination seem to have prevented spread of the infection. The mildness
of tlie contagion makes it difficult to enforce strict quarantine measures.
Health Officers have been threatone<l with personal violence on account
of their solicitation and work in the public health cause. In instances,
vaccination is at)soiutely refused.

It is gratifying to secure such complete death returns as the new
law enables us to do. I feel confident there has not been a single death
which has escaped being reported since the law went into effect in this
county. Birth reports are not yet as correct as they should be, but I
feel we are doing very well. During the year there were 952 births,
51 cases of diphtheria, 2o5 cases of scarlet fever, 29 cases of smallpox,
18 cases of typhoid fever, 1 case of dysentery, and one of cerebro-splnal
fever. There were 071) marriages. Ministers do not report marriages
as promptly as they should. J. M. TALBOTT,

Health Officer.

WABASH COUNTY.

No epidemics reported during the year. There have been a few cases
of diphtheria, scarlet fever and smalli)ox, Imt no epidemics, as said above.
To this date there have been 11) cases of smallpox reported, with no
deatlis. The cases have been promptly quarantined and all sanitary meas-
ures energetically enforced. The sanitary conditions of our public build-
ings are satisfactoiy. Tiiey are all modern buildings, and sanitation has
been observed in the construction of every one of them.

J. B. WILLIAMS,

Health Officer.

WARREN COUNTY.

Through a review of the records I find that the general health of
Warren County was very good during the year of 11>01. The average
death rate was ijelow the average for the whole State. There were 2 ca.ses
of smallpox during the year, and no deaths. Diphtheria and scarlet
fever seem to have diminished in the county, for they are rarely heard
of. The only public institution in the county, 1)esides the jail, is the
county asylum, and I find it in very good sanitary condition.

S. S. DK LANCEY.

Health Officer.

WARRICK COUNTY.

The natural drainage of Warrick County is very good. There is much
aitificial drainage and its construction has been attended with the Im-
proNcnicnt of the public healtli. Boonville. the county seat, located near
the center of the county, is a town of 1,881 inhabitants. It is well drained,
has macadamized streets, electric lights, a central heating plant and a
goo<l system of waterworks. A high school building was erected last
summer. It is modern in every resi)ect, all sanitary requirements being

Digitized by VjOOQIC

285

met. A few of the district schoolhouses are not what they should be
from a sanitary point of view. Recommendations have been made in
every instance where the same were needed. The courthouse is old, un-
sanitary and uncleanly. The county jail is in a passable sanitary con-
dition, but repairs and improvements are needed. There were no deaths
nor sickness in the institution during the year. The poorhouse is a new
structure, frame, and is well kept. It does not contain all the sanitary
features it should, yet it is heated by furnaces and is supplied with hot
and cold water and baths and toiletrooms. The ventilation should have
been better. There were 11 males and 5 females as inmates during the
year. There were 4 deaths— 2 males and 2 females. The Orphans' Home
is an excell<^nt building and well kept. There were only a few re**om-
mendatlons to be made and they were promptly compiled with. Health in
the institution has been excellent. There was no epidemic or notable
illness during the year. T. WRIGPIT,

Health Officer.

washin(;ton county.

The death rate of Washington County was 15.3 per 1,000 in 1001.
This means there were 308 deaths in all. Fifteen of these were caused
by typhoid fever, 14 by tuberculosis, 1 by smallpox, and 3 by measles.
There were no diphtheria and scarlet fever deaths reportetl. These dis-
eases, however, existed to some degree, but generally in mild form.
Measles was epidemic in the fall. The schoolhouses of Washington
County are not iX'hat they should be by considerable. Most of them are
poor structures and some of them in a dilapidated condition. The ventila-
tion and warming are generally faulty and the water supply in many
instances Is !)ad. Outhouses are not cared for as they should be in too
many instances. The schoolhouses pretty generally conform to modern
sanitary requirements and are well kept. The courthouse is a new struc-
ture of stone and Is well kept, but there are no special provisions for
ventilation, otherwise the structure may be said to be very sanitary. The
town of Salem needs sewers and paving. These two Improvements will
probably come in time. Tlw general character of the ground is rolling,
and this afTords good drainage. Malaria is rarely exlstant in this county.
The poorhouse is an old structure, very unsanitary, but as well kept as
possible under the circumstances.

W. J. PXJRKHISER,

Health Officer.

WAYNE COUNTY.

There are 87 school buildings in the county, 224 teachers and 5.910
pupils enrolled. There is an average of 30 pupils to each schoolroom
and, with rare exceptions, these rooms have cros.s-lights. The buildings
are mostly heated by wood and coal stoves, except in a few of the larger
village schools, where furnaces and ventilating heaters are used. Ventila-
tion is usually by windows and doors, very few buildings being provided
with air ducts. With rare exceptions, the schoolhouses are well kept.
The floors are scrubbed at the beginning of each term and whenever

Digitized by VjOOQIC

286

infectious diseases have ocfiirrod the schoolrooms have been disinfected
with formaldehyde. The watei* supply is from driven wells, but there are
not a few old dug wells to be abolished. The outhouses are rarely in
good sanitary condition. The County Board has ordered that all school
children shall be excluded from school who are sick In the least degree.
A sick child should not attend school. All of the schoolrooms in Rich-
mond are heated either by heaters or by hot air furnaces. None is warmed
by stoves. It is hoped forced ventilation by blowers will soon be used
in the larger i)uildings. All are provided with first-class lavatories, some
of them having these conveniences on each floor. City water, which is
of good quality, is furnished to every building. Because of the epidemic
of smallpox that has prevailed in and about Richmond, repeated requests
have been sent to all the Health Officers of the county, to stimulate
interest in the matter of vaccination. The smallpox which has existed
liere has l>een mild, and during the year not a single fatality. Measles
has been severely epidemic in every part of the county within the past
year and has affected seriously the school attendance. Diphtheria of viru-
lent tyiM» appeared among the pui)ils in the Richmond schools in the
spring and several deaths occurred. The scarlet fever cases reported were
of mild type.

The poorhouse is a very good building and is passably sanitary. It
is well kept. Th(» jail and courthouse are new buildings, sanitary and
well kept. The i)rincipal .<?anitary work of Wayne County lies along the
schoolhouse lines. The villages of the county, while not sewered, are in-
habited by most intelligent people, who believe that cleanliness is next
to (U)dliness. G. II. GRANT,

Health Officer.

WELLS COUNTY.

In giving a review of the health and sanitary conditions of Wells
County. I am at a disadvantage, because I have been Health Officer for
only a part of the year of VM)2. In addition. I find imperfect records.
From personal observation and consultation with other physicians, I feel
warranted in saying: There have been no epid(>mlcs of infectious and
contagious diseases to an extent sufficient to say they were epidemics.
Typhoid fever, which usually figures largely in the health returns of this
county, does not appear to the same extent in VM)\ as in previous years.
The first case of smallpox during the present State epidemic, appeared
in Wells County in September, and from that time on until the end of
the year, there' were constantly a few cases. Tuberculosis is the worst
disease we have to deal with.

There are in the county, outside the city of Bluffton, 101 school build-
ings, all of brick, but some of them rather old and very few of them
are sanitary. I believe that a good water supply exists at all our schools,
because it is recorded that none but driven wells have been put down.
The school buildings of lUuffton, upon inspection, are found in passable
sanitary condition. The county jail, the comity infirmary and County
Orphans' Home are not sanitary in every particular but are well kept.

LOUIS SEVERIN,

Health Officer.

Digitized by VjOOQIC

287

WHITE COUNTY.

1 have made a survey of the county and have had reports from all
subordinate Health Officers. From the data so secured, I beg leave to
submit the following:

There has undoubtedly been a general improvement in the sanitary
standing and health of the county in the last yeai*. I find it much easier
now to induce the people to clean up and put things In sanitary condi-
tion. The courthouse is a new building and is passably sanitary. The jail
!>adl3' needs a sewer and from the sewage disposal standpoint is to be se-
verely criticised. Both of these public buildings are well kept. There are
defects in the drainage of tlie high school building at Monticello. Atten-
tion of the School Board lias been called to the matter and will soon be
remedied. The Orphans' Home is a 2-story frame building, well located
and well kept. There are no children in the home at the present time.
The covmty iworliouse is a 2-story frame, in only fair repair. There are 20
inmates at the present time. There is not sufficient separation of the
sexes.

Many of the schoolhouses in the county are not sanitary and many
tnsi poorly kept. There are improvements along this line, however. Where
new buildings are being erected plans are made to include all sanitary
requirements. The town of Walcott has erected a new 2-story brick school
liuildlng with modern improvements.

A numl»er of nuisances have lieen abated, during the past year, mostly
vaults and pig pens. Tlie law was not resorted to in a single instance.
The death rati* for 11)()1 was a fraction greater than the previous year,
but the population has consideralily increased. The total deaths was
202, births 44i4, marriages 18<). There were 43 cases of typhoid fever,
48 of measles, 11) of scarlet fever, 28 of whooping-cough, 7 of diphtheria,
and t> of smallpox reported.

The rules of the State Board of Health concerning infectious diseases
have been carefully enforceil. There were no deaths from smallpox, all
the cases l)eing mild. M. T. DIDLAKE,

Health Officer.

WHITLEY COUNTY.

Tlie general liealtli of tlie people of Whitley County was exceptionally
good (luring the year. No epidemics were reported. Only a few cases
of diiihtheria were known. This is also true of scarlet fever. Quarantine
and thorough disinfection seem to have prevented any spread of these
diseases. Tyi)hoid fever has been less than ordinary. The abandonment
of dug wells and almost universal use of tubular wells is the cause of
the lessening in typhoid. There has been no smallpox in the county, which
is a remarkable fact when we consider that it has occurred In the ad-
joining counties. Some of our citi/Ams have been exposed, but by prompt
vaccination and thorough disinfection I think we have prevented the
disease from appearing. The people generally and the public press are
heartily in sympathy with iiublic health work. The rules of the State
Board of Health have been promulgated and are generally obeyed. It

Digitized by VjOOQIC

28S

is not difficult to secure their enforcement. No improvement is to be re-
port-ed in regard to the sanitary conditions of the poor asylum, jail and
c'ourthouse. These buildings are not what thej' should be in a sanitary
way. The city and country school buildings were all thoroughly cleaned
and many of them disinfected and repainted :before school opened for the
year. E^'erj' school house in the county is furnished with water from
driven wells. O. V. SCHTJMAN,

Health Officer.

Digitized by VjOOQIC

PROCEEDINGS

ELEVENTH ANNUAL CONFERENCE

INDIANA HEALTH OFFICERS.

i9-Bd.ofH..ith. (289, , Google

Digitized by VjOOQl

u Ik

Digitized by VjOOQIC

PROCEEDINGS ELEVENTH ANNUAL CONFER-
ENCE INDIANA HEALTH OFHCERS.

Office Indiana State Board of Health,
Indianapolis, May 27-28, 1901.

The first session was called to order at 10 a. m., May 27, Dr.
John H. Forrest, President of the State Board of Health, pre-
siding.

The following opening address was read :

Address of President John H. Forrest.

Gentlemen — Some years ago a movement was originated with
the State Board of Health to hold a meeting of the Health Offi-
cers of the State each year, the object being that by coming in
contact with each other, all would be benefited and the efficiency
of the Health Officers all over the State, be improved.

We believe that the result of these meetings has demonstrated
that the movement was a wise one, and that there has been a
decided improvement as a result of this "coming together" and
discussing the methods of dealing with the different conditions
which have arisen in widely separated communities in the State.

The State Board takes a great deal of pleasure in saying that
at the present time in Indiana, the vital statistics are as nearly
correct as in any of the states, and in some particulars we be-
lieve that Indiana leads, for the monthly bulletin is in demand
by insurance companies and by the health and statistical depart-
ments of all the states and a number of foreign countries. This
is a tribute of which we feel justly proud.

One of the greatest disadvantages the State Board now labors
under is the lack of a laboratory. Most of you, no doubt,
are familiar with the fact that we had a bill before the last
Legislature w^iich we hoped to get through, establishing a State

^®^^ Digitized by Google

292

laboratory, under the supervision of the State Board of Health,
where the bacteriological, pathological and diagnostic examina-
tions might be made, and where, also, all sanitary and food
analyses might be done for the benefit of the people. This bill
failed to pass. Each one of you know how important and neces-
sary it is to have such a laboratory and how gladly you would have
taken advantage of having examinations made correctly and ex-
peditiously, if you had had tlie opportunity, and how such exam-
inations would have settled vexatious questions immediately, that
were delayed indefinitely or perhaps were never fully and satis-
factorily settled.

The defeat of this laboratory bill has in no wise discouraged
the State Board of Health. ^ Looking back at the many obstacles
the Board has encountered, we feel that in spite of all, we have
accomplished a great deal, and that good progrees has been made
in establishing in Indiana ^ system of health work and vital
statistics' collection that will compare favorably with other states.
The State Board belie\''es that, tx> accomplish still better results,
it should have a fully equipped laboratory of hygiene, and we
urge each one of you to give your influence and hearty effort in
seeing to it that your members of the next Legislature are in favor
of a laboratory.

These annual meetings of the Health Officers have, heretofore,
been called by the State Board of Health. They have been satis-
factorily successful, but I now believe that their usefulness is es-
tablished and that interest has been created to such an extent that
there may be another way by which even more interest and more
good may be accomplished, and I, therefore, make this suggestion :

I believe the time lias now arrived when you should organize
yourselves into a separate body of your own, to be known, say, as
the Health Officers' Association of Indiana, to which Health
Officers of State, county and city are eligible for membership;
that you should elect your president and officers, issue certificates
of membership, charging such fees as will cover exj)enses, and hold
your meetings at such times and places as you may decide upon.

I believe by organizing this body you can get up more enthu-
siasm and procure a membership that will include almost every
Health Officer in the State, and do an increased amount of good

Digitized by VjOOQIC

29*3

as an independent organization, and wlien it comes to creating a
sentiment for favorable legislation, your power will be much
greater than when acting individually.

I can assure you that the State Board of Health will at all
times give you such assistance as lies within its power, and I
know that your Association will be glad to assist the State Board,
for our object will always be one and the same — ^to promote
good morals, health and happiness, and protect the human race
from unsanitary conditions, disease and death.

PROGR-VM.

First Session—Monday, May 27, 10:00 a. m.

Second Session— Monday, May 27, 2:00 p. m.

Third Session -Monday, May 27, 8:00 p. m.

Foiu'th Session— Tuesday, May 28, 0:(K) a. ni.

Fifth Session-Tuesday, May 28, 2:00 p. m.

The third session, Monday evening, 8:00 p. m., will be given up to a
discussion of Sewage Dlsiwsal and Water Supplies, ('has. Carrol Brown.
Engineer and editor of Municipal Rnginct»rlng, will lead the discussion.
Welcome— Uovernor W. T. I)url)in.
The Aristocracy of Health, by W. J. Fairfield, Anderson.

Discussion.
Mosquitos and Malaria, by Robert Hessler, Tx)gansport.

Discussion.
Recent Experiences with Smallpox, by 11. A. Splcicerman, Muncie.

Discussion.
The Opposition to Sanitation, by Brose T. Home, Blufifton.

Discussion.
Rural Quarantine and Disinfection, by (i. H. (h-ant, Richmond.

Discussion.
Need of Dairy and Milk Inspection In Towns and (Mties, by A. W. Bitting,
Lafayette.

Discussion.
Contagious Disease Out])realvS among School Children; How best to deal
with them; the HeaUh Officers and School Officers, by N. I). Cox,
Si)encer.

Discussion.
The Education and Training of Health Officers, by H. Cowing, Muncie.

Subjects for Discussion.

Quarantine— What is it? How should it be conducted?

Nuisance— What is a nuisance? How shall Health Officers go about
abolishing nuisances?

To what extent, if any, should the State Board of Health be expected
to furnish diagnosis of infectious and contagious diseases?

Digitized by VjOOQIC

294

How should garbage be dispoBed of in towns?

What sanitary control should be exercised over measles and whooping-
cough?

Criticisms and suggestions concerning the present methods of collect-
ing and recording bh*th8, deaths and contagious diseases.

Should the sanitary construction of schoolhouses be regulated by
statute?

ELow about typhoid fever In your Jurisdiction?

What experiences have you had In vaccination?

How about tuberculosis in your Jurisdiction?

Prevention of cholera Infantum.

Drains and sewers and sewage disposal.

Creameries and cheese factories.

Sanitary aspects of cerebro-splnal meningitis.

Farm hygiene.

A laboratory of hygiene for the State. ■

Medical Inspection of schools.

Water supply.

Diphtheria prevention and use of Antitoxin.

Antiseptics in food.

Barber shop sanitation.

How about feeding hogs with slaughterhouse offal?

The President announced the following committees :

On Constitution and By-Laws — Dr. Home, Dr. Powell and

Dr. Charlee L. Wright

On Nominations and Arrangements — ^Dr. John Eoss, Dr. G.

W. Shepard, Red Soy, and Richard Boswell, Winchester.

THE E7DUCATION AND TRAINING OF HEALTH OFFICERS.

DR. H. COWING, MUNOIB.

Mr. President and Gentlemen — I thought at this time that, in-
stead of a set paper, a few commonplace remarks upon the sub-
ject of the education and training of Health Officers would be
timely. The education and training of the Health Officer, I be-
lieve, if we were to elaborate, would cover the entire ground of
discussion which is contemplated here in our meeting.

Professor David Starr Jordan said, recently, that the demand of
today, the great need of today in professional life, is the educated
man and the educated woman. Professor Jordan is an Indiana
product, and is a man of whom we are all proud, although he has
passed to another part of the country. He is at the head of a
great university and is doing a great work. His idea is that the

Digitized by VjOOQIC

295

demand of the hour is for educated, trained men, college men, in
fact. The old idea of college life and college training was to
' round up men and women, and in a general way make their educa-
tion elaborate; but today we train men and women in colleges for
special lines. That is Dr. Jordan's idea. I have a central
thought that I wish to introduce with this introduction.

The Health Officer of today and tomorrow and of the future
must be a man who is educated in a special way for this business.
I believe he must be a physician. The law says that he shall be
a jphysician. He should be trained in hygiene and sanitation. I
do not believe we are doing this work as we should. I believe that
tlie State Board has not, as yet, adequately reminded us of the
amount of work that we are to do and the way we, are to do it, and
the amount of preparation that, is necessary. I think the sug-
gestion of the President is very timely and very proper — that we
organize ourselves into an association, choose a president and
other officers, have meetings and get down to a working basis. We
have seen the need through all these years of more accurate and
more faithful work in these meetings and in our work throughout
the State as Health Boards. The fact is that the average Health
Officer is so occupied by his professional duties that he can only
occasionally give the .Health Office attention, and in many cases
he fails signally to do the work as well as it should be done. I
believe the State Association of Health Officers should take this
work up and in some way solve the problem of a better education
for our membership. I have thought that we should meet here,
which is the most convenient place, at least once a quarter, and
that we should organize as a school wherein we may study all the
vital questions of the day that pertain to the health of the State;
that we may take them up as pupils do. Both old and young
among us should do this, for none of us are too old and none of
us are too young to enter this school. Let us have at this school
men who are able to teach us. None of us are expert in various
lines, and yet we should have expert knowledge in many things
that pertain to the sanitation and the health of the State. If it
be an analysis of water, it is well worth our while to be able to
say to the people in our jurisdiction that this water is good or this
water is bad, without having it sent to the State offices. Or if

Digitized by VjOOQIC

296

information is wanted as to the quality of milk or meat or other
food products, we should be able to say in a technical way to our
people, ''This is good," or "This is bad." The education of the
Health Officer should extend into various lines. We all feel the
need of a higher education in these duties and in our profession
as Health Officers. We liave more and more inquiries coming to
us every year. Tlio public demands a higher order of education
on our part. The average citizen is coming to us constantly with
questions that perplex and sometimes annoy us because we are
unable to give the right answers to them. There are new ques-
tions coming up incident to our conditions of life, which are con-
stantly changing. The eflFect of the pollution of streams by straw-
board and other factories are questions of great moment to us.
They mean a groat deal to the State ; not only to tlie health of the
State, but to the finances of the State. We must meet these ques-
tions fairly and intolligently, and solve them as educated men, not
arbitrarily, but solve them in a way that will be to the greatest
good to the greatest number of citizens.

In our county wo now have many of these perplexing questions
concerning the polhition of streams. Dr. Hurty has visited our
district, and is now with the State Board endeavoring to come to a
correct and satisfactory conclusion as to what to do with the refuse
of strawlx)ard and other factories that are upon the banks of our
streams. Tlie education of the Health Officer should be of a high
order, and sliould l)e technical. We should begin at the bottom
and band oureslves together, form a school and be leil by men who
are competent to teach us, and then through the interchange of
ideas among ourselves, I believe we can accomplish a good deal
toward raising the standard of hygienic education in the State of
Indiana. As it is, wo have gone on from year to year doing the
best we could, and occasionally hearin|i^ a technical paper without
altogether understanding it. Wo must get down to the rudi-
ments and to the technicalities. Of course, we have to be special-
ists to a certain extent. Xo pliysician will be able to do all of
those things, but in a town of any size it can often be divided. The
County Health Officer may be a sjx^cialist in some line, while
the to^^^l Health Officer and his assistants may be able to follow
other lines.

Digitized by VjOOQIC

297

As to the training, I repeat again that the Health Officer must
be an educated man. No Health Officer today can stand before
the peoplp if he be an ignorant man, ignorant of disease or imable
to differentiate between the various conditions of disease. We
often see this cropping out here and there where Health Officers,
by their superior knowledge of disease, are able, by their train-
ing, to determine the character of a disease. I think, as a rule,
the Health Officers of Indiana have conducted themselves very
well in the past two years, especially since the beginning of the pe-
culiar epidemic of smallpox we have had. The mistakes that have
been made have been made largely by men who have had no train-
ing as Health Officers, and by physicians who had never soeu the
disease. The Health Officer who stands well in his community,
whose relations with the physicians of the community are pleas-
ant, who has a good fellowship with them, has at least one of the
qualifications of a trained Health Officer. Unless he has this
qualification he will fail, to a certain extent, in accomplishing all
that he might as a successful Health Officer.

At this first session of our conference it is well worth our while
to consider the matter of the better education and the better train-
ing of Health Officers. I acknowledge my ignorance of health
matters when I see the wonderful amount of literature on this
subject; when I see all of the works that are being sent out by
men of culture and education. It makes me feel how very little
I do know about the subject of hygiene and sanitation, and how
very much I ought to bestir myself and improve myself in order
that I may do what little work I attempt to 5o in a successful man-
ner. I think we can all learn right here in this session to do better
work as Health Officers. I am verv' much interested in this
school of sanitation and hygiene of which I have spoken, and
would like to have you all give it careful consideration.

Dr. Carl Proegler, Fort Wayne : I have Ikm^u very much inter-
ested in what Dr. (^owing has said. Tliere is certainly but verv'
little more to say, because he has covered the ground so thor-
oughly. As far as the education and training of a Health Officer
is concerned, certainly a man who has scientific training and a
man who is a graduate of a good educational institution will, if
he has anything in him, keep up with the times and read up on
eveiything pertaining to his profession.

Digitized by VjOOQIC

298

If I Tinderstand the paper right, the doctor wants us to meet
every three months for a discussion on these subjects. I have no
objection to that, but I do not believe it would be possible for us
to meet every three months in Indianapolis. I believe it would
be possible for us to meet every six months. Hardly enou^ of
us to form a class could come here every three months.

As for the trained Health Officer, especially if he is in a large
city, he should be a trained bacteriologist. I make all the exami-
nations for my own work. I also make examinations of water.
I make examinations for physicians who call on me and ask me to
differentiate between cases of measles and scarlet fever. Making
examinations of water is a field where we are questioned veiy
much. People come to us and ask to have examinations of water
made. A man who is versed in chemical analysis and who has
a little laboratory can do it. But the bulk of the physicians can
not do this. I lately came across a simple water test. It is called
the Heltum test, and is imported by Schering & Glatz, 58 Maiden
Lane, New York, and is the result of experiments by Hugo Erd-
man, of Halle, Germany.

I think the Health Officers of large cities ought to be expert
bacteriologists, and ought to be able to distinguish any of the
diseases that come under their investigation that can be microscop-
ically distinguished. I believe a great many of our Health Offi-
oere are very practical men, and I believe the State of Indiana
has done a great deal of work in the line of health work. As far
as I can learn, I think all physicians and Health Officers have
been very alert. I think if we follow Dr. Cowing's advice and
have concerted action in perfecting ourselves, we can have far bet-
ter service. At the same time we must not lose sight of the fact
that the pay of many of our Health Officers is inadequate. The
county officers must be educated as well as the town officers in
what it is necessary for a good Health Officer to know. When
the next Legislature meets we ought to see that a better compensa-
tion is provided for the Health Officers of the State. You can
not expect a man on a small salary to work as well as a man on a
large salary. In the city of Fort Wayne the city bacteriologist
gets fifteen hundred dollars a year, but he is not allowed to
practice. i ' > ; * , .

Digitized by VjOOQIC

Dr. Powell: I should like to heartily endorse the remarks
made by Dr. Proegler and also by Dr. Cowing. It is certain that
we^ all of us^ have enough to learn about the things that oome un-
der our observation as Health Officers. I think, however, that a
meeting every three months could not be attended by the Health
Officers who have to pay their own expenses. In many of our
counties and cities the authorities are so penurious and so short-
sighted that th-ey refuse to pay the- expenses of the Health Offi-
cers when they attend these meetings and try to get better posted
for their work. This means to the Health Officer, not only the ac-
tual expense of travel, but the loss of practice while he is gone,
for most of us are compelled to depend upon our practice because
we do not receive enough compensation from the counties and
cities for which we labor. Health Officers, as a whole, deserve
better salaries than they receive. On the other hand, the city and
county authorities, having given better salaries, should insist upon
having first-class service. They would have a right to insist on
better service then. The better class of physicians, the educated,
intelligent, up-to-date men, can not afford to bother with the
health offices for the trivial sum that is paid in many places. In
times of stress, when smallpox or some other epidemic breaks out,
the town is practically without a Health Officer. Even the best
of us have enough to learn about these matters. I know that dur-
ing the last year many things have come up about which I found
I was wholly without information. I have endeavored to inform
myself as much as I could, but found many fields of knowledge
yet unexplored.

Dr. Hiirty : I desire to have something to say on the subject
under discussion — ^the education and training of Health Officers.
It is only in recent yeara that medical colleges have established
chairs of hygiene and State medicine. It is only seven years since
the Indiana Medical College established such a chair. There is
also such a chair at the College of Physicians and Surgeons in
this city. You are, of course, aware that we have a school of
Sanitary Science at Purdue University, and it is an institution
we should be proud of. It is magnificently conducted. Professor
Severance Burrage is at the head of this department, and he has
labored nobly and well.

Digitized by VjOOQIC

300

Not long ago the members of the Delaware County Medical
Association resolved to give up one of their meetings to the consid-
eration of the subject of State medicine and hygiene, and there
were one or two members who said it was ridiculous, that every
one knew all about hygiene and sanitation. That was his idea of
the situation. So you see there are some doctors that need edu-
cating, as well as some people. ^

The Bulletin for June, 1900, gave you a very short resume
of tiie course which they give at Purdue University. When one
has completed that course they will find themselves quit^ skillful
in physiological chemistry and in the analysis of foods. It is
quite unlikely that very soon we shall have officers informed in all
of this work, giving their whole time to the work, and doing noth-
ing else. But that time wall come, and not only must those offi-
cers be skilled in this work, but they must be also good diagnosti-
cians of the communicable diseases. They will not be able to con-
centrate themselves upon treatment, nor do they want to do so.
But this is a good way off. Until that time comes we must get
along as best we can with the resources at our command. We have
c(>mmence<l the work here in this State, and, in doing that in In-
diana, we are ahead in that particular of many other States. In
MassachusettvS they have a school of hygiene at the Massachusetts
School of Technology. There is also a school of hygiene connected
with the University of Pennsylvania.

In the reports of the Indiana State Medical Society for 1899
and 1900 you will find a report on. State medicine and hygiene,
and the re])orts in both the years named refer to this very subject,
and speak of more advanced eilucation for Health Officers. You
doubtless have these rejwrts, and you may get good suggestions
from them. Dr. (\>wing's remarks are right to the point. They
are intensely practical, just as Dr. Cowing himself is intensely
practical. If these meetings could take the fonn he has suggested
I think they would be very excellent, and it is possible we may
do it under the new organization which is proposed and which I
hope will he fonned.

Dr. Boswell : I went through the University of Michigan and
took a course in chemical analysis, but I got a bird's-eye view only
of the duties of a Health Officer. But I am willing to go into the

Digitized by VjOOQIC

301

procession, and if I can not keep up with the band wagon, why,
count me out. If I can, I am that much ahead ; I have learned
that much. Tliis is a grand movement, and I am glad it has some
as soon as it has. I did not expect it so soon ; in fact, I did not
expect it in my day, but I knew it would come some time. I want
to give my hearty support to the plan proposed.

On motion Dr. Earp and' Dr. Dodds, Indianapolis, were given
the courtesy of the floor.

Dr. Earp: I desire to thank you for the courtesy you have ex'-
tended me. While Dr. Hurty was speaking the thought occurred
to me that the teaching of chemistry is slighted by the average
medical student. This course was taken up in the early years and
abandoned during the later years of the student's college life.
Furthermore, if the students acquired enough knowledge to per-
form a test in urinary analysis, or if they could write out an equa-
sion of some kind — even the very simplest — and perhaps give an
analysis of water, it was considered all that was necessary for him
to attain. '

The time has arrived when the medical student must consider
— and I say we are all students — that there are other avenues
that are of importance to the practitioner, and tliis is one of them.
This matter is being agitated in all the colleges. The Central Col-
lege of Physicians and Surgeons has had a chair of this character
for fifteen years.

It is a question whether the colleges themselves have originated
this idea, or whether it is not members similar to yourselves in
different organizations that have j>rompted this and made it al-
most compulsory that these medical institutions shall have a chair
or department of this kind. There are State Boards that require
that a college shall have a chair of this kind, otherwise the col-
lege is not recognized by the Board. Therefore, I think Boards
of your kind may take credit to yourselves because you have
shown the medical colleges that it was necessary for Uiem to have
such chairs or departments.

It has been my pleasure in preliminary addresses to take up
the subject of saitary science, and oftentimes I have outlined the
work that has been suggested by Dr. Ilurty, of your Board. The
outline that he has given is the best one I have seen ; therefore.

Digitized by VjOOQIC

302

oftentimes in my classes I have taken up the work of Dr. Hurty
and made suggestions in regard to some- points. I have found this
a help to me, and I believe it has been a help to my classes. I be-
lieve we should be educated more thoroughly in this line of work.
As we become educated more intelligently we can better talk to the
people on this matter.

Another point is, do we practice what we teach? For instance:
As far as the infection of the various diseases are concerned, do
we take the precaution that we require others to take? If we au-
thorize a quarantine in some neighborhood and say that no one
must enter or leave unless they make a thorough change of cloth-
ing, do we follow out that rule ourselves ? If we do not, I believe
it destroys confidence in us and the people feel that there is not
the amount of sincerity there should be on our part I asked a
Health Officer if he changed clothing after visiting cases of small-r
pox, or if he had some special form of apparel. He said, "Oh,
no, I take a wliisk broom and brush off my clothing after I leave
the case." That physician was a prominent Health Officer in this
State. I have a little satchel which is a great deal of trouble to me,
but without which I never visit a case of the kind mentioned. I
have in it disinfectants; I have formaline and a spray, and I have
what is called a sea-grass linen coat which reaches to my feet. I
have a hat that fits closely to my head, and imder no case do I go
to see a case. of smallpox or scarlet fever, or any infectious disease,
except I take these precautions. If we do not take these precau-
tions, it seems to me the people will feel that we are not sincere.
We can aid ourselves and our colleges and associations by praetio-
ing what we teach. I believe that is a matter of education that is
of very great importance.

Is it not also true that we have members of our profession who
do not send in their reports as often as they should ? I refer .to
reports of infectious diseases. If we expect people to follow out
an outline made by us, I believe we ought to show that we our-
selves follow it to the letter. If this be done, it is a matter of edu-
cation.

As far as the education of tlie student in a sanitary sense is con-
cerned, I believe it is all-important. I believe the teachers in the
medical institutions hold an important position, and should not

Digitized by VjOOQIC

303

only instruct the students in the art and science of this character
of work, but endeavor to show the students the importance of
this character of work. If we desire to stamp out infectious
diseases, as we ought to stamp out many of them, by following out
the sanitary rules, as people are now being educated to do, there
will come a time when we will not fear the scourges of various
infectious diseases which now add so much to the fatalities in our
cities.

Dr. Home : I believe the Health Officers of the State of Indi-
ana come up to the average, and that the faults complained of do
not lie so much ^vith the Health Officers as with the people. No
matter how well educated a man is, unless he has a good deal of
backbone to carry out the measures reconmiended, he will not be
a sucess as a B^ealth Officer. As a rule, the Health Officers of In-
diana do their duty ; but in most of the cases where they do not
do it, it is the fault of the people. '

Dr. Dodds, Indianapolis: I am interested in this movement
of a better education for Health Officers. I don't believe we
should hold that the only Health Officers are the doctors who hold
the offices of Health Officers. I think every doctor in Indiana
is a Health Officer. If the Health Officer of a town does not have
the co-operation of his doctor friends he will have a pretty up-hill
business wlien he tries to control an infectious disease that breaks
out in his town. In my immediate neighborhood in this city
nearly every other house has been carded for measles in the last
few months. Some have had very severe attacks, others not so
severe. Some of the cases have not been reported by the doctors.
What can the Health Officers do in such a case? I think there
ought to be a more stringent law which will compel doctors to re-
port their cases of infectious diseases, and which will hold them
responsible for the spread of the diseases. I think that is a 'ques-
tion of importance. If you wish a thing impressed upon the
minds of the laity, the doctors are the people who must perform
that duty, and they must follow out the instructions or rules of
the health boards. '

I think the education of Health Officers should begin in the
common schools. Every man, woman and child ought to be taught
how to take care of themselves, and how to prevent the common

• Digitized by VjOOQIC

304

diseases. Of course, this is chopping our heads off, but they
should recognize that there is more in the prevention than in the
cure. The education of men at the head of institutions and
health departments is necessary, and they sliould have a technical
knowledge of the studies and branches which correspond with this,
and which are in sympathy with itj — chemistry, bacteriology, mi-
croscopy and so on. Microscopy is not a fad. I know that my
microscope has made me more money than my practice, and I also
know that my microscope has made me practice at the same time.
It is not a fad with me at all. We should instruct others and teach
this in the schools — ^teach them that the microscope is the beet in-
strument one can have. It is not a question of a fad, or of crank-
ism, or anything of that kind. It is a business proposition ; people
demand it. I know from experience that this thing is true. The
microscope is not an expensive thing, and it is more valuable than
anything else a man can have in his office. It is not necessary to
have a large instrument for show. Indeed, it is not necessary to
have a very great number of surgical instniments, because the best
work is done with few tools.

I hope the education of the people will be accomplished through
the doctors. Every doctor should feel it his duty and privilege
to instruct the i)eople in the method of sanitary prevention and the
value and benefit which it brings to a community.

Adjournment.

Digitized by VjOOQIC

305

SECOND SESSION.

The second session was called to order at 2 p. m., May 27, by
Dr. Forrest.

The first paper read at this session was: "Contagious Disease
Outbreaks Among School Children; How Best to Deal With
Them; the Health Officers and School Officers."

CONTAGION AMONG SCHOOL CHILDREN.

N. D. COX, M. D.

The genial Autocrat of the Breakfast Table has remarked, in
substance, that all diseases are curable, if only the physician be
called in time ; but he adds that, in many cases, to be in time, the
visit should have been paid to the great-grandparents of the pa-
tient. The Autocrat's thought is so related to my topic that I may
be pardoned for referring to it. When we Health Officers visit
the schoolhouse in an intelligent and effective way, our fingers
certainly touch the pulse of the coming man and woman, and,
through them, we minister to succeeding generations. From the
beginning of our State's history we have been growing up to a
realization of the immense significance of "The Little Red School-
house," as it relates itself to the intellectual and moral status of
our people. We know, in some measure at least, what is its influ-
ence upon the intellectual and moral development of the com-
munity. The idea also grows that this same schoolhouse is some-
how intimately connected with the business prosperity of the peo-
ple— ^that "book larnin,' " onoe a mere acx^mplishment of the few,
has its value in dollars and cents, and may make itself felt in the
growing of crops and in the market places.

Considered as a mere business enterprise, the school easily outr
tops all others. Indirectly every one contributes to it and is a mem-
ber of the corporation. Its capital, its income, and its expenditures
are measured by millions. It has a great organized army of serv-
ants and agents, and the whole realm of childhood and youth is in
its possession. We of middle age have seen a great and intelligent
awakening of public interest in all that pertains to our school sys-
tem, and have had cause to rejoice in its results. We have seen

20-Bd. of Health. ^.g.^.^^^ ^^ GoOgk

306

a thorough revision of the whole scheme of education, a widening of
its scope, a reorganization of its forces, a revolution in its methods,
a concentration and adaptation of its agencies. We have seen sys-
tem evolve out of disorder, and intelligent and specific direction
and purpose take the place of haphazard effort More and more
the public school is enlarging, or seeking to enlarge, its influence
over the man that is to be. About the bare tripod of the three RV
are assembling all the agencies of culture and of intellectual and
moral help. Some of us are old enough to remember when the old
"Deestrict Director" was jealously regarded as a supernumerary,
when the "County Examiner" was gnidged his title and miserable
fee, and when anything like a real assertion of jurisdiction or con-
trol in any material way would have been quickly resented.

But the patience of intelligent and persistent effort has been so
rewarded that we see our whole public proudly rejoicing in the
splendidly equipped system of today.

I have tried to realize the extent and the importance of the offi-
cial trust I assumed in accepting the position of Secretary of a
County Board of Health. Eeflection and experience have led me to
believe that the most interesting and responsible phase of that trust
is the relation in which it brings me to the public schools and the
educational forces in charge of them. If we would teach the laws
of life and health, we must get into contact with the teachable.
We must cleanse the fountains if we would have pure waters. I
am not going to stop to talk to you doctors about the agency of the
school in the dissemination of disease. Nor is it within the topics
assigned to me to discuss their tendencies to produce disease: I
want simply to emphasize the importance of our official functions
so far as they relate to the public school and education, and to make
a few practical suggestions in relation tliereto. I would begin by
stating that we should impress upon ourselves and others that our
office has a real and practical connection with the school system.
It is true that we must, in most instances, find approadi to those
sdiools through the regular school officers ; but as to the matter of
sanitation, our access is more direct, and in the matter of epidemic
and contagious diseases, our authority is plenary. I think that
there is a feeling of apprehension among the thoughtful and ob-
servant, and especially among our own profession, that present

Digitized by VjOOQIC

807

educational efforts tend too exclusively toward the dcYelopment of
fruit and flower at the expense of the root and trunk. We are not
realizing as fully as we might old JuvenaFs prayer for "a sound
mind in a sound body." I am not pessimist enough to believe
that our race is decadent, or even nonprogressive in the matter of
health and longevity, but I feel sure we do not utilize, aa fully as
we might, our educational system as a factor in promoting the
health and strength of our race. We have scarcely yet arrived at
the point where there is a profound and universal conviction that
our schools must not be permitted to contribute to the deteriora-
tion of the health of the pupils and of the community. The educsr
tional idea is so fixed on the gray matter of the brain that the red
corpuscles and the heart beat are scarcely thought of in connection
with child-training at school. The functions of the modem peda-
gogue seem scarcely of kin to those of his ancient prototype. The
modem one is so intent in leading the mind along the paths of
learning that he seems sometimes to have little thought for the
weary and uncared-for body that lags in the race. There is press-
ing need that the educational idea shall continue to expand until
the laws of physical life and health shall find some place in the
school curriculum. It is our duty as Health Officers, and we
should esteem it a privilege as well, to have regard for the physical
well-being of the school population and to become co-laborers with
the educational forces, not only in protecting the community from
the dissemination of disease through the agency of the public
schools, but also in making those schools most helpful agencies in
teaching and enforcing the laws of health.

We shall never be able to make our health laws what they ought
to be to the community until we shall have trained a new genera-
tion and prepared it to receive and administer them.

We have a hint here as to how we shall visit the greatrgrand-
father of the future patient. Our journey will be of necessity
somewhat circuitous. Possibly it will lead us first to the house
of our member of the Legislature. We shall want him to bring
the school trustee, the county superintendent, the teacher and the
Health Officer into closer relation to each other, that each may
better support the other in teaching and enforcing the laws of
health. We shall want to call on the State Superintendent and

Digitized by VjOOQIC

308

State Board of Education and persuade them that nature's laws
relating to physical right living are worthy of companionship with
the laws of mental training and de\'elopment, and that they should
have more conspicuous recognition in the school curriculum. The
examination questions submitted by them to teachers might be none
the less valuable should they test the teacher's capacity to recognize
the foes to his pupil's health and life that may lurk in and about his
schoolroom. I would emphasize this point. If the public school
is to contribute anything to the preservation of public safety from
contagion and epidemic, or anything to the development of a
stronger and healthier race, there must be a beginning point where
public interest shall manifest itself and public authority assert its
purpose. When the school authorities, beginning with the chiefs of
the system, shall take this matter in hand in real earnest and make
the matter of public health distinctively a part of public education,
distinctively a part of the teacher's qualifications and responsibili-
ties, shall bring it into the county institute and the teacher's asso-
ciations, when the law shall compel the trustee to first procure the
Health OflScer's approval of his proposed site and plans for the new
schoolroom or house, for Uie water supply and conveniences, and
when the county superintendent shall stand guard along with the
Health Officer over these laws and regulations our battle with epi-
demic and contagious diseases will already be half won, for we shall
soon have prepared for us a generation that will regard the laws
for the preservation of public health as living statutes ; a genera-
tion that will regard the Health Officer as a beneficent public serv-
ant rather than as a predatory aggressor against private rights for
his personal gain. Our profession has emerged far enough from the
age of charlatitnism and humbug, from pseudo mystery and bla-
tant quackery, that we can afford to t^ke the public into our confi-
dence. Why should the simple A, B, C's of the physician's lore be
a sealed book to the public at large? Does nature maintain her
signal service for the profession alone ? Shall her danger signals
remain as if flashed in cipher language of which only the physician
holds tlie key ? Why should not all those who have the guardian-
ship of precious lives be made sufficiently acquainted with these
signals that they may diitinguish health from disease — that they
may at least know how and when to protect the whole flock from
the contagion of one member i

Digitized by VjOOQIC

309

I do not know why the simple manual, descriptive of the
symptoms of the ordinary communicable diseases which are apt
to assail our schools, might not form part of every teacher's stock
in trade and might not so instruct such teacher as to make him
a much more eifective protector of the health of the school and
of the public. We might not demand that the teacher shall be
able to distinguish between pemphigus and smallpox, but there
are certain broad symptoms that attend every ex)mm'unicable dis-
ease which are easily recognizable, and, while they may be com-
mon to other ailments also, still their presence should signal possi-
ble danger and the teacher should have such knowledge as to be
warned thereby. The County Health Officer should seek to form a
very close alliance with the county superintendent, the school trus-
tees and the teaching forces of his county. Without their aid and
sympathy, the schools will become a menace and hindrance to him
in the prosecution of his duties. Without the intelligent co-opera-
tion of the trustees in locating, building and equipping ' school-
houses, we may find sure provision for ill-health and contagion laid
in the very foundation of the school building and developed
throughout its whole plan. I have experienced serious trouble at
this point from officers whose views were fixed and stiffened before
sanitary science had invaded the field of their training. They re-
sented my interference with tlie plans of proposed school buildings
as an impertinent and unwarranted intrusion in matters that did
not concern me. It is this sort of experience that leads me to think
that our sanitary regulations so far as defined by public statute,
should find distinct recognition in the statutes regulating the du-
ties of every class of officers required to co-operat-e with the Health
Officer. If the laws relating to the building and fitting up of
schoolhoiises were so framed as to compel the officers having that
duty in charge to consult with the Health Officer and conform to
his directions in the matter of sanitation, there would he much less
room for jealousy and conflict. •

It is widely known that w^e had a serious invasion of smallpox in
the western portion of Owen County during the fall, winter and
early spring montlis about a year ago. The disease was central at
Clay City, a few miles from our western border, ami entered our
county at different points. For a while the situation was alarming

Digitized by VjOOQIC

810

to all who really understood it; all the more so because the type of
the disease was mild and dealt so leniently with the majority of
those attacked that the public fear was not sufficiently aroused to
stir the people up to vigorous and active resistance. It did oauae
a number of deaths, and other cases which recovered assumed se-
rious and alarming features. Had only these very serious cases
occurred, there would have been little difficulty in securing united
effort to suppress it, but the added multitude of milder cases
seemed to arch in front of graver ones and to quiet apprehensions
of danger. Certain ones of our own profession aided its progress
by giving it a certificate of good character and turning it loose to
roam at will. In certain quarters it was a matter of serious debate
whether it was the disease or Drs. Brayton, Hurty and the local
Health Officers that ought to be quarantined. It was fortunate
for our people that the character of the disease had become pretty
well understood before it broke into our county and that the mind
of the general public, had been prepared to resist it. The Health
Officers met it with all the diligence and vigor we could command,
and our medical men, school officers and teachers rendered all pos-
sible assistance. I utilized very successfully two cases which were
among the first that occurred. They were of severe type and repul-
sive in appearanca I caused photographs of them to be taken and
placed the pictures in public places to serve as object lessons. The
average layman who saw them was as well prepared as his family
doctor to judge of the value of a lecture on Cuban itch and pem-
phigus, as a contribution for the relief of the situation. The dis-
ease did not get into the schools, for we met it at the outer and
safer lines of defense, and did not suffer it to approach them. I
put myself in communication with the county superintendent,
trustees, teachers and schools themselves, physicians, postmasters^
and merchants, and through these various sources tried to bring the
whole of the threatened district under close and constant supervis-
ion. It was thus that I was reminded how important an aid the
teacher and his school may become to the Health Officer, for
through them I could gather up every rumor of danger. The vac-
cination of pupils was enforced and a rigid exclusion and quaran-
tine of all who had been exposed. The Health Board also gave the
matter of public assemblies their attention, and, as a rule, found

Digitized by VjOOQIC

311

the people ready to conform to requests or directions in this regard.
It was by such means as these that we dealt with the matter
of closing of schools during our epidemic. By great vigilance we
closed out the disease and kept open the schools. We used the
privilege of continuing the school as the incentive to all who were
interested in it to join in the fight against the enemy.

As to this matter of quarantine, I would pause to add this:
All of us who have been called on to attempt it have experienced
the difficulties of enforcing it and the hardships that attend it It
places the whole family in most irksome isolation and affects all
others who, for any cause, would visit them. It takes the bread
winners from their employment and often cuts off eveiy source
of income. It threatens the loss of employment for the future or
it may very seriously affect a business enterprise or investment.
All these matters demand serious consideration in connection with
the proposition to establish it, but they must all yield to the neces-
sity of preventing the spread of contagion. It, at the best, is a
serious misfortune to the persons affected, but it is a misfortune
that can and should be largely shared and alleviated by the com-
munity at large. We should insist that provision be made by such
community for thus sharing it as far as possible. The family quar-
antined are the prisoner guests of the public and should be sup-
ported while thus in custody and every attention to their -comfort,
possible to be given them, should be cheerfully extended. This is
not difficult to effect if the Health Officer will but summons pru-
dence and tact to aid him, and it is only by such reciprocal sac-
rifices on the part of the community and the prisoners that a quar-
antine can be made effective. I might add that a community
which will not thus bear its portion of the burden does not deserve
protection except for the merit of the innocent ones in their midst.

The invasion of smallpox above referred to found us in a situa-
tion not always prevalent. We knew the enemy was approaching
and would soon be in our midst. We had time to prepare for him.
We immediately rallied about the public schools, the church as-
semblies, the public funerals, all the places and occasions that as-
sembled the people together. We prevented some such assemblies,
we conditioned others, we made the schools our allies instead of
allowing their capture and enlistment in the opposing ranks. We

Digitized by VjOOQIC

312

could not suppress all the fools and we did not kill any of them,
but their influence became quarantined by a wall of ridicule, w^hich,
as occasion provoked, assumed the aspect of menace and warning.

But these epidemics do sometimes get into the schools and per-
plexing conditions arise. I can no more advise how to treat those
conditions than I can tell you how to treat your future patient who
is yet in perfect health. The one thing that the Health Officer
should impress upon his mind and conscience is that the scliool
thus attacked is his patient, a patient that the law^ turns over to
his charge and for which he is reeponsible. The notice that con-
tagion is there should bo treated as an emergency summons and
met with the promptest response. A conference should be had
at once with the teacher, the trustee and the most intelligent of
the patrons. From these he should learn the whole situation, and
not forgetting that his decision must govern, the officer will so
direct his consultation that such decision shall be based on the
soundest reason and, if possible, shall commend itself to the ap-
proval and hearty support of all. There should l>e no hesitation
as to the suspension of the school if it shall seem probable that
such a course will ultimately prove nece8sar5^ The keynote of
success is promptness and vigor at the start. '

I do not regard such a visitation as smallpox as the scourge
most to be dreaded by the Health Officer, especially if it shall pre-
sent itself in its more rugged aspect It is the soft-footed and half-
domesticated beast — such as measles, whooping-oough, scarlet
fever, diphtheria, etc., that is most to he feared. Tliey are such
old-time and familiar visitors that the>^ seem almost to have estab-
lished a prescriptive right to sojourn with us fnnn time to time.
As to the first two, measles and whooping-cough, the old-time coun-
try school was expected to distribute them through the neighbor-
homl just as it did the itch and the variegated samples of head lice.
They seem yet in many localities to l)e regarded as foreordained
experiences on the road from childhood to maturity, a kind of
physical disturbance as natural and necessary as those incidental
to teething. T am amazed sometimes at the density of the stupidity
I meet with in connection wnth these old-time contagions and no
less so as to the quarters where I find this stupidity intrenched. So
fixed is tlie idea that everj- one is fated, at some time in life, to

Digitized by VjOOQIC

313

ejdiaust tliis catalogue o£ maladies, that we can induce no sort of
care to avoid them. As well talk about quarantining against the
processions of the seasons. Instead of heeding the instruetiona of
the physicians as to how they may be avoided, folk lore is resorted
to to determine what season of the year and when "the sign is
right" for contracting them with least danger and inconvenience.
It would surjirise the inexperienced to learn with what promptness
and fierceness the interference of the Health Officer is often met
in cases of tliis kind. Only a few weeks ago I learned that an
epidemic of measles was in progress in a certain part of my county.
I had on file at my office the official rei)orts of twenty cases then
in progress there and had ^liable infonnation of several cases not
then officially reported.

I learned that a young lady lay at tlie point of death with it (she
died next day), and that a neighboring lady of average intelligence
was proposing to send her child over there that it might catch the
disease. Humanity and official obligation prompted me to call the
lady to the 'phone and to suggest to her the danger and respon-
sibility she was about to risk. The quick and blazing response 1
received made my 'phone feel like a live wire. A good neighbor
lady on the same line whose ear happened! to pick our controversy
off the wire, joined in the chorus and I — ^fle<l. I had learned
though that that crop of measles was the common property of that
neighborhood and that these families had determined to have their
share of it Ix^fore the supply was exhausted witliout regard to con-
sequences. I reported the facts to the State Health Officer and they
got into print The next week an anon\Tnous writer assailed me
through the neighboring paper as a slanderer, a meddler and liar,
and offered to prove by die same doctors whose certificates I had
on file that there was no such malady in tlie neighl)orhood.

Do you ask, "What can the Health Officer do, where such a dis-
ease invader the school in a neighborhood like this ?" He can only
strike at the symptoms — for the malady is located outaide the
schoolroom and in the minds of the parents.

Quarantine and the prosecuting attorney may aid, but perver-
sity will prevail when backed by the approval of the community.
The real remedy is an educational one. We must break down the
fixed and false conviction tliat every child is foredoomed to have

Digitized by VjOOQIC

314

these diseases. We must make it thoroughly understood that there
is no more excuse for having these diseases widely prevalent than
there is for having smallpox a universal scourge. Could these
good people be made to know that there are communities without
number where these maladies are ahnost as rare as smallpox, where
nine-tenths or more of the people live and die without ever con-
tracting them simply by observing a degree of prudence not at all
onerous, we will have established the beginning of reform. We
can't make people quarantine against death from senile decay.
People solicit the approach of these diseases to their children sim-
ply because they regard them as inevitable and think the period
of youth is the safest period to encounter them, and when death
or other serious consequence follows, they resignedly accept it as
unavoidable, a dispensation of Divine Providence, a natural death.

Following our instruction that these diseases can be avoided, we
should strive to make the people understand how very serious they
are. If some velvet-footed animal were stealing through our State
year after year marking his path by thousands of oases of sick-
ness, more or less severe and protracted, by large expense for medi-
cal aid, by anxious hearts of parents, by loss of time to the la-
borer, by interruption of schools and business, by hundreds of
bright eyes destroyed or dimmed, by hundreds of quick ears
ruined or dulled, by the prophetic hectic on scores of cheeks, by
the hollow cough telling of the fatal wound, by about 500 fresh
graves every year, our help would not be needed to drive the
whole people into arms against the marauder. But such is the
annual record that measles is writing against itself in our com-
monwealth. And yet fond and foolish mothers coddle and toy
with this malignant beast and invite it to become their guest.

We have been clothed with some measure of oflScial authority to
battle against diseases like this lor the life and health of our
fellowmen. I have tried to be diligent and faithful in the exer-
cise of this trust But as often as I have been called to meet these
scourges the autcxjrat's aphorism comes back to me. My visita-
tion is too late. Some one, alive to duty and opportunity, should
have been sent to the grandfathers and grandmothers of the chil-
dren of the present day to teach them that all these pests are
largely subject to the dominion of man and that man himself,
lii most cases, is responsible for them. I am more and more im-

Digitized by VjOOQIC

315

pressed with the belief that the burden oi this fight against them
must be borne, not by our profession, but by the educational
forces of the country, and I include in those forces, not the schools
alone, but the press, the pulpit, the rostrum, all the agencies for
the dissemination of knowledge. Ours is the surgical and relief
coiT)s which gathers up the wounded, ours is the pioneer corps
that pilots the way, but teaching, teaching, teaching is the need
of the hour. Until the teaching forces are made to realize that
the laws that send the blood through the body, and the air through
the lungs are from the same source that sends the planets
around the sun and speaks redemption to a soul, and fully as
worthy of study and application, the war against these diseases
will continue to be a series of guerrilla skirmishes. I do not un»
derestimate the importance of the office which we hold, nor the
beneficence of the statutes which assign our duties, they are al-
ready excellent and productive of a rich return to the public;
they will be still further improved and enlarged, but I feel that
the step to be taken which is now most important is the bringing
of at least the elements of sanitary science into our system of
school laws. I do not forget that we have text-books on anatomy,
physiology and hygiene, which some of the pupils reach and study
if they hang on long enough. But the A, B, C of personal habit
has been acquired and fixed before that period is reached and
the lore of these text-books bears much the relation to personal
guidance and training that geography has to the raising of crops.
Bat in addition to the instruction of pupils in the laws of health
and their training as to bodily habits, I would have the whole edu-
cational force charged with the duty of co-operating with Health
Officers in the performance of all such of their functions as are
conni?cted with public schools. I would put the physical man in
evidence in these schools much more conspicuously than he is
today. The laboring forces of the future might have less to
forget about Plato and his Republic, but they would have a better
equipment of muscles and rear a healthier brood of children, and
even the future scholar would carry a better body and more capa-
ble brain into the fields of higher learning.

The removal of the predisposition to disease is the most thorough-
going way of making all infectious disease impossible, and in this
direction much practical advance has been made. It seems to me

Digitized by VjOOQIC

316

indeed that in demanding full consideration for this question,, hy-
giene carries within itself a powerful educative force for social
healthfulness, the significance of which the future hygiene of the
race can perhaps hardly be divined. This force, however, can
make itself felt only through a general sanitary education, and
this education must begin at home and continue through the com-
mon schools. Our educated youth, instead of fuddling themselves
and killing time in smoky rooms with foul air and but little sun-
shine, would do better to develop the body by strong gymnastic
sports and atliletic games. I am glad to notice that our educators
generally are encouraging manly physical exercise in athletic
games. Our colleges and universities are doing a great deal toward
developing a stronger and healthier race.

Gentlemen, if you have suffered your expectation to be guided by
our printed program, I feel sure I have disappointed you by the
manner in which I have treated tlie topic assigned to me, but I
have tried to cruise within signal distance of the general subject
suggested by tlie text. I realize that what I have said might have
appeared fully as relevant had my name been printed under any
one of se\'eral other themes printed on the same program. But,
like yourselves, I am but a laboi-er in the outlying provinces. In
preparing this paper, I have simply cried out from the midst of
my environments and difficulticns and tried to voice some of the
more important suggestions, those environments forced to my at-
tention.

I have scarcely referre<l to some of the points suggested by the
program for my use, knowing tliat I could not aid a body of medi-
cal men, learned in their profession, by dealing Arith them. I have
tried to reach the public outside, to which we must all appeal for
help, and in some offwtive way, before we can accomplish what
we ought toward making this great commonwealth, which God has
so blessed, the kind of abiding place He would have it be.

Spencer, May 7, 1900.

Digitized by VjOOQIC

317

DISOUSSION.

Dr. Hurty : I want to inform the officers present what we tried
to do in the matter of sanitary schoolhouses in the last L^islature.
Mr. Jones, the Superintendent of Public InstnictioUj went among
the legislators and found among them two men who were school
teachers, and he brought them to my office. We worked together
to get a statute framed that would require that hereafter all school-
houses to be built should conform to the requirements of the
statute, which was known as House Bill 455, and was introduced
by Mr. O. G. Davis, of Wayne County.

I want to call your attention to the excellencies of this bill, and
yet it received, after full exposition, blit nine votes in the Ilbuse
of Eepresentatives. A man who is an editor in this State, a man
who had been a reporter on the great Courier-Journal, arose and
talked about the foolishness of microbes, the nonsense of trans-
missable diseases, etc., until he talked that bill to death. There is
a lesson for us. We must not get out of patience, or get angry
with that poor fellow. Not at all. He is to be pitied. He does
not know and does not understand ; and, as we all know, ignor-
ance is the only sin. *

Professor Kendall, Superintendent of the City Schools, took
the bill before the high school teachers and the principals of tlie
Indianapolis schools, and they went over it and endorsed every
word in it. You see it was pretty well considered, for besides, it
was submitted to the Superintendent of the State.

Those who have listened to the reading of the bill will, I am
confident, say if it had been passed that in the next ten years the
number of short graves in Indiana would be greatly lessened, and
the number of cases of consumption, pneumonia and diseases of
the air passages would be lessened also. Each requirement in the
bill is in accordance witli well known sanitary laws; and it was
simply intended to save money' for the people, to save them from
disease and unnecessary deaths, and in that way promote the
general happiness. Yet the bill received nine votes in the General
Assembly of the State of Indiana ! I tell you, gentlemen, we have
a great deal of educating before us.

The health law says that the State Board of Health shall have
the power to regulate and prescribe the ventilation, the plumbing.

Digitized by VjOOQIC

318

the heating and other sanitary conditions in all public buildings.
You may say, "what is the use of this bill if the State Board of
Health has that power?" It has that power and can exercise it
and execute it through the courts. Here is the trouble with the
State Board enforcing that law. Each schoolhouse has to be fought
out by itself under the State Board of Health rules. We have to
find out the location of the schoolhouse, we have to serve the notice
on the trustees who are having that schoolhouse built, and then
follow them up and see that the orders are carried out. Gentle-
men, that is a prodigious job! We have 1,013 townships in this
State, and the State Board has only a small appropriation, $6,000,
fordoing all its work, and $6,000 would not do the work alone of
looking after the sanitary construction of schoolhouses. Now, note
that this law would have enforced itself. Why? Because con-
tractors could not build schoolhouses and have valid claims unless
the buildings were sanitary. That law would have brought every
set of plans into the central office for approval. The question was
asked: Why not submit the plans to the local Health Officers?
That would do all right in a majority of the counties in the State;
but you all know that there counties where it would not work at
all, because among us are some men who do not know a single thing
about those matters. Then the local officers may be changed every
four years. The best way is to provide for sending the plans to the
central office where proper attention can be given to it. You offi-
cers do not give your whole time to this work, and it would impose
a burden upon you. The plans of every schoolhouse would have
to be approved before the claims of the contractor would be valid.
I hope some one mil introduce a resolution showing that this bill
receives the endorsement of this body, and tliat it is heartily rec-
ommended to the next T^egislature, and it will certainly come in
time.

Dr. Kennedy, of Morgan County : The paper read by Dr. Cox
is so good, and the remarks made by Dr. Hurty were so appro-
priate, that there is not much left to be said on the subject I can
not, however, refrain from saying a few words. I live in a town
of 600 inhabitants. It has been incorporated for three years.
About the time it was incorporated our schoolhouse was burned
down — a circumstance which was not altogether a misfortune. The
old building was too small and was built close to a railroad. The

Digitized by VjOOQIC

319

new building is built very nearly like the plans laid down in the
bill read by Dr. Hurty. I was consulted as to the building, and I
advised the employment of a good architect A firm of architects
who furnish plans and specifications for such buildings were con-
sulted. The result is a school building after the plan laid down in
the bill. The building is a credit to the little town. I have directed
teachers as to the proper admission of light^ and as to'the examina-
tion as to the eyes of the children. I advised the employment of
a good oculist or optician, and that the children with defective
vision should be fitted with proper glasses that they mi^t not
permanently injure their sight On my visits to other neighbor-
hoods I have noticed school girls with spinal curvatures. A good
deal of this is caused by improper positions at their desks. I have
advised the teachers to watch for this sort of thing and to correct it.
I think all of you who have anything to do with the schools should
instruct the teachers to notice carefully the position the girls take
at their desks.

In relation to the prevention of contagious disease. I have been
•successful in preventing the spread of diseases in our village. I
have been able to do it easily, because I have secured the confidence
of the people. I have also the friendship of all the doctors in the
vicinity. It is more our duty to prevent disease than to cure
disease. '

On motion of Dr. Proegler each person present was limited to
five minutes for the discussion of any paper.

Dr. Benoe : I have a resolution or two I would like to introduce.
Among the older Health Officers who have been accustomed to meet
here in the past years we have always observed a vacant chair. It
is painful to me to come here and miss Dr. Hibberd. He has been
a Health Officer continuously from the organization of the Health
Board until this year. Now his limbs fail to do their duty. I
think Dr. Hibberd is about eighly-seven years old. His mind is
as clear as it ever was, but his feet refuse to carry his body. He is
at home to-day, but he is thinking of us.

I move you that this conference adopt a resolution and send it
to Dr. Hibberd. I offer the following:

"Resolved, That the Eleventh Annual Conference of Health

Digitized by VjOOQIC

320

Officers send greetings to Dr. J. F. Hibberd, of Richmond, the
!JTestor of scientific medicine and sanitation in Indiana/'

The resolution was adopted and the Secretary was instructed to
send the message to Dr. Hibberd at his home in Richmond, Ind.

The following resolution was offered by Dr. Bence :

Resolved, iTiat this Conference of Health Officers heartily en-
dorse the late House Bill No. 455, that met so untimely a death
in the last Legislature, and would recommend it to the next Legis-
lature for passage, believing it is in the interest of the school chil-
dren of the State, and we pledge our influence to secure its passage
when introduced.

On motion the resolution was adopted.

The Committee on Nomination of Officers for a permanent or-
ganization reported as follows:

We, your Oommittee appointed for the purpose of presenting three
names as permanent officers of the organization for the year, beg leave
to present the fololwing:

Ist. President, Dr. Brose S. Home, of Bluff ton.
2d. Vice-President, Dr. N. D. Cox, of Spencer.
3d. Secretary, Dr. A. B. Powell, of Marion.
4th. Treasurer, Dr. H. A. Cowing, of Muncie.

5th. We recommend that the first meeting of the permanent organiza-
tion meet at Indianapolis, Ind., on the last Monday and Tuesday of May,
1901.

Respectfully submitted,

J. G. ROSS,

R. BOSWORTH,

G. W. SHEPHERD,

Committee.

On motion the report of the committee was adopted as read.

The Committee on Constitution and By-Laws reported as
follows :

Digitized by VjOOQIC

321

CONSTITUTION OF THE INDIANA HEALTH
OFFICERS' ASSOCIATION.

ARTICLE I,

NAME.

The name and titlo of this organization shall he the Indiana Health
Officers* Association.

ARTICLE IL

OBJECT.

The object of this organization shall be the advancement of sanitary
science; the protection of the interests of its members; the extension of
the bounds of medical science, and the promotion of all measures adapted
to the preservation of public health and the prevention of disease.

ARTICLE III.

Section 1. Any Health Officer, or deputy, who is in good moral and
professional standing with the Indiana State Board of Health, upon sign-
ing the constitution and paying $1.00 to the Treasurer, shall be entitled
to full membership in this organization, and shall receive a certificate Of
membership.

Sec. 2. Each meml)er of the State Board of Health is hereby declared
a member of this organization.

ARTICLE IV.

OFFICERS.

Section 1. The officers of this Association shall be a President, Vice-
President, Secretary and Treasurer.

Sec. 2. Each officer shall be elected by a majority of all the members
present, at the annual meeting, and serve one year from the date of such
election, or until their successors are elected.

Sec. 3. In case of the death or retirement of any officer of this Asso-
ciation, the vacancy so created may be tilled by the appointment of a suc-
cessor, by the President of the Association, to fill the unexpired term.

ARTICLE V.

DUTIES OF OFFICERS.

Section 1. The President shall preside over the meetings, preserve
order, and perform all such other duties as custom and parliamentary
usage may require; he shall have power to appoint all committees.

Sec. 2. The Vice-President shall perform all the duties of the Presi-
dent in his absence.

Sec. 3. The Secretary shall keep correct minutes of the proceedings
of the Association, and when approved, shall fairly transcril)e them into

21-Bd. of Health.

/Google

Digitized by VnOOQ I

322

a book kept for that purpose. He shall have charge of all papers, books
and records belonging to the Association, excepting such as may belong to
other officers and give notice of meetings of the Association. The Secre-
tary shall be vested with power to purchase all books stationery and neces-
sary supplies required for the proper transaction of all the business of this
Association, and shall certify said bills to the Treasurer, who shall pay
the amount required upon the presentation of said bills.

Sec. 4. The Treasurer shall give bond in the sum of $500, with good
and sufficient security, or such further amount as the Association shali
require, and shall collect all moneys belonging to the Association and dis-
burse them as may l>e directed by the Association. At each annual meet-
ing he shall file an itemized report, giving the condition of the treasury.

ARTICLE VI.

QUORUM AND AMENDMENTS.

Section 1. Two-thirds of the members present at any meeting of the
Association, after the Secretary has issued written notice to all the mem-
bers thereof one week previously, stating in full all amendments proposed,
shall be competent to alter or amend this constitution.

Sec. 2. Ten members shall constitute a <iuorum to do any business,
except alter or amend the constitution.

ARTICLE VII.

POWERS AND DUTIES.

Section 1. The Association sliall have full power to adopt such meas-
ures as may be deemed most efficient for mutual improvement, for ex-
citing a spirit of emulation, for the dissemination of useful knowledge,
for promoting friendly intercourse among its members, and for the ad-
vancement of sanitary science.

Sec. 2. It shall have power to raise money, from its members, for the
pun>ose of securing its objects, by a tax, which shall not exceed $5 an-
nually on each member.

Sec. 3. It shall have power to adopt a seal for the use of the Associa-
tion.

Sec. 4. It shall hold at least one meeting each yesir, the meeting place
to be decided upon by vote of the Association, at each previous meeting.

ARTICLE VIII.

Every proposal for altering or amending this constitution shall be
made* in writing, and tiled with the Secretary at least ten days before the
meeting at which such amendments shall l)e considered.

ARTICLE IX.

PLEDGE.

In order the more effectually to secure the object of this Association,
we, who hereunto subscribe our names, do agree with, and to each other,
that we win faithfully observe all the requirements of the constitution,
and do all In our power to promote the interests of sanitary science.

/Google

Digitized by VnOOQ I

323
ARTICLE X.

HONORARY MEMBERS.

Anj' person distiugnished for his attainments, members of Boards of
Health, or ex-Health Officers, who are in good standing with the State
Hoard of Health, can be elected as Honorary Members of this Association
by a vote of majority present at any meeting, and upon being elected, said
Honorary Members are entitled to take part in the meetings.

ARTICLE XI.

Section 1. It shall l>o the duty of the Secretary of this Association,
sixty days prior to the annual meeting, to drop from the list of members
the names of all members who have not at such time paid all dues to this
Association.

Sec. 2. All applications for membership in this Association shall be
handed to the Secretary and read to the Association for action.

ARTICLE XII.

SEAL.

The seal of the Indiana Health Officers' Association shall consist of,
«nd be similar to, that now in use by the State Board of Health, except
that the words in the margin reading "Indiana State Board of Health,
Instituted November .^. 1881," shall be changed to read "Indiana Health
Officers' Association, instituted May 27, 1901."

BY-LAWS.

1. Calling Association to order.

The President or Vice-President shall call the meeting to or-
der, or in case of their absence, a chairman shall be appointed
pro teni. for the purpose.

ORDKR OF BUSINESS.

2. Roll.

The Secretary shall Call the roll,
li. Minutes.

The minutes of the previous meeting shall be read and approved.

4. New Business.

Receiving applications for memliership, and members, and intro-
ducing visitors, etc.

5. Reports of Committees.
(), President's address.

7. Presentation of subjects for discussion,

8. Election of officers.

9. Unfinished business considered.
10. Adjournment.

A recess of twenty minutes was taken to allow the members of
the Conference to call on Governor Durbin in his oflSce^.^ by GoOqIc

324

The session was reconvened at 4 p. m., and the following paper
presented :

THE ARISTOCRACY OF HEALTH.

BY W. J. FAIRFIELD, M. D., ANDERSON, IND.

It is generally recognized that national, state, county and mu-
nicipal Health Boards render invaluable service in restricting and
preventing epidemic and epidemic diseases. It is they who enforce
quarantine laws, and such controlling measures and hygienic regu-
lations as to l>e8t protect and promote public health.

But, looked at from one standpoint, it is doubtful if this public
health work l)e in tlie l)est interest of the race. It protects the weak
at tlie expense of the strong, by extending the life of the frail and
sickly — those who, with hereditarily defective and depraved sys-
tems would othenvise die early, under the operation of the inex-
orable law of natural selection. These weak, lower types of the
race, with their tenure of life extended, mingle and intermarry
with the strong; and thus the individual longevity of the strong is
materially decrease<l. And so, as foretold of old, "the race is not
to the swift, nor Uie battle to the strong." Tlie law of natural
selection is a weeding out process to grow and produce the best.
But the genius of Christian civilization demands the uplift of the
fallen, champions the cause of the weak, and puts in operation
through its law of humane control, public sanitary forces, which,
controverting nature's weeding-out motliwl, safeguard the w^eak,
and in a sense, leave the strong to look out for themselves. But
what would you —

*\Spiirn thou the weak, the Eternal is thy foe.
If that thou hast the gift of strength, then Isnow
Thy part is to upHft the trodden low."

It is not the province of this paper to enter into any lengthy
discussion along these line«^, but enough may ho granted to raise the
serious (nu^stion, is not, therefore, our race stock deteriorating? At
first tliought tliis question may appear absurd in view of the fact
that the average length of life has l)een doubled within the last two
luin(lre<l years. But when we remember that this increase of the
average age of man is not from extending the span of the strong
and vigorous, the representative type-form of the race so much as

Digitized by VjOOQIC

325

iif the weak and lopping branches of the life tree, we can readily see
that the question is most pertinent.

If the normal type-form of the race is pathological with more or
less organic derangement, then the question must be answered in
the negative.

If the normal type-form of the race is physiological, all the
organs being perfect in structure and function, then the question
must \)e answered in the affirmative.

If our increased average longevity were the combined result of
increasing the number of aged people, and of extending the years
of the puny and degenerate, we could come to no other couclusibn
than tliat the constitutional vigor and vital capacity of the race
were increasing, or rather were being less fettered. This would
mean that the weak and the strong alike were afforded better and
inci-casing opportunities for living.

But public sanitation in its results does not balance up to this
proposition, does not show equally well for both tJie strong and the
weak. While it is lengthening the life line to the weak, it is at the
same time, shortening it to the strong. A review of its work thus
far does not encourage the writer to expect, that, without a broaden-
ing of its methods, there will be very much farther increase in
the average length of life. In fact, the increasing number of
degenerates, criminals and constitutionally tainted which statistics
reveal, and the increase of chronic diseases due to overwork, fast
living, feminine and effeminate indolence on easy street, pernicious
narcotic habits and over-indulgence in various ways, make a for-
midable force working to shorten life, and filling uswith foreboding
that our present average life of 42 years will not be maintained.

Sanitary science must introduce into its legal lines of work re-
strictive and prohibitory marriage laws. This much counterbal-
ancing protection is due to the strong — is imperative for the general
welfare.

If man^wore not the paragon of all animals, the ruler of himself,
if over him were placed a higher order of material life, his stock
might be improved in much the same way that we improve our do-
mestic animals. The science of domestic animal breeding and cul-
ture has l)een so rapidly developed within the last fifty years as to
be almost an exact science. Through its application different types

Digitized by VjOOQIC

326

of animals may be produced almost at will, to meet the require-
ments of man, the master.

Human life, however, above all sordid barter and slavery, is
placed upon the high plane of equality and liberty ; and the problem
of its uplift must be worked out, not for the weak alone, nor for the
strong alone, but for each and every individual regardless of his
status in the scale of life.

The first and greatest leader in this work was Moees. He stands
unique in history as the great master sanitarian of the ages. Broad
and comprehensive, he saw the whole need of a down-trodden,
degraded race, and with marvelous skill and wisdom, he taught and
trained the Israelitish host to become the greatest sanitary nation
of the world.

Xo doubt the Jews, when delivered from Egyptian bondage, had
many weak and puny in their ranks; but by the wise application
of l)oth public and individual hygiene, deteriorating forces were
checked and the natural powers of life restored ; thereby affording
at the end of 40 years the greatest exhibit of the rational, scientific
healing of a nation that has ever been recorded.

The sanitary code of Moses, a recognized model even to the pres-
ent day, included minute instruction about diet, cleanliness, cloth-
ing, domestic sanitation, disinfection, quarantine and marriage.
This wholesome and enforced hygienic regime, the training
in morality and religious principles, the out-of-door life,
the marching and counter-marching under the wisest and
greatest drill master the world has ever produced, led this semi-
barbarous people up to the level of a godly race where there was
not a feeble one among them. And Moses, what a splendid speci-
men of manhood, 120 years old, athletic, eyes undimmed, and all of
his natural forces unabated. And what a splendid, full, rounded,
complete gospel of deliverance he taught and demonstrated, re-
deeming from physical as well as moral degeneracy.

The crying need of to-day is for the forceful preaching of this
physical wholc-nian-salvation gospel. We turn to the churches,
hut the churches, devoting their time t<o catechisms and creeds,
staiue<l glass and st(H?ples, cults and fashions, overlooking the
broad, necessaiy, every-day, humanitarian and sanitary principles
of Christianity, what can they do?

Digitized by VjOOQIC

327

The gospel as it is preached to-day is not saving us. The gospel
wagon, equipped with a preacher and a choir of sweet singers, goes
through the streets of slum-town to spread the gospel, but it is a
one-legged, a blue-sky affair. Slum-town needs a bread-and-butter,
a bath-tub and scrubbing gospel, an industrial school gospel, to
teach them how to work, to teach them good habits and the best way
to live. The sanitary plumb line must be made to strike the land-
lords so that they will build proper tenement houses. We may
ring the curfew bell, but what about the children who are driven
from the street into a worse place, called home?

With slum-town on the increase, with insanity, idiocy, disease
and crime on the increase, can the churbh consistently preach the
near approach of the millennium? There were 10,000 murders
committed in the United States in 1896, 1 to 7,000, a greater aver-
age than heathen countries give.

Disease and piety have no natural association. Sickliness is not
saintliness, nor a symptom of an approaching epidemic of godli-
ness. A bilious attack is not a conversion. A face reflecting the
blues from an indigestion does not reflect religion. The so-called
saints of the middle ages debased the body, never combed nor cut
their hair, nor trimmed their finger nails, never bathed, and never
renewed their clothes except with patches. This medieval doctrine
that the soul is purified by debasing and abusing the body is re-
sponsible for a good deal of evil in Christian lands to-day. Upon
a Sunday we still sing "Oh worthless worms are we." In the
progressive Sunflower State, we find the epitaph :

Under this sod, and under these trees,

Lieth the body of Solomon Pease;

He's not in this hole, but only his pod.

He shelled out his soul and went up to God.

But this body is not a pod, nor a clod of clay for the church to
ignore, neglect, abuse and throw away. Matter is indestructible.
Force is indestructible, flatter and force make up the body, and
every atom of our body quivers with the divine and wonderfully
mysterious force we call life.

It is a fact not to be overlooked or undervalued by modern sani-
tarians, that Nature places a premium upon health and healthful
living. The more natural the mode of living, the more abimdant

Digitized by VjOOQIC

328

ia life and the greater the freedom from sickness. A person with
the health credentials of Nature is nearest immune, by far and
away the best protected citizen from disease of any kind.

If our states and municipalities would imitate Nature and place
a premium upon health and its maintenance, by inaugurating and
carrying on an effective working system of individual hygiene, to-
gether with the present system of public sanitation perfected, such
a foundation of prophylaxis would be laid as to eventuate in a
health Gibraltar for mankind and a Waterloo for all pathogenic
tribes. When the individual and the state co-operate to this end,
better and longer life will follow, and an aristocracy of health will
result which nothing but accident or ripe old age can overthrow.
Learned college professors are advocating the desirability of build-
ing up an aristocracy based on the refined culture of higher educa-
tion; naval, army and civil officials, an aristocracy upon pre-emi
nence of position; plutocrats, an aristocracy upon an array of
wealth; and others, an aristocracy upon a lineage from kings,
dukes, lords, or colonial ancestors; but these, like the house built
upon the sand, when the storm of wind, rain and hail comes, will
fall. The only aristocracy imperishable and worthy and able to
outride the storms of life, is the one founded upon ''a sound mind
in a sound body," which can oome only from a natural life, one
of sobriety, clean living and of full comi)liance with sanitary laws.

This arisitocracy promulgates the gospel of good cheer, the
gospel of plenty. Our Pilgram fathers did not recognize this.
Stern of visage, hewing to the extreme letter of the law, indulging
in little or no song, with much fasting, harboring no pleasures for
this tabernacle of clay except that of anticipation of future rewards,
they shut out Christmas, and a bright, friendly, beneficent, gen-
erous, sympathetic, mutually helpful w^orld. ''

But the mission of Christmas is infectious, and crossing tlie
sea it infused the blood of all New England ; warm hearted, full
handed, a Christmas that cheers and consoles, that lights the land
witli a smile, that practices as well as preaches, emphasizing the
fact that the religion which it celebrates is adapted tx> human
nature and to human wants, and enjoins upon every- one of us to
nourish the physical, man in the best manner }x>ssible, remember-
ing that "as a man eateth so is he," and that "whatever defileth the
body defileth the temple of the living God."

Digitized by VjOOQIC

329

This nation is fast becoming a world leading power, leading
even in the fulness and abundance of this greater gospel.

England may have her roast beef, ale and plum pudding;
France her absinthe, frog and horse meat; Italy her macaroni;
garlic and fat geese livers, and Germany her lager beer, limbur-
ger, Wienerwurst, and switzer, but give me tJie good old New
England bill of fare, with her venison, baked fish and turkey, full
of dressing, her buckwheat cakes and maple syrup, her sweet cider
and goggle-eyed, feathery doughnuts, criep, brown and golden;
and her pie, New England pie, two inches deep, full mooned, size
of a small cartwheel, with dromedary scallops all around its edge.
Don't it linger in the mouth and taste good ? Think of apple pie
made of Rhode Island Greenings, or Pound Pippins; and mince
pie, not Chicago or Cincinnati, nor Indianapolis, nor machine
made, but the genuine, the mince with the true brand, not on the
can, but in the article itself, so that it looks, smells, taste and feels
New England all over, through and through, inside and out, and
even in our slumbers gives us good old "down east" dreams. And
that other delectable pie — um-um.

**How dear to my heart Is the old yellow pumpkin,

When orchards are barren of stuffln' for pies.
When peaches and apples have both been a failure,

And berries of no kind have greeted our eyes.
How fondly we turn to the fruit of the cornfield.
The fruit that our children are taught to despise.
The old yellow pumpkin,
The mud-covered pumpkin.
The Yankee-ribbed pumpkin that makes such good pies.
We chop It, and slice it,
And stew it, and bake It,
And pass it around as the queen of all pies."

But this strong and generous diet of a strong race, is caught in
the seething maelstrom of the modern business world, where the
evil genius of substitution has crept in, where extreme sordid
commercialism prevails, where the mad chase after the nimble
and elusive dollar seems to have the right of way; and so the
labeled, triple X, three-ply article the provision dealer sells us
here in Indiana too often proves to be the shadow, not the sub-
stance, or but the shriveled remainder of a problem in subetrao-
tion.

Digitized by VjOOQIC

330

By enacting a most excellent pure food and drug law, our State
has made a banning effort to protect our foods from substitution
and adulteration. Two Legislatures, however, have adjourned
since this enactment without the necessary appropriation being
made for putting this wise and economic law into service. And
as a result, to say nothing about the injury to life and health, there
is annually lost to the State $4,000,000 or $5,000,000 from adul-
teration of food alone.

This aristocracy of health upholds the gospel of sobriety, a sal-
vation from intemperance and drunkenness, the greatest cause of
crime, insanity, disease and pauperism. Experiments and ex-
perience from all over the scientific world are strongly indicating
that alcohol is neither food nor source of strength, nor even the
best of stimulants from a medical standpoint, and could, with
pronounced advantage, be dispensed with both in ordinary life
and in medicine. This being true, removes the last trench with-
holding public sanitation from extending its aggressive work of
restriction and regulation into the camp of king alcohol.

The tobacco and other narcotic habits, serious drawbacks to
human life, are under the ban of this gospel. Yet, notwithstand-
ing their recognized evils, and in the face of increasing hygenic
knowledge, these enslaving poison habits are growing to an alarm-
ing proportion.

This aristocracy emphasizes clean living, recognizing that clean-
liness is not only next to godliness but is godliness. The opera-
tive force of the gospel of purity would weed out a vast, festering
niRvSS of disease which is now living almost riotously upon the
splendid vitality which is pushing the Anglo-Saxon raoe to the
front; it would rob the operating table of the gynaecologist of
the larger portion of his patients, stop filling our institutions
for the blind, and solve the problem of social morality, and con-
trolability of sexual passion.

The half is not told of the destructiveness of syphilis and
gonorrhea, nor will it ever be known. Although it can not be
accurately^ determined, it has been estimated that 5,000,000 of
people of this country alone are tainted with syphilis, and that 90
per cent, of the men have or have had gonorrhea.

Without further touching upon detail, the whole working for-
mula leading up to the establishment of an aristocracy of health,

Digitized by VjOOQIC

demands an ever increasing vigilance upon the part of the State
in the exercise of her protective function, coupled with greater
attention on the part of every individual to correct habits of life.

In devoting himself to the physical welfare of the human race
the physician and the sanitarian assumes great responsibilities.
In genuine scientific spirit, a worshipper in the sacred temple of
truth, a devotee to progress, his whole life should be a constant,
consistent and practical expi'ession of the best type of humani-
tarianism.

His mission is the mission of tlie greater gospel. His analysis
of the well of salvation finds it filled to the brim with the healing,
waters of sanitation. With his sole creed to extend life and to pro-
mote happiness, I hail him as a charter member of the new church,
which is radiant with promise of a new heaven and a new earth.

DISCUSSION.

Dr. Gammel: I do not like the word "aristocracy," the way it
ia used there, when the democracy of this great republic is solving
all those questions. I think we are solving these questions; we
are doing away with the slums, we are educating and strengthen-
ing the minds of tlie weak, and all through our great democracy.

Dr. Hurty : The essayist spoke about extending the duration
of life. The Governor also spoke upon this subject this morning,
saying that sanitary science had made life longer. Recent re-
searches say that the duration of life is determined by the needs
of the species. Why do we live to, say a period of forty years ?
Why do a pair of eagles live about one hundred years? Why is
it that horses and dogs have their period of life? The answer is
found not in hygiene, or pathology or sanitary science, but in the
needs of the species. The question is, "How long must they live
on the average to reproduce their kind and perpetuate the species ?"
If this is true, we never can hope, by any sanitary means whatever,
to extend the duration of life beyond that point, whatever it is,
because there must be a revulsion. But this we can do by sani-
tary science, and I think it is the great object, that while we do
live we will live more abundantly, we will live better and higher
and more nobly — we will live the ideal life. Of the children
that are bom in the ordinary course to live forty years — assuming

Digitized by VjOOQIC

332

that that is the average duration — 25 per cent, are cut off within
one year, or four or five years at the most. x\re all of those unfit ?
Do we say they are extinguished for that reason ? I think not.
A great many of Uiem are extinguished by accident or by diseases
that were communicated to them.

Dr. Fairfield : I used the term "aristocracy" in the democratic
sense. I don't suppose we will ever have the aristocracy of health
until we get into the. "kingdom come," but we can have the ideal
before us. If a man. has any habits that reflect upon his ancestors,
he had better begin to get rid of them. The paper was not to
criticise the work of general sanitation that is done by the Health
Boards ; they are doing splendid work, but at the same time their
work necessarily must he somewhat one-sided if it does not have
the full and hearty support of the people. In presenting the
subject this afternoon, it was as a balanced equation. We are un-
balanced now. We want the Health Officers and physicians to
come up to this standard, and then we can better help our public
sanitation.

THE OPPOSITION TO SANITARY SCIE^NCE.*

History demonstrates that when an effort is made to raise the
people alK>ve their ordinary life, that there is always opposition.
In the twentieth century the fight will go on, and sanitary science
will be called upon to take no small part in the conflict. It is to
be hoped that those who are working for the cause will, not grow
intolerant. We must be patient and hold fast to the truth, in-
tolerance obscures truth, destroys faitli and obstructs the road to
success. "If one is absolutely sure of his ground, he can be bound-
lessly patient and tolerant towards those who stand upon some
other ground." We need but do our duty honestly to be excused for
our mistakes. As Herbert Spenoer says — "It is the duty of every
one who regards a doctrine as true and important to do what he
can toward diffusing it, leaving the result to be what it may." As
advocates of sanitary science we are forced to meet disappoint-
ment, surrounded with commercial greed that attempts to destroy
all the movements that are intended to uphold the supreme law

* Delivered before Blerenth Annual Conference of Indiana Health Officers, Indianapo-
lis, Ind., May 27-28, 1901.

Digitized by VjOOQIC

333

of health, it appears that some excuse could be made if we, at
times, do grow intolerant.

Appreciating that only a fraction of the good work sanitary
science has in store for us has been accomplished, we can not grow
weak, but must say :

"I will go forth *mong men, not mailed in scorn,
But in the armor of a pm^e intent;
Great duties are before me, and great songs,
And whether crowned or crownl^s when I fall,
It matters not, so as God's work is done."

When governed by a selfish spirit, men will resort to unfair
means, and if circumstances demand they will not stop at even
destruction of health. It appears that those who have only the
gain of money in mind often resort to tricks that are vile in
character, and, of course, these individuals wish to keep the peo-
ple ignorant of what a great blessing hygiene would be to them.
The commercial interests of the country offer the strongest oppo-
sition to sanitary science, for they well know, many of them, that
the manufacture and sale of adulterated foods is in direct opposi-
tion to the principles of this science. They wish to continue
selling deleterious foods, and impure drinks, tliey are no respector
of i>ersons, even the babe in its mother's arms does not appeal to
their sympatliy. lleoently in St. Tx>uis, 332 specimens of milk
were examined and each specimen was found adulterated. To
demonstrate the extent of this criminal practice of adulteration, I
wish to call your attention to the Ohio Dairy and Food Commis-
sioner's reports, which shows the following: Allspice, with cocoa-
nut shells; butter, with oleomargarine; coffee, with roasted hulls
of wheat and barley, crushed pebbles, cocoanut shells, peas, wood,
bark, damaged blackberries, rye; out of twenty-two samples of
cream of tartar, analyzed, not a single one was found to be pure.
This is only a sample of what is being done all over tlie country.
We have these conditions to face. Commercial greed stands out
prominently Ixjfore us, ready for a conflict. We must demon-
strate to the people that sanitary science works at all times for
their l)enefit. When this is accomplished, there will l>e a reor-
ganization of our social state. Even in this day we can see that
''The movement is grinding itself to happy issues." The ordinary
observer can readily see that it is the people's welfare that should

Digitized by VjOOQIC

334

be looked after and not an individual's profit. The people be-
come antagonistic to great movements only when they are ignorant
of the true cause desired. So the constant demand is for educa-
tion upon sanitary principles. There can be no question but
that ignorance has in the past and always will obstruct the ways of
progress. People should be taught that no matter what station
in life they occupy, that they must lead natural lives. An arti-
ficial life leads to disease. The demand, in order to have health,
is pure air, pure water aiid pure food. We know that drunken-
ness, vice, dirt, heavy labor, want of rest bring disease and death.
These sanitary questions must be considered by the true follower
of the science and if considered they are bound to lead him into
the study of economics.

If what we have said be true, it must be admitted that many
of the factory and commercial interests of the country must give
\v'ay to the onward march of sanitary science before the whole
j)eople can receive that which they are justly entitled to — good
health. Witli all these great questions before us, many, of course,
will hesitate to make much individual effort to push ahead or act
as leaders, to do so, personal interests can not be considered, for
oven in our present day — the embryonic stage — it is common to
hear of the crucifixion of all the advocates of sanitary science who
fhauce to get in the way of sotne progressive ( ?) manufacturing
establishment, which did not care to be compelled to stop empty-
ing poison into the mouths of the hungry multitude. We are some-
times sadly reminded by experience with these people that "ser-
monizing or lectures on moral philosophy" are not what are needed,
but laws that will be enforced to punish all offenders; but often
after obtaining such laws the "distinguished pleaders defeat jus-
tice while establishing points of law."

Give the common people knowledge and a chance to assert
themselves, and, if this is done, we need have no fear for the
future of sanitary science. Although the people are now ignorant
of the great blessings modem hygiene has in store for them, it is
not from this source alone the greatest opposition comes, but on
the contrary, we discover that energetic antagonism arises from
some of the so-called financial leaders of this country, that have
factory interests and under a competitive system they do not wish

Digitized by VjOOQIC

335

to have their establishments changed or even have their products
analyzed to meet the demands of sanitary science.

Oi^e prominent manufacturer made the statement that if a pure
food law \vp passed and enforced that it would ruin business, for
the reason that a great many retail dealers throughout the country
wanted adulterated foods in order to undersell others who were
their competitors. What is needed in this country, it seems, is
to have some system that no longer offers a premium on dishonesty.
Sanitary science brings an indictment against this commercial age
and demands, for the sake of health and happiness, that "commer-
cial cannibalism" be destroyed. Her laws demonstrate beyond
disputation that people are being poisoned day by day. She
places the individual who adulterates food or drink, in order to
satisfy his "pigism," in the same class with all violators of law —
a criminal.

In this friendly conflict with these factory owners, sanitary
science says that it is useless for them to preach contentment to the
overworked, unhealthy and much abused laborer, while they are
maintaining an industrial town, furnishing the inhabitants foul
air, foul water, adulterated foods, dirt and long hours of labor,
and providing ill ventilated and overcrowded dwellings, the impure
air of which occasions a languor and sluggishness which lead to
functional derangement, and produces a profound feeling of de-
pression, and causes the inhabitants of these unhealthy dwelling
places to resort to intemperance in alcohol.

With these conditions existing, where we see lives being sacri-
ficed at the altar of commercial greed, the sanitarian is forced to
appreciate the great fact that sanitary science is not an indepen-
dent science, but it is a part of the great political science that
in the near future will be active in forcing upon the world a
system of government that will be a vast blessing to our race. We
know it was ignorance and lack of human sympathy that caused
the contagious disease of olden times to spread unchecked over
the land. So it is with the present system now being followed
in this country. It is our hope that soon the day will be past and
gone forever when it will be called good politics to oppose the en-
forcement of laws that have been passed to protect the people's
health. We do not want laws that only protect the rich, for "art

Digitized by VjOOQIC

336

is always prOvStituted when it only serves the vanity of the rieli,"
!?o it is with laws.

After due consideration we are foree<l to the conclusiou that
under our present system of government "adulteration of pro-
visions has everywdiere become a social institution" and we have
arrived at a perio<l in histoi^ where the people must stand by the
laws of sanitary science, if health is to be considered wealth.

T feel that the people of this great State can well aflFord to con-
gratulat/? themselves upon the fact that they have a Governor in
the chair wlio is willing at all times to enforce laws and do all in
Ill's power for the benefit of his people. With such men at the head
of tlie State, we need have no fear of our destiny.

DISCUSSION.

Dr. Tucker, Noblosville: This opposition to sanitation is very
prevalent. We liave had epidemics of diphtheria and scarlet fever.
Tn looking for the probable causes of the spread of the disease,
we l)egan to inspect the smaller dairies within the city limits. We
had an ordinance passed regulating the dairies and the sale of
milk. As a residt of the enforcoiuent of that ordinance several of
the small dairies, dairies in which there were only from two to
f(mr cows, were abandoned. Tw^o of the larger dairies in the
country compUiined to us that they oould not do business under
the ordinance regulating the sale of milk, and they also were
abandoned. Since that the epidemic has come under our control.

Dr. Powell : T approve heartily of the motive of the paper. I
notice that a number of the speakers here to-day emphasize the
j)olice aspect of the Health Officer's duty, in contradiction to the
teaciiing part of the Health Officer's duty. Some one has said
that we can post up notices and make law^, but that does not make
things go ; we have to after them and see that they are done. I
think wo nee<l to do more and more of this teaching work. It is
a thankle.es task, to be sure, but a great deal of our work is thank-
less and we may nev^er get our reward here, unless it is in kicks
and curses; but we will nc*\'er get it in our own consciences.

T)r. Home: I had the impression for several years that I was
the most un])opular man in Bluffton. Not very long ago there was

Digitized by VjOOQIC

33Y

an organization formed in Blnffton and called the Federation of
Labi>r. It is made up of laboring men. They endorsed the work
of tht Health Boards of the State, county and city, and also intro-
duced a resolution against a certain official in Bluffton who be-
liev-es in anti-vaccination. It is not so very long since Dr. Hurty
was the nvost unpopular man in the State of Indiana; I know he
was unpopMlar in Bluffton. He was considered a crank. Dr.
Hurty attended a meeting that was held in Bluffton and delivered
a lecture, and in the estimation of the people after that there was
not a more popular man in the State. ITow he is one of the most
popular men in the State, at least in the estimation of the people
of Bluffton and Wells County. They are not only satisfied with
him as State Health Officer, but one man in the meeting suggested
that he be nominated for Governor of the State of Indiana.

Dr. Shepard, Jay County: I believe the best thing for the
Health Officers of the State is to keep on with the educational
work they have started. I am also of the opinion that every
Health Officer ought to get the physicians to co-operate with him in
this work. In my home I find that the great trouble is with my
constituency. They think the enactment of the Legislature at its
recent assemblage is the grandest thing on earth. When you
present to them your ideas of what iJiey should do for the health
and benefit of their families and the community, invariably they
will call you a crank. I have been called a crank, and called it so
often that I have begim to imagine I must be a crank of cranks.

Once or twice I called upon Dr. Hurty to come to my town.
He has talked to my town board. Last winter we had 600 or 600
cases of measles. I think I had about 400 cases reported; the
others I knew nothing about until after they were well. Some of
the good citizens of my to^vn pulled off their coats and rolled up
their sleeves, went to the Superintendent of our s<^ools and said,
"Our children shall go to this school until they take the measles,
scarlet fever or diphtheria, and we defy you to turn them out."
I said to the teachers and superintendents, "You keep every
pupil out of these schools from every family in this community
that has measles, scarlet fever or diphtheria in it, and I, as Health
Officer will be at your back, and I believe the State of Indiana
will be at your back." I succeeded in winning the affections of

22-Bd, of Health. ^ j

Digitized by VnOOQlC

338

the school board, and they worked in harmony with me, and we
kept the children from families where, there was contagious dis-
ease out. I frequently consulted the Coimty Health Officer, and
he said, "Go on, you are right." A little while after I saw by tie
Indianapolis papers that Dr. Hurty had said, "Go on ; do as you
have been doing in these cases, and do not regard the recent legi^
lation."

We must call to our aid and assistance the physicians in our
towns and counties, and we must gain their friendship.

SOME EXPERIENCES A\1TH THE RECENT SMALLPOX EPI-
DEMIC IN DELAWARE COUNTY,

BY H. A. 8PI0KERMAN.

This paper is given, not for anything new and recent concern-
ing smallpox and its treatment, but for a brief summary of facts
relative to the disease, and a desire on the writer's part to sym-
pathize with any one present who may have been so fortunate ( ?)
as to have indulged in the trials and tribulations concomitant
with the care of smallpox.

My last acquaintance with the disease began the middle of
February in a new railroad camp situated nine milee southeast of
Muncie. '

The personnel of this camp consisted of men from the lower
class of society and from almost every state and territory.

An individual yclept George Bickmyer, had bummed his way
from Cumberland, Md., through Piedmont, W. Va., starting Feb-
ruary 1, and arriving some few days later. He stated that to
his^positive knowledge smallpox was prevalent in both towns and
that he heard of its existence in many other places through which
ho passed, from tramps he met on the way.

Bickmyer was employed as a gi'ader and continued to work un-
eventfully until February 1:3, when symptoms of variola ap-
peared. The next day found him still at work but feeling worsa
On the 14th he was unable to work at all and the following day,
on arising in tlic morning, he noticed a slight discoloration of the
skin about the forehead. He then consulted a neighboring coun-
try doctor whose diagnosis was "the grip," and who gave him
medicine accordingly. By night his aching had considerably

Digitized by

Google

339

ceased and the fever seemed very much abated. During the suc-
ceeding three days improvement was marked as to subjective symp-
toms Itiut the objective symptoms were more apparent

On the 18th, at the earnest solicitation of his employer (who
would not permit him to work, fearing the ailment was of a con-
tagious nature), he again called upon the doctor and offered a
diagnosis of smallpox. \

By this time the doctor too was thinking of smallpox and sent
a letter to the Board of Health, indicating his suspicions.

The sick man, however, arrived in town two days before the
letter and assiduously started in quest of a Health OflSoer.

He stated that from the agitation displayed and lack of satis-
faction given by the medical man, he. concluded the best thing to
do wafi to go to die city and find out.

On his arrival he accosted persons on the street, inquired at
business houses and private residences before reaching the desired
goal.

The frankness and eagerness of Bickmyer to learn liis condition
is not often met in such cases. Muncie then owned a small con-
tagion hospital and here the patient found refuge in less than an
hour. He experienced a typical, mild, discrete form of smallpox
and an imeventful recover^'. The only sequella was a secondary
infection.

I now ask you why it is that any physician in Indiana, only
half up-to-date, with such forewamings as were given by our State
Board a year ago, a subject before him in the pustular stage of
smallpox, giving his subjective history and wanderings through
infected districts, will permit the patient to scare him into the
true nature of aifairs and allow him to infect others ?

I have known physicians who said they were not afraid of any-
thing (the devil not excepted). But when a case of smallpox was
ushered in, their much boasted fearlessness was at once supplanted
by trepidation beyond all reason. And self-preservation being up-
permost in their minds, their security was not felt until the af-
fected one was a mile away or in the hands of a Health Officer.

An Irish servant girl refused to open the door when Bickmyer
called at her employer's and advised him at once to consult a Health
Officer.

Digitized by VjOOQIC

340

A German policeman passing Bickmyer on the street im-
mediately thought of smallpox and came into my office while Bick-
myer occupied the consultation room to offer his diagnosis.

Is it any wonder that contagion spreads when physicians are
too sluggish to "catch on" where Irish servants and German police-
men can find a hold ?

Without delay fresh virus was obtained and upon its arrival in
the morning Dr. Hugh A. Cowing, our efficient County Health
Officer, and myself visited the said railroad camp.

Forty men, women and children were vaccinated regardless of
pleas of bad blood, scrofula, eczema, syphilis, or time and number
of previous vaccinations. To influence such an uncouth, hardened,
heterogeneous mass was no easy task. The doctor's plan was to
begin on the head lx)ss and after getting him in line we talked to
the men individually and collectively. The first martyr to di^lay
his bravery, common sense and arm, was the boss, next the sub-
boss, then their families, and by this time it was easy sailing to
get the white men. The colored required more persuasion, but
after insisting that smallpox is as fatal to the negro as yellow
fever is to the Caucasian, they all consented.

Where ignorance is bliss 'tis folly to be wise, and it is unnecessary
to say that a Health Officer is sometimes compelled to deviate from
the truth and must fill his hearers full of fairy tales in order to
accomplish the rational and desired end.

When visiting this camp two weeks later I found thirty-six
arms to have successfully taken, or 90 per cent. Of the few which
(lid not take, two liad been successfully vaccinated during the
Cuban War, one, five years before, and the last man had had the
disease, virtually making 100 per cent. '

I also found two men having prodromal symptoms and a new-
comer in the papular stage. Of the first two, one had occupied the
same bed with Bickmyer, and the other had slept in the same tent.
Both of these men had sore arms but no adenalgia. The disease
was greatly modified, the pustules small and widely separated, the
prodromes sliglit and dcvsquamation very rapid.

Tliey were confined but fourteen days. The third man, thirty-
eight years old, l)elieved he had varicella, because, as he stated, the
doctors in Mansfield, O., from whence he had come one week

Digitized by VjOOQIC

341

before, pronounced it ' 'chicken pox/' But after making further
inquiry as to this particular kind of chickenpox, lie said, "Well —
it was a funny kind of chickenpox, and they put the fellers w'at
ketched it in tents outside of the town and had 'em guarded."
This man had never been vaccinated, experienced severe pixKiro-
mal symptoms five days prior to the two others, had a semi-con-
fluent form of the disease, was slow in desquamating and was re-
leased ten days after his companions.

I could cite many concrete examples such as the above, where
individuals have been successfully vaccinated, some two to five
days (and even longer) after exposure, and, if having suffered tlie
contagion previous to the vaccination, run a mild, brief course of
variola.

After experiencing such results, I can not but believe in the
modification of small]>Ox even during the first few days of the
incubation period.

I have noticed that quite a number of such persons, when vac-
cinated during the period of incubation, may have very sore arms,
but no adenalgia.

The care of tJiese three men was entrusted to a young fellow,
named Lindsay, who had a soi^ arm, having been vaccinated on
my first visit. Lindsay lived closely confined for four weeks with
these men, cooked their food, washed their clothes, bathed them^
slept in the same bunk with one, yet did not get sick. His only
precaution was an ivory point.

A committee of indignant and angry farmers waited upon me
and insisted that tlie camp and all it contained should at once be
moved. I agreed that the patients should be in a County Isolation
Hospital and the camp disinfected. But an isolation hospital ex-
isted only in their minds, and we were decidedly handicapped.

I mentioned vaccination as being a preventive, their only safe-
guard, and gave a glowing report of the thorough and good results
already obtained among the illiterate members of this camp, whom
we considered Ixilow the average in intelligence.

No, sir! They were "lawabidin' citizens, didn't believe in vac-
cination, nohow, would rather have smallpox anyway than to lose
an ann and have to beg for a livin' the rest of their lives." Xot
one of thepe men was vaccinated, not a member of their families,

Digitized by VjOOQIC

342

not a scholar in their school, enrolling over fifty students, except
cne small boy that happened to be present on my previous visit
and hearing the informal talk about the disease, he came up with
the colored men. He registered a nice sore arm but his irate
father whaled him good for "the damn foolishness," as he ex-
pressed it, and "doin' things without his consent/^

Children and fools tell the truth. On February 25, a mis-
chievous lad attending the Lincoln School in Muncie, and desiring
to be i:elieved of school work for the day, reported to his teacher
that an older sister had smallpox. A systematic investigation
proved that the boy's story contained more truth than poetry.
When two other physicians and myself entered the Hartley home,
this boy was thoroughly frightened. He explained that it was
only a ruse upon his part to get to stay at home, and to scare his
teacher. He scared his teacher aU right and everybody else in
the building, got out of going to school and enjoyed a fifty-five
days' vacation, shut up in a two-room house.

We found that this girl had chickenpox only four weeks before,
and on top of her recovery had contracted varioloid. The other
five children had only recently gotten over chickenpox and in due
season each also had smallpox, except the boy, who, by mistake,
told the truth. He was very successfully vaccinated and escaped.

A houso-to-house canvass revealed two other well marked oases
of smallpox.

The neighborhood, after learning the story told by young Hart-
ley to his teacher and the subsequent diagnosis made by the phy-
sicians, believed or at least stated, that it was only a scheme of the
doctors to make more money. That, if the boy hadn't told his tale
in school, the Health Officers wouldn't have known anything about
it and that there would be no smallpox.

There is no doubt but that Health Offi-cers are magicians, well
up in the occult and can transform chickenpox into smallpox. One
man, whose wife was then in the pustular stage, told me it wasn't
smallpox and that he'd prove it by not getting it himself. Said he
never did take any "ketchin" disease, as it never run in his family,
that he'd been exposed to every disease known, and only got ty-
phoid fever.

This man was Henry Hale, and in several days he began to feel
"fainty" as he expressed it, but thought it was due to the confine-
Digitized by VjOOQIC

348

ment of quarantine. He had the severest prodromal symptoms I
ever witnessed, but, secretly, they were not too severe to suit me.
I didn't wish Henry any bad luck, but I did wisb him to have
smallpox good and plenty, as he had been qiiite belligerent and
drew a gun upon Dr. Cowing when the doctor called at his home.
My ^vish was gratified, and Henry thought for about four days
that his time had at last come.

As the prodromes disappeared the rash came on. Henry said
it was only bad blood and the sulphur and cream of tartar he'd
been taking brought it out. I heartily agreed that some bad blood
coursed through Hale's veins, as the police docket will bear me
out in my statement The first day that Heftiry felt "fainty" he
asked to be vaccinated and I kindly acceded to his desire. To
show his gratitude he told me two weeks later, that he'd never have
broken out if I hadn't vaccinated him and rubbed some of the
poison in his arm.

Strange to say, this man never advanced the diagnosis of
"Cuban Itch" until desquamation began. At this time intoler-
able itching set in and so impressed him that an attack of ague
couldn't shake his belief, and he now tells his friends that he had
the Cuban Itch.

Hale's temperature, for several days, hovered about 100 de-
grees, but Mrs. Hale said it couldn't comparA to her temperature
which ran up to 120 degrees and she knew as the Red Cross Doctor
took it out of her mouth.

The disease in this locality was directly traceable to the grocery
of Geo. Richardson. The proprietor's son had not long before
been visiting in Chicago. A case of smallpox broke out in the
house next door to his stopping-place. Young Richardson felt bad
for the patient and went in to see him several times 'ere the ail-
ment was diagnosed and his removal to the hospital. Richard-
son returned, subsequently broke out and infected the entire fami-
ly. The mildness of the disease was such that no physician was
called. The father merely visited the family doctor, gave the
symptoms then existing, and a diagnosis of chickenpox, being
careful, however, not to mention the son's visit. The old dootoi*
sent out some medicine, but didn't go to see for himself.

About thirty cases developed from this nidus of infection. From
another end of town was reported a case and upon investigation

Digitized by VjOOQIC

344

we found a young man named Williams, just recovering. Wil-
liams had consulted a doctor at the Russel Medical Institute, and
iiis trouble was diagnosed, syphilis. In about three weeks he was
discharged, cured. Both he and his folks lauded the doctor's
ability to effect such a speedy cure with a disease that other
doctors required eighteen to twenty-four months to cure. But lo
and behold ! Williams' father had a touch of the same thing, only
milder. (IIo had been vaccinated forty years ago.) Then his
brother-in-law and sister broke out. The brother-in-law became
very much excited when his wife broke out and swore up and
down that both ho and his wife were virtuous. His suspicions
l)oing tlius aroused, another doctor (a reputable one this time) was
consulted with the result that the true nature of the malady be-
came known. My last case probably gave me more notoriety than
anytliing I have yet encountered. I am now accused by resi-
dents of ShcdtowTi of planning a putup job to get my name in the
Chicago American.

I Avas just on the verge of congratulating myself upon the
speedy wiping out of the disease and had only finished cleaning
up my last c^se (supposedly) about fifteen minutes, when word
came to investigate the family of Wm. Marlowe. On making
known my errand I waa permitted to enter the Marlowe homo by
the father. To cuf a long stor^^ short, I remained a captive one
hour and a half which seemed to me pretty long. Tlie infurated
man after locking the doors, pocketing the keys, drew out a knife,
and opposed my exit. I don't know the exact measurement of
tliat knife, but under the existing conditions it was the largest
knife I ever saw carried. The angry wife armed herself with a
long metal spoon which she occasionally brandished over my head.
Amid such turmoil and confusion I was offered ten dollars for
every pock I could find on Marlowe's daughter, whose eruption
was then becoming pustular. At that time a six-shooter would
have iK^en more of an object to me than ten dollar bills. If I had
accepted the generous offer T might now be a millionaire, but
being poor in matliematics while at college, I hadn't the heart to
display my ignorance by counting.

The parents insisted that the little girl was broken out with
vaccination which had "gone in." Their doctor told them it

Digitized by VjOOQIC

345

would do this as she had scrofula. Her ami showed two spots
which had evidently been prepared for virus but neither had
taken. Two months later I learned that after vaccinating, the
doctor applied a strong solution of carbolic acid to kill the virus.
I was given to understand that no member of the family 'would
be vaccinated save over the lifeless body of the infiu-iated father.
This was altogether too novel a way to suit me, so I didn't insist.
I was informed that a buggy, which I had purchased six months
before, was the recompense I received from the Board of Health
for telling people they had smallpox wlien they didn't. That I
posseseed only one suit before smallpox appeared, and many other
rich accusations which hurt my feelings and impressed my guilty
conscience. Every doctor in the city, except their physician, was
a scapegoat or drunkard and had plenty of money. If any one
present knows of a brotlier in distress, please send him to Muncie
to enrich his coffer, providing he has the courage to practice
among such an inferior, immoral set of professional brothers.

Tlie son, wife and husband had the disease in the order named,
yet were not ^^aseptically" vaccinated as the little girl was. This
man through obstinacy cost the city $246 and much trouble.
Whenever it becomes necessary, we treat smallpox in Delaware
County by the shotgun method. Marlowe, after being given ex-
plicit directions and told to stay in, took it upon himself to go
to the factory and work. When our worthy mayor was informed
of the escapade lie hastened three stalwart policemen to escort Mr.
Marlow^e to his home in the Black Maria. Force and arms make
good citizens out of some men as in this instance, when our frac-
tious charge became meek and lamb-like, and the spell lasted for
forty-one days. A few of our most troublesome charges only come
to their senses when brought into court and fined. It helps to
pay their expenses while quarantined, makes a good impression
upon the sympathizers of the guilty, and avoids much future
trouble. A few of the arguments put forth in our coimty as to
why the disea^ is not smallpox, are: That eveiy one attacked
was not pitted, was not quarantined sixty days, was not bed
ridden for wrecks ; that every one exposed was not infected ; that
those physicians who did not see and possibly never have seen
a case, said it wasn't smallpox; that no one succumbed. I must

Digitized by VjOOQIC

346

say it i8 a pity that the deaths from variola have not been evenly
distributed or at least where most needed to convince the doubt-
ing laity.

One family that had been visited by four phyfiicians well versed
in diagnosis and agreeing upon the nature of the disease in ques-
tion, was not convinced until an old soldier came along who had
smallpox in ^61, and viewing one of the patients through an open
widow twenty feet away, pronounced it "the real thing."

Conceit, maliciousness and ignorance cost the State of Indiana
more money than all its smallpox. Just as long as the anti-
vaccinationists persist in beliefs contrary to actual fact and ap-
plied science, and have their following legislate laws reeking with
stupidity, just so long may we expect to indulge in this contagion.

Will the time ever come when a Health Officer may approach
the evening of life unembittered by experience and able to con-
template tlie past with serenity, the present witli tolerance, and
the future with resignation ?

May 27, 1901.

DISCUSSION.

Dr. Hunston : In a recent number of American Medicine, the
editor, commenting upon the number of cases in the United States,
intimates that it is the Health Officers and not the physicians who
are to blame for tlie spread of the disease. From my experience
I am inclined to believe it is the profession at large, and not the
Health Officers who are to blame. I will cite an instance which
illustrates this: A young man came home from Dakota where
the disease was prevalent, and his case was not recognized
as smallpox. The rest of the family took it, and their
cases were not recognized as smallpox. Other cases appeared in
the neighborhood and were diagnosed as grippe. One case ap-
peared in the hotel there, and it was not recognized as smallpox,
a great many cases resulted from that. When the disease was
finally recognized and they began to quarantine, there were forty
cases. In vaccinating for the disease, where the vaccination pre-
ceded the taking of the disease it proved a preventive, but where
T vaccinated them after the patient to whom they had been exposed
was in the pustular stage it did not prevent them from taking the
disease, but the cases were mild.

Digitized by VjOOQIC

847

Dr. Hunter, Lawrence County : I sympathize with the gentle-
man who read the paper. I shall give my experience with vac-
cination. I toi a little peculiar about that. People ask me about
^vaccination and I tell them that if they are sure the smallpox
would not be more severe than the cases we have had in Lawrence
County, take the smallpox and be immune for life. The vaccina-
tion will run out, and you will have to be vaccinated again after
a certain lapse of time. We have been using Mulford virus. In
some of the light cases of smallpox I think I would prefer to run
the risk of having the disease, instead of having the very sore
arms w^e have had from the use of Mulford's virus. Park Davis'
virus has been a failure where we have used it. I would favor
extending the quarantine from fourteen to twenty-one days.

We have had some trouble about disinfecting. Some of the
people wanted to do the disinfecting themselves. I got the con-
sent of the County Commissioners to appoint a man to go and
disinfect the houses, but we have no law to enforce his services
upon the people, and when they wanted to do the work themselves
we liad to let them do it.

Dr. Gammel : A young man came from Dakota to visit in the
town in which I live. After a few days he was taken sick. The
attending physician diagnosed his case as smallpox. On the day
the physician pronounced his disease smallpox, there had been
seventeen persons visiting the patient. Those people were all
quarantined and vaccinated, and the house in which the young
man was staying was quarantined. The father and mother in
this family had been vaccinated, but the children had not. The
seven children had the smallpox. After that we had no trouble
in getting the people to consent to be vaccinated, or in enforcing
the quarantine.

Dr. Powell: I think we should discuss soifte of the reasons
why vaccination is not successful. Last year we had one epidemic
of fifteen cases of smallpox. I vaccinated probably 500 people
altogether, and I found a great many cases where the vaccine did
not take. I used Mulford's virus entirely, and had some very
sore arms, but no serious results. I vaccinate the people at the
county infirmary, and shall continue to do so regardless of protest.
They talked about bad blood and syphilis and such things, but

Digitized by VjOOQIC

848

T can not see that it made any difference, for they got along as
well as any one else.

Dr. Hunston : I had a case' a few years ago, and when the
patient had recovered I disinfected the house and burned the
clothing and everjthing that was in the patient's room. After
that we went to the Coimty Commissioners to get them to pay the
bill for the burned goods. They would not pay it, and I paid the
bill, which, by the way, was ten dollars more than my year's
salary.

Dr. Smith, Kokomo: We have had about twenty-two cases in
Howard County. The first case w^as that of a young man who
had just returned from Oklahoma. He cartie to Greentown and
visited the doctor's office to find out what was the matter with him,
as he was not feeling well. The doctor made up his mind im-
mediately that he had smallpox and called in two other physicians,
who both diagnosed the disease as sallpox. I wanted to quarantine
thefamilyof the young man, but the citizens objected; they wanted
to go in and out, and asked me to diagnose the case as something
else. This I refused to do, and the objection to my diagnosis of
the case became so strong that they made up a purse and sent for
Dr. Powell, of Marion, who came over and told them it was small-
pox. Afterwards they had Dr. Ilurty there, and his decision was
the same as ours. The young man was in the pustular stage
when he visited the physician's office. While in town he went
into nearly every store in town, and shook hands with a great
many people. The night before he had staid at a livery stable in
Greentown, and two young men staid there with him. His own
family and the families of the two young men who staid with him
at the livery stable were the only ones who took the disease, ex-
cept the proprietor of the feed store where he had called. When
Dr. Ilurty was there I invited the people to come and hear him.
After he had talked to them they had different opinions about
some things, and one of the physicians, who had opposed Dr.
Hurty's diagnosis of the case, afterwards came to my office and
apologized for it.

Digitized by VjOOQIC

349

QUESTION BOX.

Do we have to have a burial permit for bodies shipped into the
State?

Dr. Ilurty: The law says that no human remains shall be
buried in Indiana without a permit. Therefore I think we must
have a permit to inter remains shipped into the State. But the
law does not say that we must have a record, because the death
occurred out of the State. The Health Officers should, therefore,
without hesitation, issue a burial permit upon the strength of the
shipping permit.

Can a member of a Health Board of a city be removed from
office by the State Health Board for refusing to report contagious
diseases or births in his practice ?

Dr. Hurty : The law is wevy plain ; it says "Yes."

Dr. Powell : He is liable the same as any other physician. It
is a matter outside the Board of Health entirely ; he is simply a
physician who has failed to reports

Dr Fairfield: The Mayor of a city is President of the Board
of Health. The State Board of Health could not remove him
from his office if he was a pliysician who failed to report.

Wlfat are the duties of a Secretary of a Board of Health, be-
sides gathering statistics?

Dr. Hurty: To enforce the health laws; to enforce the rules
of the St^te Board of Health, and to enforce the rules and orders
passed by his own board.

If a coimty seat fails or refuses to elect a Secretarj' of a Board
of Health, under Section 8, and the County Secretai-y performs
the duty as Secretary of the City Board, to prevent a break in the
records of the county, is he entitle<l to pay, as pnwided under
Section 8, for such service ?

Dr. Powell : I should think that was a question to submit to
an attorney. I think if the man has not been legally appointed
he could not collect for his services.

Digitized by VjOOQIC

350

Dr. Smith, Howard County: I think the constitution settles
that question, because it says no citizen shall hold two offices of
trust. .

How can we enforce vaccination upon those exposed to small-
pox, when they refuse to be vaccinated ?

Dr. Fairfield : Wo can not enforce it.

If a Board of Health is created by a city ordinance, and the
ordinance is repealed, does that repeal remove the Secretary?

Dr. Powell : We had a town in our county that resolved that
they didn't need a HeaJth Officer any longer, and voted the man
out of office and the office out of existence. The statute says that
ever}' county and corporate city or town must appoint a Health
Officer, and if they fail to do it they lay themselves liable.

Dr. Shepard: The city of Dunkirk once elected a Board of
Health, and Iiad Dr. MuiTay appointed as its Secretary. Some
time ago they repealed the city ordinance. Dr. Murray wants to
know what he is going to do with himself.

Dr. Rose : He wrote to me about it, and I told him to go ahead
and do his duty.

Will Dr. Hurty explain why glycemated vaccine deteriorates?

Dr. Hurty : The vaccine IjTnph, when taken from the animal,
contains pyogenic organisms. How will we get rid of them?
When you mix it with about 20 per cent, glycerine and place in
cold storage said organisms disappear but the lymph retains its
vaccine power. It is put into capilarv^ tubes, when, by bacteriolo-
gical process it is found the organisms have disappeared. From
that time the lymph deteriorates, and gradually losses its power
to produce vaccinia. It is knowTi that if glycemated lymph is
allowed to get to the temi:)erature of eighty degrees and stay there
for any length of time, say from three to six hours, it will lose its
power to produce coinpox. In being transported it may be placed
against a radiator or near a stove, and will then lose its strength.
That has happened. Tlien druggists keep it badly sometimes. In
one town I saw a lot of the little wooden cases in which vaccine is
packed lying in the front window of a drug store with the sun

Digitized by VjOOQIC

351

shining directly upon them. I asked the druggist why he did that,
and he said so it would sell. I told him it was probably ruined.
We placed a thermometer in the window and found a tempera-
ture of eighty-five degrees. T took some of the tubes and tested
them, and found the stuff was worthless. The manufacturers of
lymph places a date on the package. After the expiration of that
date it is not to be used. Wlien the lymph leaves such propagating
establishments as Park-Davis', Mulford's or any^of the standard
makers it is all right. All would be surprised and gratified to see
how careful and particular they are in putting it up. I went to
the Mulford establishment and introduced myself as a doctor
from Indiana. They showed me about the place. There was no
reason to suspe(^t any special preparation, but everything , was
going on w^th the most perfect exactness and cleanliness. Every
care that it was possible to take was being taken. I found the
same condition prevailing at Park-Davis'. If any virus so care-
fully prepared and treated produces bad arms, I do not believe
the pyogenic organisms that produce the necrosis are to be found
in the vaccine. Not infrequently the organisms are found in the
epidermis itself.

Can a c<>ri>se be taken from Indiana and buried in another State
without a i>ermit from Indiana officers? The corpse in question
was taken in a wagon, and the undertaker lived in Ohio.

Dr. Hurty : An undertaker from another State has come into
Indiana and taken a body and gone out with it. We can not do
anything after he is out of the State; he is not then under our
jurisdiction. But if he returns to Indiana at any time you can
swear out a warrant, put it in the hands of a Justice of the Peace,
and he may be arrested and punished.

Should a County Health Officer appoint an undertaker a deputy
in a town where tlie Town Council has elected a physician to the
office of Health Officer?

Dr. Hurty: I think this question refers to a case at Oxford,
Ohio, or at College Corners, where the undertaker lived in Ohio
and was employed by Indiana people. Dr. Fosdiok, of Union
County, appointed an undertaker as deputy to induce him to obey

Digitized by VjOOQIC

352

the Indiana law which up to that time he had refused to do. He
did not do his full duty after he was appointed a deputy, because
he was not a conscientious man.

In case of an interment of a corpse dead of a contagious dis-
ease ^vithout the proper permit, should tlie County Coroner ex-
hume the remains as in other cases ?

Dr. Hurty: The law is very plain. It says if there is an in-
terment of a body without a burial permit the Coroner shall have
it disinterred and hold an inquest over it. I don't see liow the
Coroner can escape.

Adjournment.

Digitized by VjOOQIC

858

THIRD SESSION.

The Third Session was called to order at 8 p. in., May 5:7.

Charles Carrol Brown led the discussion on ^'Sewage l)is])osal
and Water Supplies."

-Mr. Brown: I would like to speak of one or two tilings which
have arisen in my experience of sewage disposal and the purifi-
cation of sewage and the pollution of streams, that may give rise
to some discussion. As I understand it, that is the purpose of my
l)eing here to-night. We have had a great many conflicting de-
cisions recently about tlie matter of the pollution of streams, and
they have been on all sides of the question. In New Jei-sey we
have had decisions on both sides; in Indiana we have had one
or two decisions which most of us think are on the wrong side, and
in Wisconsin we have had decisions which we think on the right
side. Most of the decisions have been on a partial aspect of the
question. The decision was intended to cover a special case, not
one similar to the ordinary^ run of those cases. I think that is
true of at least two of the New Jersey decisions w^hich have given
us some trouble. There is one decision in which the judge has
gone into the consideration of the matter so carefully that I want
to read to you the part of it which discusses the principles on
which the decision should be made. This is from one of the
Wisconsin decisions:

Pollution of Streams by Sewage Flow.

The Supreme Court of Wisconsin has affirmed the decision of a lower
• court enjoining the city of VVaulsesha from discharging unpurified sewage
into a stream and gi*antiug a jury trial to determine damages for injury
already sustained. The statement by Judge Dodge of tlie grounds on
which the decision is based is the clearest statement of them which has
yet been made. It is as follows:

"We can not but recognize that as the density of our population in-
creases, as our citizens engage in new and greater industries, and as the
municipal aggregations of population multiply and expand, the original
purity of streams and water basins can not be wholly preserved. They are
the natural and unavoidable courses and receptacles of drainage, through
and into which must flow the refuse of human habitation and industry.
How far these changing conditions must bring about a yielding of the pri-
vate rights of continued purity of those lakes and streams to the necessity

23-Bd. of Health.

' Digitized by VjOOQIC

354

of use thereof for the public and general health and convenience, and
upon what terms such jieldiug shall come, are primarily questions of pol-
icy for the Legislature, within the limits of its power over private rights
defined by the constitution. Wlien, if ever, the Legislature shall enact
that streams generally or any streams shall be used as sewers without
liability to the owners of the soil through which they run, the question of
constitutional protection to private rights may be forced upon the courts
for decision. Until such enactment is made, however, in clear and unam-
biguous terms, we shall be slow to hold by inference or application that it
has been made at all. The right of the riparian owner to the natural flow
of water substantially unimpaired in volume and purity is one of great
value and which the laAv nowhere has more persistently recognized and
jealously protected tlian in AVisconsin. Not alone the strictly private right,
but important public interests would he seriously jeopardized by promis-
cuous pollution of our streams and lalvcs.

"Amid this conflict of imiwrtant rights, we can not l>elieve that the
Legislature concealed, in words merely authorizing municipalities to raise
and expend money for the construction of sewers, a declaration of policy
that each municipality might in its discretion, without liability to individ-
uals, take practical i)os8ession of the nearest stream as a vehicle for the
transportation of its sewage in crude and deleterious condition. The au-
thority granted to municipalities is to construct sewers, but subject to the
general legal restiictions resting upon such corporations forbidding in-
vasion of private rights !)y the creation of nuisance or otherwise. This
view of the legislative purpose is enforced by the cH>nsideration that al-
though liquid sewage must flow off along the general drainage courses of
the vicinity, it is by no means physically necessary that it should carry
Avith it the solids in an offensive or unhygienic condition."

Tliat, it seems to nie, puts the case on scientific grounds, and
,o:rounds which can be thorouglily well established and taken care
of. The question which arises is as to the effec*t of this sewage
discharge upon the stream into which it is discharged. That is
a question which it takes a good deal of ex|x?rience and a goo<l
deal of examination of actual cases to be able to make any sort
of guess beforehand as to what will happen. I might give a few
examples of which I have come across in my own practice as to
the differences in the action of streams upon the sewage which
•is discharged into them, or, perhaps better tbe action of the sewage
which is discharged upon the streams.

One is the case of a small stream, which was large enough, a
fair share of the year, to run a mill, and on which there was at
least one dam below the sewers of the city of Aliddletown, N. Y.
The amount of sewage was too great for the stream to take care
of, and it very soon produced a serious nuisance Inflow the city.

Digitized by VjOOQIC

355

It was most serious in the stream below the dam. The amount
of water in the daju was not very great, but the amount of sewage
was more than could be taken care of. From immediately below
the dam until this creek opyened into the river, some three or four
miles below, there was considerable nuisance. There was odor
for a considerable part of the time, and the physical condition
and the looks were very bad indeed. We were called upon as the
State Board of Health to examine it. We condemned this method
of the disposal of the sewage of the town because of the serious
jiuisanee whicli it produced. The effect of this sewage was shown
for at least five miles below the outlet of the sewers. The stream
was becoming gradually worse throughout the w^hole length of
its flow until it reached the river. When there was a considerable
increase in the flow after a heavy rain storm or a long continued
rain it was cleaned out to some extent, but that \vas not sufiicient
to keep it clean for any length of time. In that case the sewage
could not be permitted to enter the stream.

Now, to take two cases w^hich are quite similar, and in which
the amount of sewage which flow^ed into the stream was not too
groat for the stream to take care of. I want to show by compar-
ing the two ciises, what tlie difference is in the action of a stream
by the difference of the way in which it flows. These two cas^
are of Amsterdam and Schenectady, X. Y., which are located on
the ifohawk River, within twenty miles of each other. There is
hardly any water entering the river l>etween the two cities. The
two cities are al>out the same size and have about the same service
by sewers. The conditions are about the sjime, except as to the
method of flow\ Jfetween Amsterdam and Schenectady the river
flows quite ra])idly over a series of rapids and through a series
of pools. In the jiools the current is quite rapid, so there is practic-
ally no opportunity for ?odimentation at any point in the course
of the stream from Amsterdam to Schenectady. We took a series
of samples of the water at inten^als of from two to four miles all
the way from Amsterdam to Schenectady. We took a series of
them in the winter time and another series in the summer time.
We analyzed these samplers chemically, and w^e also had a bacteri-
ological analysis of them made. Wo found evidences of the
sewage in the stream all the distance from Amsterdam to Schenec-

Digitized by VjOOQIC

356

tady. Thoro was some improvement as tlie stream flowed, but
after we liad gone five or six miles the improvement was very
eliglit. We found very near as many bacteria in the water at
Schenectady as half way between the two cities, and we found,
by very careful analysis, that the pollution was nearly the same.
We tested some of the water for the number of bacillus ooli
communi which were in it, and we found quite prominent evi-
dences of the presence of this germ at Schenectady. We thought
we could determine quite readily the number of bacillus coli
communi which were in the water at that place. There was no
place for thorn to come from except Amsterdam.

At a point about three miles below Schenectady there was the
old Stat-o diun, and the sewers of the city of Schenectady dis-
chani^od in the pond forme<l by that dam. The water at the point
of discharge is perhaps twenty feet deep. The stream at that
point runs through a rather soft bed, and the flow of the stream,
during high water, is so .strong that it digs out the bottom to that
depth, and k(^ps it very generally at that depth during the year.
At tlio dam there is a le<lge of rock which comes to tlie surface,
and the dam is located on that ledge, so that for the last three-
foui'ths of a mile alK)ve the dam the water is quite shallow. We
took cross sections opposite the sewer and at two points below the
sewer in the dam, and tried to find out whether it settled or climg
to the same bank as discharged. In fact, we did everything we
could think of. We found that the sewage practically disappeared,
so far as the effect on the water was concenied, before it reache<l
the dam. There was some effect sho\^Ti still at the dam, but very
little, hardly any more three miles telow the city of Schenectady
than then* was eight or nine miles below the city of Amsterdam.
Below the dam the river runs over the ledge of rock at a very rapid
rate, and is s])read out very wide and shallow. It runs that way for
six or eight miles, when it reaches the intake of the West Troy
waterworks, and that runs over a ledge of the same sort imtil it
reaches the dam at Cohoes, where the city of Cohoes gets its water
sup[)ly. By the time we reached the West Troy waterworks intake
the effects of the sewage had entirely disappeared. This is nine
inih^s helow Schenectady. The number of bacteria Avas very small,
th(^ number of bacillus coli communi was practically nothing, and
the chemicHl analysis was very satisfactory indeed.

Digitized by VjOOQIC

357

I give this as aji illustration of the way in which an amount of
sewage which is not too great for a stream will affect it. In
neither case would it be necessary to purify the sewage for any
effect it has upon the stream itself, unless you are going to use it
for a water supply. If the sewage at Amsterdam would have to
be purified to protect the water supply at Schenectady, apparently
it would be necessary to purify the sewage of Schenectady to
make the water supply of West Troy all right.

I will quote a case to show the difference of the effect of sewage
in the water. Tliis case is reported by Professor Mason in his
book on water supply. There are one or two corrections I want to
make. The city of Schenectady originally drew its water supply
from wells in the city, and it became a hotrbed of typhoid fever.
The wells were shallow, and they had cesspools and no cisterns or
sewers. They put in sewers and changed the water supply to the
river, and the typhoid fever decreased, in fact, almost disappeared.
One year an epidemic of typhoid fever appeared. The water in
the river was muddy, and the people did not like to drink it.
They went back to their wells, and the epidemic of typhoid fever
was the result. The first case below occurred in West Troy, the
first intake down the river from Schenectady. West Troy is be-
low Cohoes, but the typhoid fever occurred there first. After-
wards it occurred in Cohoes.

The city of Albany iakes its water supply from the Hudson
River below AVest Troy and Cohoes. Green Island is below West
Troy, but Green Island did not have tlie epidemic. It isn't safe
to assume that b^^cause under certain conditions the effects of the
sewage upon tlio stream is zero, under certain other conditions
it is also zero. This case has not lx?on definitely traced out in all
its details; we have not made all the examinations which would
indicate the reason for this epidemic of typhoid fever in these
different towns; but it seems fair to draw the inference that the
conditions of the stream in winter time — which was the season in
which this epidemic occurred — under the ice and snow, were such
that the disease germs could be carried for that distance and pro-
duce a serious effect upon the health of the cities below.

The next question is as to what can be done to the sewage to
make it safe to discharge into the stream. We have made a great
many experiments in the past on this line, and have had all sorts

Digitized by VjOOQIC

358

of results. 'None of them have been satisfactory, because none of
them have gotten rid of the whole of tlie nuisance. When we
tried the chemical precipitation we got rid of the solids to a
certain extent, but we had still left in the discharge a certain
amount of organic matter which was in a state in which it was
subject to further putrefaction. The same has been true of most
other experiments in which we have tried to discharge the effluent
from the purification works into the stream. The most modem
mctliod, and one which seems to promise the most, is the so-called
septic method, which in its entirety consists of a septic tank and
one or two or three filters. The principle upon which this septic
operation depends is that tliere are two classes of bacteria which
operate to destroy the organic matter in the sewage and turn it
into inoffensive and inorganic matter, those bacteria, which re-
quire oxygen for their action and those which require no oxygen,
which, in fact, for their work without oxygen in the septic tank.
In the septic tank we have excluded the oxygen so that the
anarobic bacteria get in their work in the tank. We have a com-
paratively small amount of sludge left in the tank, and a reason-
able amount of the organic matter removed from the sewage. The
amount is practically the same, perhaps in the best examples it
is more than removed by the chemical method, and the amount
of sludge is materially less, because we have no lime added to
increase the sludge, and the amoimt of organic matter in the
sewage is properly destroyed. If properly taken care of the or-
ganic matter from tlie septic tank is not ordinarily subject to
additional putrefaction in the stream itself. So far as any or-
dinary case of nuisance the septic tank may be sufficient. But
it does not get rid of the bacteria as a whole; it leaves plenty of
food for some of them, and it does not get rid of all of the disease
germs.

I Avill (leseribo the tank at Champaign, 111. The tank is a rec-
tangular lx>x in which the sewage stands perhaps six feet deep.
Tlie sewage flows in at the uj>i)er end into a small chamber at
that end, sf) tliat its velocity is stopped entirely. It wells up in
that eh amber and overflows by a lip the entire width of the tank,
and flows into the tank at a imiform, slow rate. That rate, of
course, depends upon the amount of sewage flowing in the sewer

Digitized by VjOOQIC

359

and the width of the tank. The tank is perhaps twice as long as
it is broad, and in the distance through the length of the tank we
find baffle plates located, one in the bottom, which causes the
sewage to rise and flow over it, and then one in the top which
keeps it from flowing over the surface of the tank, so that the
tendency is for the sewage to flow up and down, first over a baffle
plate and then under one, until it gets to the other end. That
prevents currents forming on the surface or near the bottom. If
the currents do form they carry off the scum which forms on the
surface, or disturbs it, or disturbs the light sludge as it settles to
the bottom. Then at the lower end of the tank the water over-
flows at a lip similar to the one at the upper end and drops down
in a little waterfall in a channel which extends the entire length
of the tank.

The sewage which flows into the tank is straight from the sewer.
It should not be too stale. The water as it runs over the lip at
the lower end of the tank is quite clear, and there is very little
floating matter in it. You can see a little; it is slightly milky.
The amount of matter which is in the water depends upon the
rate at which it has flowed j:hrough the tank, and on several other
conditions which I need not go into. The effluent rims through a
vitrified pipe about fifty feet into a small stream. In tlie summer
time the stream is perhaps not larger than the stream of sewage
that flows into it. There is no complaint about the stream below.

The tank may be covered or may not. In this climate it is
better to cover it. The original idea was that these anarchic
bacteria were injured by the action of the sun, and that the tank
must therefore be covered to keep the light from the tank. But
it has been fojmd by experience that the scum which forms on
the surface, which is in some instances six inches thick, is suffi-
cient to cut off any light which may be objectionable, and that the
tank operates in the warm weather as well without a cover as
with it

The residual matter is practically all destroyed by bacteria.
There is a certain amount of inorganic matter, sand and such
matter, which is washed off the streets and gets into the tank.
The heavier parts are kept in the channel at the upper end of the
tank. There is a certain amount which is light enough to go

Digitized by VjOOQIC

360

over and settle in the bottom of the tank. It is necessary tx:>
clean it out occasionally, perhaps twice a year. The tank needs
to be proportioned to the amount of inflow, to the strength of the
sewage and to its age. The flow of sewage in the sewer varies
60 per cent, say, in a day, without taking into account the storm
water. There is, of course, a diiference of something like 50 per
cent in the rate of flow in the sewage in the tank in the course of
a day, but that does not seriously affect the effluent

Now, tlie question is, will this septic tank discharge be suffi-
ciently purified to allow it to go into the stream, whether it is to
be used for water supply or not ? That has not yet been decided,
because we have not had sufficient experience to determine it.
The Local Goveniment Board of England is very strict upon that
point They say that the effluent from a septic tank is not suffi-
ciently purified to go into a stream. At Manchester the septic
tank discharges its effluent into tlie Manchester Canal, and from
that into the sea; but they are obliged to run it over the contact
beds before discharging it into the canal. The storm water is also
nm through one filter before it is allowed to go into the canal. Of
course, that canal has been a very serious nuisance since it was con-
structed, although the Manchester people have tried their best to
purify it, using the best metho<ls obtainable. Where there is a set
of two contact beds, the first is a tank very much like the septic
tank filled with coke broken to a size of two to two and a half
inches. Those are filled with effluent from the septic tanks in sev-
eral different ways. The Manchester way, I believe, is to fill the
tank full, then shut off the inflow, turn it on to another bed, allow
the sew^age to stand in this contact bed for a short time and then
draw it off. The effluent is considerably purified. The principle
on which this effluent is purified seems to be that the bacteria,
which do require oxygen, get in their work on the organic matter
in his bed. The coke is very porous, and the bed is still more
porous, so a large amount of oxygen is contained in the bed. Then
the sewage flows in and the bacteria in the coke — which, by the
way, are not there at the beginning, but have to be fed in by the
se\vage or some other way — take hold of the organic matter in
the sewage and act upon it. It is possible that most of this action
takes place as the sewage is going out The bed is allowed to

Digitized by VjOOQIC

361

rest three or four hours after the sewage is run out. The bacteria
get in the work after the sewage is run out, from the fact that
the organic matter is deposited on the coke in the form of a slime
which is left, and the bacteria seem to act upon that slime and
decompose it. When the next lot of sewage is let in the slime is
carried out. The second bed through which they are compelled
to run this sewage is filled with much finer coke. This coke is
not much coarser than gravel. This gives a considerably larger
number of surfaces for the organic matter to h6 attracted by. Of
course, the sewage which runs onto this second contact bed is much
purer than before, so the amount of organic matter which is to
be attracted is much less and more finely divided. This fine
contact bed seems to do it, and the effluent from it is, as a rule,
very satisfactory indeed. I think the Local Government Board
at Manchester has for a good many years had a hobby of land
filtration, and they do not like to give it up, so they have added
the requirement that if to determine the effluent from the second
contact bed is not sufficiently pure, the city of Manchester must
be ready to run it over an area of land which they already have,
and which they have been using in their attempts to purify by
other methods.

It seems to me that this method has more promise in it than
any of the others.

DISCUSSION.

Wliat is the probable cost of a septic tank for a city of 3,000 or
4,000 inhabitants?

Mr. Brown: The cost of tlie septic tank at Champaign, in-
eluding the roof, which I would advise in this climate, was about
$2,500 to. $2,800. The cost of taking care of it does no£ amount
to $60 dollars a year. There are probably from 8,000 to 10,000
peop:G in Champaign.

Dr. Taylor: You speak of sewage becoming stale. Under
what circumstances does it become stale?

Mr. Brown: If it flows for a long distance through a sewer
the septic action will take place in the sewer itself, to some extent,
and the oxygen will be almost entirely removed from the sewage.

Digitized by VjOOQIC

862

If the sewage stands too long before it gets into the tank it does
not have as satisfactory an action. If it takes too long a time to
flow through the tank itself the same thing occurs.

Dr. Ilurty : I understand that the septic tank you speak of is
built in the ground.

Mr. Brown: It is a tight tank which usually is most con-
veniently constructed in an excavation in the ground. The first
chamber in the tank is very small. It is simply meant to stop the
flow of water and to let it into the tank at a very slow rate. The
most of the sediment dropped there is the sand and heavy matter
of that sort, which can be dug out with a spade without inter-
fering with the flow of the sewage.

Dr. Hurty : The purifying bacteria destroy all the pathogenic
organisms. While the sewage may contain typhoid infection, as
it flows out in the other end of the tank, it may be rich in bacteria,
but contain no intestinal bacteria.

Mr. Brown : I think that is true, but it has not been proved
yet.

Dr. Hurty: At Brockton, Mass., I examined their system of
purification, which is through gravel beds. They had fifteen
beds, containing about three-fourths of an acre each, laid out like
a checker-board. They had a dyke around them. They had been
scooped out and then underdrained and filled with gravel, and
there they pumped their sewage. The lay of the land was such
that they could not have it flow. After sewage has been pumped
on bed No. 1, they do not use it again for several days. TTie
next day they use No. 2, the next day No. 3, and so on. The
under drains leading from this acre of ground emptied into a
stream about half a mile from there. The water which ran from
tlie tile into the stream was cold and clear. There was a bright
tin cup there, and Mr. Snow, the engineer who was with us, drank
off a pint of this filtered sewage. Dr. Ferguson, of this city, who
was with us, and I also drank some of the water. At the labora-
tory we- found it was free from intestinal bacteria. Mr. Snow
told us it was difficult to get such a high degree of purification,
and that the beds had to be run slowly to do it. He said any

Digitized by VjOOQIC

368

municipality could multiply those beds and take care of any
amount of sewage. He said the beds were raging furnaces, where
bacteria bring the oxygen of the air in contact with effete matter,
burning it up.

In London, Canada, at the Ontario Insane Hospital, they had
laid off ten acres of ground and underdrained it, just as a farmer
in Indiana lays tile drains, only about twice as much tile was
used there as for ordinary draining. All their sewage was led
on to this area, and the ground was planted in com, tomatoes,
beans, peas, in fact, all kinds of top crops. They got rid of every
bit of their sewage that way, and they were surprised to find that
little or no water ran out of the underdrains, so they had one of
the acres dug up and found that it was really unnecessary to have
drains there in that particular soil. They afterwards ran an acre
there by the irrigating process without any drains at all. The
land took care of it and there was no odor at all.

In a little park in Philadelphia I saw the works that were put
in by Colonel Waring. Those were coke beds, four of them, built
in the ground. Just beside them was a pump-house with a big
steam engine. The sewage would run on one of those beds and
run over them. This strained out all the coarser part of it. In
the meantime the engine was blowing air up through the other
beds. They had underground pipes and machinery to blow air
up through the beds. That is called an areating bed. There was
sewage running in a good big stream from that park and the
small settlement around it. It amounted to taking care of the
sewage of a town of 10,000 or 15,000 people. This place was en-
tirely free from odor, and the water tliat ran out underneath they
caught and used for sprinkling. They sprinkled the walks and
the grass and the flowers with it, and I never saw such luxuriant
vegetation as there was in that park; it was really tropical in its
appearance. Why would not that be a good process to use in a
town, say the size of Crawfordsville, in this State? Or, why
would not a septic tank and a couple of contact beds be a good way
to dispose of the sewage? I think if Crawfordsville or any other
town in this State would do that it would be to its credit. Mr.
Brown has made plain that it will not do to put sewage in a
stream unless you want to breed disease. I think Indianapolis

Digitized by VjOOQIC

364

IS the most abominable place on earth for this pollution of streams.
If you want to smell something awfully repulsive start in below
the mouth of our aewer and go down White River. It is nothing
but a noisome open sewer all tlie way, and seems to be getting
worse and worse. For a distance of ten miles down it is simply
horrible. You can get samples of w^ater as far south as South-
port in ^vhicli tliere is intestinal bacteria. We caught fish as far
south as Gosport w^hich we sent to Washington to be examined by
Dr. Salmon, and sent back the report., without knowing anything
about where they were caught, that they were from water over-
loaded with sewage. Now, in the face of tliis, our Supreme Court
has decided that all cities have a right to empty tlieir sewage into
streams. In his last message the late Governor Mount said the
time was here when tlie State Legislature \vould have to pay very
close attention to this matter of emptying sewage into streams.

Dr. Brown: It seems that the Indiana courts* have decided
without reference to the Legislature or any one else that we can
use the streams for sewers, and that any one has a right to use
them. The courts in New Jersey have decided that Uie Legisla-
ture has the right to detennine whether the streams shall be used
as sewers or not. This Wisconsin decision seems to say that the
Legislature has a right to determine whether the streams shall be
used as sewers or not, provided it does not interfere with the
rights of any individual. That is a decision which has common
sense behind it, and which will finally have the law behind it,
and the decisions of Indiana and New Jersey have to be brought
up to it

On motion of Dr. Davis, of Richmond, a vote of thanks was
extended to Mr. Brown for his address.

Adjournment.

Digitized by VjOOQIC

865

FOURTH SESSION.

The Fourtli Session was called to order at 9 :30 a. m., May
28 ; Dr. Davis, of Eichmond, in the chair.

Dr. Pritchard, Vanderburgh: It seema that there was an or-
ganization formed liere yesterday about which some of us are in
doubt. We do not understand thoroughly tlie nature of the or-
ganization or the objects of it. I would like to know what the ob-
ject of the organization is, and whether it will have any effect
whatever upon the present organization.*

Dr. Hurty : All I know of the matter is what occurred before
all of you. Dr. Forrest in his address suggested that the time
had come when the Indiana (vonforence of Health Officers would
probably do better and be moi^e flourishing if it assumed an inde-
pendent existence, rather tfian to meet under the auspices of the
State Board. He suggested that this conference be organized as
an independent body ; that we each year elect our President and
other officers, and keep up an organization as is usual in such
cases. As you know, that was proposed ajid was brought forward
in due form, committees were appointed, and it was endorsed by
the association. The question was, Would that be better than the
pixjsent condition? It seems the association thought it was, for
they voted for it.

Dr. Pritchard: It seems to me that in the organization we
have, we, as Health Officers of the State, are subordinate to the
State Health Board and are subject to the State officers. We
represent in the State between 600 and 700 Health Officers. It is
my idea the coming municipal year to try and get an appropria-
tion in so tliat subordinate officers could attend these meetings and
get the advantage of them. They serve without pay, and if we tax
them one dollar a year, with the privilege of taxing them five
dollars, you will not get them in.

•I move you that we reconsider and rescind tlie action of yester-
day afternoon in regard to the new organization.

The motion to reconsider and rescind was seconded.

Dr. Taylor: When I was connected with the State Board of
Health this. same question came up. At that time it was decided

Digitized by VjOOQIC

866

that the better policy would be to keep up tlie organization under
the supervision of the State Board of Health. In my town, and
I have no doubt it is the saiue in many others, a statement is made
to the City Board of Health that the State Board of Health has
called a conference of the Health Officers of the State, and that it
is desired that a delegate be appointed to that conference for the
purpose of effecting a thorough organization and instructing
Ileal th Officers on their duties and procuring a imited effort on the
part of all Health Officers. They will usually make an appropria-
tion for this purpose if the matter is presented to them in this
form. I am very sure, liowevei:, that if I should make tlie an-
nouncement that the Health Officers are called to a conference in
Indianapolis simply on the authority of the officers of the organiza-
tion they would not bear the expense. When the conference is
called by the authority of the State Board of Health, they will pay
the expense of the delegate. When I first heard of tliis I thought
it was an organization outside of the old one, and that it did not
al)olish the old conference.

Dr. Bence: We did not hear very plainh' what was read in
Dr. Forrest's address, and sat still and let this tiling go through.
It was ill-advised, immature and very little considered. I have
heard the members say since that tlu^y did not intend to join the
scHuety. We are only Health Officers, and our tenure of office is
uncertain ; tlie men who are here this year may not all he here
next. There will be new men here. Instead of our getting up a
new organization, I think this association we now have can be im-
proved very materially. Instead of the meml>ers getting up here
and reading papers, I would like to see men of national reputa-^
tion, si>ecialists in every department, come here with a matured
paper, a paper that will teach us. If necessaiy, let us pay our dol-
lar into a fund to get these men here to instruct us. I did not vote
on the matter at all yesterday, l^ecause I was not well enough in-
formed to vote. I think the State Health Board ought to make
their request a little more mandatory and get more of the Heftlth
Officers of the State to come to the conferences.

Dr. Smith : I thought yesterday I imderstood the motion, aud
voted against it. I am heartily oppose<l to it. I think it is the

Digitized by VjOOQIC

367

duty of the conference to vote it down. Wo do not want to go out-
side the jurisdiction of the State Board of Health.

Dr. Pritchard : I would include in the motion that each member
who has paid a dollar have it refunded to liim.

The motion to reconsider and rescind the action taken on Mon-
day was carried.

Dr. A. W. Bitting, Lafayette, addressed the conference on '

NKED OF DAIKY AND MILK INSPECmON IN TOWNS AND

CITIES.

Dr. Bitting: I shall not speak at great length on the subject,
but shall relate w^hat can be accomplished and what is being ac-
complished in a small way, but still effectively, in the city of La-
fayette. Lafayette is pTX>bably representative of the smaller
cities. It has about 20,000 inhabitants, and there are sixty-nine
dairies, and in those dairies there are 4Y4 cows. These dairies are,
under the usual conditions as found in the State, good, bad and
indifferent — ^mostly indifferent and bad. These dairies are located
from within the city limits to eleven miles out in the country. In
this I include dairies that contribute milk to the city creamery,
because a large part of that milk is not made into butter, but is
sold to other dairymen and sold over the city. This requires an
inspection of all the dairies retailing milk in the city and furnish-
ing to the creamery.

When the ordinance w^as adopted providing for meat and milk
inspection in the city of Lafayette, we consnlted the reports of
Health Officers from the prominent cities in the United States.
The princij)al thing they shelved was the number of bacteria in
milk in their cities, and a few reported the sanitary condition of
the stables. Upon that basis we decided that we could not carry
out efficient meat and milk inspection, but that we must get at
something that would be practical. There is a very large overdoing
of bacteriological work in City Boards of Health, and not enough
coming down directly to the things that appeal to the people en-
gaged in business. Whether milk contains 12,000,000 or 12,000
bacteria does not appeal to many people. Whether the milk con-
tains 6 per cent, of fat or 3 per cent, of fat does appeal to people.

Google

Digitized by VnOOQ

368

Whether the milk conies from dairies where there are ten cows in
a stall only large enough for three, and those cows are badly cared
f(^r, thin and covered with lice, or whether it comes from a dairy
where the stables arc large and roomy and tlie cattle fat and in
good condition does api>eal to the people. We have endeavored to
have the cows kefTt in a more cleanly condition, to have them cur-
ried and to use the spray pump and the whitewash brush about
the stables. Before this year there were only two dairies in the
city that did this. Xow nearly all of them are whitewashed.
About two weeks ago we sent out twelve rapid-cooling devices ; a
year ago there were only two of those devices used. This cooling
device le?5sens the need of using pre^erv^ativc^. T'pon that basis we
have proceeded, and we are gradually getting tlie dairies into the
condition we wish to liave them. Instead of having tlie opposition
which was veiy apparent among the dairymen in the b^inning,
wliere only a few of them would show us around their stables, now
tliey invite us to come and inspec^t them. Instead of having only
half svip]K)rt on the part of the people, as we did at first, we have
now their heartiest support. It is a daily occurrence to have
some one telephone to the office to know^ how their milkman stands,
or where they can buy milk that they can be assured, if fed to a
baby, will be all riglit.

Last summer at this time we made a test and found thirteen
dairies below standard. Last week w^c made a test and found four
at the standard and all the rest above. We can not accomplish
all that we w^antto accomplish at once. It is a thing that must be
gone at slowly to gain a little step by step. Last fall we found one
herd with forty -seven case^ of contagious abortion. We could not
close up the herd at once without a great deal of opjK)sition, but by
going slowly we have secured the disposal of that entire herd. We
found the same disease in another herd, and closed that out in the
same way. We know of the presence of the disease in a third, and
tliat herd is Ixiing sent to the block. If we can get an approach to
healtliy herds and a good degree of cleanliness in two years, we
have accomplished something that the dairymen as well as the
people can appreciate.

We have had more trouble with meat inspection. The first
morning T w(^nt to the slaughterhouse I fonnd a case of lumpy jaw.
The rules of the United States Bureau of Animal Industry are

Digitized by VjOOQIC

869

applicable, I l>eHeve, to all cases of disease. The animal was not -
badly diseased ; it was purely localized, and it was passed under
the same rules and regulations it would be if slaughtered in the
Indianapolis yards. We have since found cases of the disease that
we have had to condemn. We found animals brought to the yards
in an emaciated condition and sent them home again. We found
others brought there in an advanced stage of pregnancy, and sent
them home also. We found one butcher who was buying up dead
animals and feeding them to his hogs which he was fattening to
slaughter. There is no law against that sort of thing in the State
of Indiana ; he could feed them gold dollars if he wanted to. But
we advertised the fact that he was feeding dead animals to the
hogs. I do not think he could have secured the same amount of
advertising for several hundred dollars. It had its effect, however,
for nearly 9 per cent of his business fell off. Another man bought
a load of hogs, and one of them died in the wagon before they were
unloaded. He dressed it and hung it up with the rest. We ad-
vertised him in tlie same way; tliat is, we published in the papers
the results of our inspection, and his business also fell off.

The examination of the stock is made each morning, both anti
and post-mortem. This means the inspection of about 16,000 ani-
mals a year. This, together with the milk inspection, costs the
city only $500 a year. We have tried to direct our energies to look-
ing after the things that need the largest attention at the begin-
ning, and we will gradually work up to the other things later. We
have not used the tuberculin test so far, but we will in the future
as soon as the dairj'men will stand it,' and as soon as we have gained
sufficient confidence to make it assured that our position is right in
this respect I tliink we have followed out the proper method of
meat and milk inspection for small cities. I do not believe we
should begin with tuberculin tests and bacteriological tests. Don't
waste time in the beginning on the higher art, so to speak, of in-
spection of meat and milk, but get down to the things that people
can appreciate and there will be any amount of backing.

Dr. Taylor: By what process do you determine that a lumpy
jaw animal shall be passed or condemned?

Dr. Bitting: If the disease is small, purely localized, no indi-
cation of infection of the lymphatics, and confined to a single area,

24-B(l. of Health. f^ n.r^n]o

Digitized by VnOQ^ IC

870

it is passed for food. If the animal is emaciated and there is dis-
tribution of the disease to other organs of the body, it is condemned.

Dr. Taylor: I understood you to say the animals condemned
in the dairy herds were sent to the block. Does that mean the
butcher's block ?

Dr. Bitting: That is what I meant. If you cut out every
animal that has a bad udder and condemn it on account of that,
you will arouse the ire of the dairymen. You can send it to the
block, and, if it passes the government inspection, that man will
get the value of his animal.

Dt. Bence: Would you pass tuberculous animals?

Dr. Bitting: Yes, sir; I would send tuberculous animals to the
block. Here in this city you will find the Government inspectors
passing animals that have tuberculosis; that is, those where the
disease is localized. Tliose which have tuberculosis which is dis-
tributed through the animal condemned.

Dr. Tucker: Is a special man required for the inspection of
meat and milk you speak of?

Dr. Bitting : I do the inspecting myself. It takes an hour in
the morning, between 5 :30 and 6 :30, to make botli meat inspec-
tions. The dairies require about three or four days in the month.
T ride around and malif the inspection myself.

SUBJECTS FOR DISCUSSION.

Quarantine — What is it? How should it be conducted?

On motion Dr. Bence was requested to speak on this subject.

Dr. Bence: It is a big subject, and one that is very hard to en-
force. A quarantine is ineffrctual unless you have the sympathy
and co-operation of the attending physician. The physicians need
educating in matters of this kind quite as much as do the laity.
It is true that among the intelligent laity and the honest laity you
can explain the rationale of this infection, and how long the bac^
teria remains in the throat after diphtheria, and how long the infec-
ti(^n remains on the surface after ccarlet fever. There are, how-
ever, people, who, if ihc-y did believe this, will not stay away from

Digitized by VjOOQIC

371

the infection. A good deal depends upon the positiveness of the
County Secretary. If I give an order, the people of my county
know I will expect it to be enforced, and that a prosecution will fol-
low if it is not enforced. As a consequence, when a disease breaks
out in a neighborhood, they are glad I am in the saddle, and they
look to me.

I ^vould like to know who here has ever seen an epidemic of
measles quarantined? You all know that the mischief is done be-
fore you recognize the disease. The most infectious period is be-
fore the eruption appears. 'Before the eruption appears the child
goes to school, to church or any other public place, and the disease
spreads. I say, therefore, that it is absolutely impossible to quar-
antine an epidemic of measles. I tell tlie people that measles and
diplitheria could be stamped out as well as smallpox, and that
scarlet fever is a disgrace, and that we ought never to have but the
one case, and that ought to be confined to the one room.

We had a few cases of smallpox that slipped over from Clay
County. I w^ork a great deal among the teachers. Every time
we have a teachers' meeting I have a place on tlie program, and I
talk to the teachers and instruct them and get them to understand
the system of quarantine, and when and how and where the chil-
dren should be quarantined. We are getting them so that the thing
is pretty well regulated. I do not advocate closing the schools.
We had forty-five cases of diphtheria in Greencastle at the begin-
ning of the school year. The city Secretary and I co-operated.
We got the principals and superintendents of schools together and
decided not to close the schools. Many of the casies had been con-
cealed, and cases had gotten in every ward in the city. We let
the schools go on, but instructed the teachers that whene\^r a cliild
came to school with any sickness whatever to send it home and no-
tify its parents that it had to be examined by a physician and have
a certificate that it was free from any contagious disease before it
. could re-enter the scliool. We also made a rule that when a child
was absent one day it could not return the next day wdthout a
similar certificate. We have an agreement with the physicians not
to charge for examinations, so tllat the cry can not l>e raised that
it is a scheme to make fees for the doctors. We do not agree to
treat them free, simply to examine them. We harnessed that epi-

Digitized by VjOOQIC

372

demic, and we found where the sick children were. A person who
had been out of school could not re-enter without a certificate. A
number of the concealed cases had not had a physician, and would
not have had were it not for this necessity for a certificate. In that
way we located every case and quarantined it. The people of the
city sent their children to school after that with as much confi-
dence as if we liad not a case of diphtheria in town.

Dr. Taylor, Crawf ordsville : I belioye with Dr. Bence that it
is impossible to quarantine against measles. The great majority
of people believe that measles is inevitable and hold — what is per-
fectly true — that it is better to have them in childhood than later
in life. I have known many people to take their children where
tliere were cases of measles, because they said they were mild this
time, and it was better to have them at that particular time.

Dr. Hunter : I have been in the habit of establishing a partial
(piarantine. I put up a card, so that no one will come in the house
where there is a case of measles if they w^ish to avoid the disease.

Dr. Dale, Marion : I had occasion to inquire yesterday how the
C^ity Board of Health of Indianapolis quarantines for measles.
I was stopping with an uncle whose small son had measles. The
Ijoy's mother told me the oiBScer came up and put a card on the
house just as tlie child was well, and that none of tlie family were
at any time confined to the house. The other children were al-
lowed to attend school. I don't think that is a quarantine at all.

Dr. Tucker: Since the 1st of January we have had about 200
cases of measles in our city. I did not attempt to close the schools,
but I made a visit to the different schools every other day and
picked out the children I thought were suffering with symptoms of
measles or scarlet fever and sent them home. One morning I
sent seventeen out of one room. I carded the houses, and gave
strict orders that no child from any house that was carded should
l>e allowed in tlie schools.

Dr. Bence : Do you keep the children of a family out of school
aftor they have recovered, but some other member of tlieir family
h}i5? the measles?

Dr. Tucker: I do.

Digitized by VjOOQIC

373

l)r. Beiice : l)u you l)e]ieve measles is a transmissible disease ?

J )r. Tucker: I do.

Dr. Bence: When I go to s(>o a case of measles I do not put on
the suit I wear wlien I visit other cases of infectious disease. I
admit children to the schools who have had the disease when some
other members of the family have measles.

Dr. Kennedy: I believe with Dr. Bence tliat measles can not
l)e carried in the clothing. T have practiced since 1860, and I
never knew a case of measles to l)e carried in tlie clothing. As to
persons that have had measles going in and out of the house, I
never thought there was any danger. There is danger in scarlet
fever, whooping cough and diphtheria.

Dr. Ilurty : Suppose you were to take the clothes of a child in
the eruptive stage of measles and put them on another child,
would that transmit the disease?

Dr. Kennedy: Possibly that might. That is an extraordinary
condition.

Dr. lioss: I should like to know just how long a quarantine
should be kept up. In my county a yoimg man was exposed to a
case of measles, and the eruption occurred fourteen days after-
w^ard. Eighteen days after it appeared in him it appeared in a
second child in the family. It appeared in a third twenty-two days
after it appeared in the second, and in the fourth it appeared
twenty-eight days after it appeared in the third.

Dr. Ilurty : Before the subject is closed I wish to speak of a de-
cision Uiat has l>een rendered. The question was brought up
whether the father of a family should be detained while there was
a quarantine on the house for diphtheria. Tlie man refusfcd to be
quarantined, because he said he was not in contact with the child,
and lived in a part of the house remote from the child. The judge
sustained his position. There is not a man in the State more de-
sirous of helping this cause than this judge, but he said that was
the law, and that it was right. That throws a great deal of light
upon what we can do in regard to the quarantine. We doctors go
right in and handle the patient, and then come out, and some of us
do not take any precautions. Then people will say, "Wliy not

Digitized by VjOOQIC

374

let others do it?" If the doctor does not establish a reasonable be-
lief that he is not infected himself, he has no right to go about
other people. The Boards of Health have enormous power, but
by the opinion of the Supreme Court tiiey can not do unreasonable
things, and it seemed unreasonable to Judge Roby to keep a man
at home who was presumably uninfected.

Dr. Taylor : It is within the experience of every Health Officer
that many reasonable persons have raised this question. They ask
the question, "Why is it, if you impose so strict a quarantine, that
you will let no one come to my house or go away from it, when the
doctor can make his visit and then go into another house to see
another patient a square away without changing his clothes or
using any disinfectant? Now, why do you allow him to do that?"
There is no answer to that. We have a rule, but it is never en-
forced. If we had an absolute nile that would require a physician
to prepare himself and provide for the disinfection of his clothing,
and impose a penalty if he neglects it, we would get better results.
People are not so unreasonable in rebelling against quarantine
when they see that physicians are not allowed to go without restric-
tion.

Dr. Hurty: There is a specific rule of the State Board of
Health in r^ard to that. The penalty of the health laws, if any
exists, can be applied to cases of this kind. I know of very few
cases where people have protested against physicians coming into
their houses after they have been to houses where communicable
diseases prevailed.

Dr. Taylor: That "is because that family thinks the physician
knows the proper thing to do.

Dr. Hurty: Some physicians uphold tliis and agree with us in
regard to the rules, and some disagree with us. One medical so-
ciety devoted a whole session to ridiculing the rules as fommlated
in the State of Indiana. The common people generally accept
them, however, without question.

Dr. Beckes, Vincennes: The objection I have found in cases
such as Dr. Hurty lentions is this: In one family the husband
is allow^ed to go a1 ;it his usual business. I ascertain before giv-
ing the permispI'iT; : liat this is all right. He lives in a house where

Digitized by VjOOQIC

876

it is possible for him not to come in contact with the patient. The
next case may be in a house of two rooms, and the man there wants
the same privilege as the first. It is hard to grant privileges to
one family that you can not grant to the other.

Dr. Hurty : It is not a privilege, it is a right, according to the
judge's decision.

Dr. Dale : I think we have partially overcome that in Marion.
It is a great hardship to cut a man, of poor circumstances, off from
his work, because he is apt to run out of money. I state to these
men that they can board away from home and continue with their
work, or stay at home and obey the quarantine. I have had no
trouble since I made this rule.

Dr. Hunston: I give the people the privilege of staying at
home and being shut up, or of taking a bath, putting on clean
clothes and going away from home and staying away. Some go
away and stay. I have no trouble except where there is ignorance.
Most people now take it in good part.

KUISANOES.

What is a nuisance ? How shall Health Officers go about abol-
ishing nuisances ?

(Dr. Cook in the chair.)

Dr. Hurty : We have had a great many inquiries as to how we
should suppress a nuisance. First, What is a nuisance? You can
find that out by consulting your Book of Instructions, page 15.

(Dr. Hurty read from Constitution and By-Laws.)

The Supreme Court says that Boards of Health can not make
regulations that are unreasonable, arbitrary and oppressiva They
can only deal with public nuisances that are dangerous to the pub-
lic health. The individual, if his property is lowered in value, or
in any way injured, has action, but Boards of Health have no ac-
tion. If you are appealed to, you can say, "Does it affect your
health V^ If the answer is, "We can not say that it does," you can
do nothing. "Do you believe it will ?" "Yes, I believe it will."
"Very well, then, we have to do with it." As an officer you have
no power to suppress that nuisance; that power is in your board.

Digitized by VjOOQIC

376

You can go and tell the exact conditions .that exist, and add to that
re]X)rt your recommendations, present them formally to your board,
and then await your orders.

Dr. Smitli: If a County Board of Health meets only every
thirty days, are you obliged to wait for that?

Dr. Ilurty: If it is an extraordinary ease, you can call a spe-
cial meeting.

Dr. Stanley: In a case where a man had been keeping 3,000
or 4,000 pounds of fertilizer in a barn on an alley, the neighbors
all claimed that it was a nuisance. I went to the man and noti-
fied him that it was a nuisance, and he promised to take it out in
the course of a week. I told him that was too long to wait. He
then said he would remove it as soon as possible. I waited for a
week, and as he had not removed it, I filed an affidavit against him.
I had l>ef()re that given him a written notice to remove it. A war-
rant was gotten out, and he was arrested and the Mayor of the city
found liim guilty. He took an appeal to a Justice in an adjoin-
ing township. The Justice fined him a dollar and costs, and he
took a change back to a court. It has been in court ever since last
summer, but has l)een put off from time to tima

Dr. Hurty : At any rate, you got the thing removed, and you
have caused him a great deal of trouble. We should not be dis-
couraged in our work because of the delays of the courts.

Dr. Von Osinsky : In one family where I was called there were
two cases of scarlet fever, and the family refused to be quaran-
tined. Tlie Secretary had the people arrested, and the Justice told
them to go free, that the Health Officer had no right to quarantine
them. He said the rules of the Health Board were not laws, but
by-laws.

Dr. Hurty: Had your lawyer known that the Supreme Court
of the State had passc<l a ruling on the subject that need not have
gone by default. Tlie Supreme Court has said that all the rules
of the State Board of Health, if reasonable, shall be regarded as
law.

Dr. Von Oinsky : The lawyer did know that, and did say it,
but the judge held to his ruling.

Digitized by VjOOQIC

377

Dr. Derbyshire: Have we, as Health Officers, any jurisdiction
in cases where there is simply a bad odor, but no evidence of its
being deleterious to the health of the people? Have we any busi-
ness to interfere with anything of that kind unless it can be proved
that it is deleterious to tlie public health ?

Dr. Hurty: The public Board of Health can deal only with
things that are deleterious to the public health. If people can tes-
tify that it made them sick, made them vomit, as bad odors often
will, then it is deleterious to health. That question comes to me
frequently on account of slaughterhouses in the cities. I think the
way to manage that is to say tx) the people who complain, "Will you
go into court and swear that it is deleterious to your health, and
get other people to do the same thing ? Then I can act."

Dr. Taylor : I always say that when an oilor of that kind will
not produce a disease, it will, by disturbing the system predispose
to other diseases, and in that way is deleterious to health.

Dr. Tucker : We had a case of that kind. The roar of a butcher
shop abiitt-ed on a candy kitchen, a grocery and a drug store. The
candy kitchen man complained, and, when I asked him if it in-
jured his health, he said it did not, but that it injured his business,
Ixjcause his candy taste<l of it. Part of the odor was caused by
the rendering of tallow in the shop. Tlie druggist complained that
he had to use various kinds of perfumes in his drug store to keep
down the odor. We had that shop removed.

Dr. Hunter : We had some butchers in Bedford that would
slaughter animals behind their shops in the city. We had no law
to prevent them, but had an ordinance passed forbidding the
slaughter of animals within the city limits.

Dr. Sheets : If any nuisance is covered by the laws of the State
or by an ordinance of a city, we will have no trouble with it. I do
not like to make complaints myself, and usually have the person
who is injured make the case. If anything aflFects myself or my
family, then I take it up myself and make the complaint. My
greatest trouble is with poultrymen. Poultr}' houses usually
sooner or later become offensive and endanger the public health.

Google

Digitized by VnOOQ

878

Infectious a.nd Contagious Diseases.

To what extent, if any, should the State Board of Health be
expected to furnish diagnosis of infectious and contagious dis-
eases?

Dr. Sheets: I have had trouble with the blank the State Board

.of Health furnishes us. At the end it says, "Eeport , day

of , 1901." I find sometimes that the doctor carries it around

in his pocket for a week before I get it. The patient may have
died of diphtheria, and this late report is the first news I have had
of the fact that diphtheria was in town.

Dr. Smith : That is not the fault of the blank ; it is the fault
of the physician. ' ^

Dr. Sheets : It is the fault of botli. A place should bo left for
the date of filling out and another place for the date of the return.

Dr. Ross: I believe the State Board of Health ought to be em-
powered to send a specialist where smallpox is suspected. I know
of a case that was diagnosed as grippe by a physician in my vicin-
ity. That was on the first visit. The next time the physician saw
the patient he said it was chickenpox. The next morning he
thought it was smallpox, and advised the patient to have some one
else see him. They telegi*aphed for me. I went over and it seemed
to me a very plain case of smallpox. While it may be regarded in
the liglit of the duty of the Health Officer of the county to diagnose
these contagious troubles, I do not think he ought to be asked to
do it for the small remimeration he receives.

Dr. Benoe : I think al)out all we ought to require of the State
Board of Health, is to settle disputes where doctors disagree in
diagnosis. In cases of diphtlieria I have received great benefit
from a diagnosis on cultures sent to the State Board of Health.
They were mild cases whore a very small amount of membrane
appeared in tlie throat My diagnosis would be disputed if I said
it was diphtheria, but when I could refer to the diagnosis of the
State Board of Health, they were satisfied that it was true diph-
theria.

Dr. Dixon : Some time ago I had a case that was reported to me
as smallpox. I telephoned Dr. Hurty, and he told me to quaran-

Digitized by VjOOQIC

379

tine immediately and that he would be down on the first train.
He came and pronounced it smallpox. The patient was a soldier
who had but recently retiimed from Cuba. We quarantined the
case, and a great deal of fuss was made about it. Most of the doc-
tors dispute<:l the fact that it was smallpox. They suggested that
we call Dr. Wagner down. Dr. Wagner and Dr. Hurty came, and
both pronounced it smallpox. The next case did not occur until
six or eight months afterward, and this time there was no talk or
opposition to a quarantine. The State Secretary should be called
in to settle disputes. On account of the very cordial support that
is being given by our present Governor, we are able to do that.

Dr. Hurty: You know there was a $50,000 fund appropriated
eight years ago for the suppression of epidemics and contagious
diseases. It is under the control of the Governor. The present
Board went to Governor Durbin and asked him about it. He him-
self told you how it was. He first exacted a promise from the
State Board of Health to use energy and care and he would give
hearty support. Ho told us to send in any reasonable bills for this
serx^ice, and now we are able and willing to send an expert to settle
disputes for you. Eemember, however, that you can always settle
disputes in cases of diphtheria as Dr. Benoe has suggested. Tou
can always settle such disputes by sending the cultures. Let the
State Board of Healtli be a court of last resort.

Dr. Taylor : The fund spoken of by Dr. Hurty was provided
for during my connection with the State Board of Health, and we
very soon found that there was ai keen recognition on the part of
the people of the State that there was such a fimd, and it was not
very long until we had propositions to draw on that fund from all
over the State. We saw^ there was a chance for great abuse, and
we referred the matter to the Governor at a joint conference with
him. We had a delegate here from a certain city in the eastern
part of the State who desired to draw on the fund to a consider-
able amoimt. The Governor teld them he expected the municipal-
ity to deal with the epidemic as long as they could do it. When it
became a greater burden than their resources could bear, he would
help them, but he would require an itemized account of everything
they had dra^vn on that fund for. You will find a growing ten-
dency to call on this f imd to save the funds of towns, and to throw

Digitized by VjOOQIC

380 ^

the whole resiKmsibility on the State Board of Health. To keep
tliat fiiiid intact you will need to guard it with the greatest care. 1
think, too, there is danger of abusing the privileges of the State
Board of Health. Small]x>x is no new disease ; it is more or less fa-
miliar to most of us, and with the assistance of our reports and the
aid of the local Health Officers, there ought not to be great diffi-
culty about it, and the Stat« Board of Health should only be called
on when all other eflForts to settle disputes have failed.

How should garbage be disposed of in towns?

Dr. Beckus, Vincennes: Two or three years ago I attended a
meeting similar to this, and went back home and made a report to
our Council. I recommended to them the consideration of this
question. For the summer months they provided a garbage system
and the depositing of the garbage south of the city, but not far
enough out. I was persistent in the matter, and have just now
begim to get them to do what I recommended at that time. We
have now under construction a garbage reduction plant, and have a
system of collecting ever^^ other day through the hot weather and
twice a week in cold weather. The city is beginning to see the need
of this kind of disposal of its garbage, and I am glad to say I was
in some way instrumental in bringing it about.

Dr. Hurty: The question of the disposal of garbage in towns
is one of considerable importance; yet, it is not given much at-
tention. In the small towns, where there is simply a Town Board
of Trustees, the people will have hogs and chickens and heaps of
garbage, and they tlirow slop water on tlie ground. A simple ordi-
nance passed by the Town Board would regulate the whole matter.
A small town will not likely buy a reduction plant, although there
are some efficient and cheap ones to be had. I would recommend
that an ordinance be passed that all liousehold garbage shall be kept
in galvanized iron cans made with covers. Let them feed their
garbage to the hogs in the small town if they will, but let the pens
1/0 regulated. A simple ordinance will do it. It is desirable and
profitable, and should be done.

I think county officers should recommend to the tow^ns the ne-
cessity of taking action upon this matter. In this city we not only
have to keep the garbage in cans, but must keep it in a place where

Digitized by VjOOQIC

381

the garbage collector can get it, and it is burned to ash in the gar-
bage crematory\ We have to keep a separate can in which to keep
trash, such as paper, sticks, etc., and they carry that away sepa-
rately. Where you have no sewers you will have to resort to sinks
for dish water and slop water. Or, if a person has a garden, they
can throw it out evenly over the surface, and the ground will take
care of it all right.

Adjournment.

Digitized by VjOOQIC

382

FIFTH SESSION.

Tlio fifth session was called to order at 2 p. m. by Dr. Cook.

The first question discussed was —

How about typhoid fever in your jurisdiction ?

Dr. Arwinx3 : We have typhoid fever in our county, and have
been havinp^ it every year for some time, especially in the eastern
and southeastern portions of the county. That portion of the
county is underlaid by limestone. It is difficult to get ice there;
we can not get the people to use anything to cool the water; they
will drink it warm. They have wells eight feet deep, and an hour
after a rain they wall be muddy.

Dr. Hurty: Typhoid fever is a disgrace to civilization. It is
a filth disease, and, when we quit eating and drinking filth, we will
quit having typhoid fever. I heard Dr. Benjamin T^ee, of Phila-
delphia, speak upon this matter. He said : "India has its cholera,
and it is a disgrace to those people. South America and Cuba —
that was l>efore our occupation of Cuba — have yellow fever, and
it is to their disgrace ; but worse than all, and killing more than
yellow fever and cholera, is the typhoid fever of the United
States." Typhoid fever is one of the velvet-footed diseases Dr.
Cox spoke of. Wo can not do a better work than to be continually
crying out and calling attention to the fact that as soon as you want
to get rid of typhoid fever is to do it, for all you have to do is to
cease eating and drinking human filth. Tliat w^ill settle it. It is
within our control, and it is a disgrace to us not to control it I
think that you county officers would do well, indeed, if, every time
a death was reix)rted, you would take occasion to remark quietly,
"Another. disgi-ace I" After a while the people will begin to rec-
ognize the great work you have done. I regi'et that our laboratory
was not allowed, for then we could have aided you greatly in the
diagnosis of typhoid fever. It is hard to detennine whether it is
typhoid fever or not. With a laboratory and the reaction and the
diaso test the diagnosis could be helped to a great degree. That was
a good economical measure which was defeated.

Google

Digitized by VnOOQ

383

Dr. Arwune: We may say that not only typhoid fever, but
every other fever is a disgrace. Purity, and purity alone, is a pre-
ventive of disease. If we can get such a degree of purity that we
can avoid typhoid fever, we will have taken a big stride along the
path that will prevent disease.

Dr. Kennedy: I got Park-Davis vaccine in hermetically sealed
tubes and vaccinated a few cases. In my mind it is a failure. The
sore was not suiBcient to satisfy me or to satisfy the patient either.
I complained to the druggist, and ho said he would exchange it for
Mulford's. I used that kind once, and got a very satisfactory
sora Whether it is necessary' for us to have such a sore as in the
last case, or w^hether just a little papule with a little redness sur-
romiding it is sufficient for a good test of vaccination, is a question
I want to put before you.

Dr. Cook: I l>eHeve the size of the scab or sore does not cut
mnch figure in vaccination.

QUESTION BOX.

There being no physician willing to take the }x>sition of Health
Offia^r, tlu* County S(xjretary appointed a private citizen to the
office. He does not perform his duty, but will not resign. How
are the Tnist>ees to get rid of him ?

Dr. Hurty : The County Secretai-y had no right to appoint him ;
tJie man never occupied the position, so there is nothing to resign
from. They had no right to appoint a Health Ofiicer not a physi-
cian. You can appoint a deputy who can issue permits of burial,
l>nt that is the only duty he can perform. If you have no physician
in your town, you can not have a Health Officer. The man has
never Ikhmi a valid officer, and has no claim, nor would he have if
the whole Towii Board had appointed him.

At what distance from driven wells twenty or thirty feet deep
can vaults l)e placed?

Dr. Hurty : The well readies the first water-bearing gravel, and
the vault does not reach that far; but if it fills with water after
rains, and the water sinks away and goes down to the water-bearing
gravel, it will affect the water in the well. The prob>ibility of pol-

Digitized by VjOOQIC

384

liitian is so great that to put driven wells down to the first water-
bearing gravel where there is a privy vault near is itself a foolish
proce<lure, and invites sickness.

Dr. Dixon : We have an ordinance forbidding the putting in of
a privy vault unless it is laid in cement. We regard this as being
safe. Even then we do not allow them t^) l>e placed nearer to a well
than 100 feet.

What about the recent law passed whidi allows children from
families in which there is contagious and infectious disease to
attend schools ? I have been excluding them.

Dr. Hurty : I don't know until it goes through the courts, and
we are trying to grind out a case in this city. You know the
Louttit law provided that no child shall be precluded from attend-
ing school who is in good mental and physical condition. That
will mean there will be no authority for keeping children out of
the schools from houses where there are infectious or contagious
diseases provided they are themselves well. It is expected that the
Supremo C^ourt — if the question ever gets there — wuU decide that
such a law as that should have no such interpretation. The L^is-
lature has no power to pass a law giving people a permit to set fire
to buildings. Has it power to give a permit to people to carry
disease ? Our recommendation is that you go ahead as of yora If
you are sued in any way the prosecutor will have to defend you.

Is it not better in trying to remove a nuisance to have the citi-
zen who is damaged bring the suit?

Dr. Hurty: It would be better to have him do it, but the law
says of all Boards that they shall remove and abate nuisances.
Attorney -General Taylor said once, in speaking unofficially, that
Ifeards of Ilealtli had a right to pro(»eed summarily and remove
a nuisance. He said they might even go so far as to get wagons
and remove it, if possible. But he also said that if it was proved
afterward that it w^as not a nuisance, he could recover damages*

T have just heard that the Supreme Court has this morning
handed down a decision that will be of great importance to us. It
is a decision sustaining Dr. Homo, Health Ofiicer of Wells County,
in a ix)sition he took in regard to vaccination. If the Supreme

Digitized by VjOOQIC

386

Court has sustained a health Officer in ordering vaccination, it is
a very important decision. The court has reaffirmed the power of
the Health Boards to order vaccination among school children.
Dr. Home is here, and will give you the history of the case.

Dr. Home, Bluffton : We have in our county a few anti-vaccina-
tionists. It happened that, upon the city school board of Bluffton,
there was an anti-vaccinationist, and other officers who believed
much as he did. The town was threatened with, an epidemic of
smallpox. I had the County Board of Health pass a ruling en-
forcing vaccination among school children. The CXty Health
Board passed the same rule. The school board refused to enforce
the rule. Suit was brought. It happened that the judge rendered
his decision to the newspaper the night before he rendered it from
the bench. I learned from one of the reporters that I could read
the decision by going to the newspaper office. I went over and
found out what the decision was, and next morning went up and
made a motion to dismiss the case, as I did not want any decision
against vaccination. I knew he w-as opposed to vaccination. He
said we did not have any right to dismiss the case, but we did.
Finally we let that be the decision. We appealed to the Supreme
Court, and the Supreme Court has decided that the County Board
of Health of Wells County and the City Board of Health of Bluff-
ton had a right to order the school board to enforce vaccination
among the children, and if the children were not vaccinated they
could be kept out of school.

Dr. Hurty: This question has been asked of us several times.
Where a child is kept out of school for cause, what is the consist-
ency in the Truant Officer's forcing him back? The Attorney-
General has decided that if a child is covered with vermin, he may
be kept out of the schools. It is right to force him back through the
Truant Officer, because tlie disability can be removed. In the case
of vermin, the same can be removed and then the child is eligi-
ble. In case of vaccination, the child can be vaccinated very
quickly, and then he is eligible to the schools. There is no conflict
in the tw^o laws. You can exclude pupils for any right cause, but
when that cause is removed, they must be admitted again.

25-Bd. of Health. ^ ,

Digitized by VjOOQIC

S86

Save you any tuberculosis in your jurisdiction ?

Dr. Hurty : I will tell you what should be done in regard to
tuberculosis in this State. We should have a State sanatorium
for indigent consumptives. We are already taking care of them
in the poorhouses and by outdoor relief in townships. ' We are
taking care of them in an expensive way, and in a way which in-
sures the perpetuation and spread of the disease. Every poor-
house in which consumptives have been treated is infected. Now,
when Indiana wants to restrict this white plague, when Indiana
wants to save money, when Indiana wants to enter into a higher
state of civilization, she will establish such a sanatorium. Suppose *
we had such a sanatorium built for that purpose. The indigent
consumptive is taken there and cared for in the right way, and in
about 10 or 12 per cent, of all eases there is a chance for recovery.
In that sanatorium those who do recover — ^and perhaps 15 per cent,
may — ^will go homo fully instructed about how to prevent con-
sumption, what care they should take of their sputum, and how to
deport themselves in every way to prevent the spread of the disease.
Those who die — and a majority of them will — will be cared for in a
proper manner to the last moment. And while being cared for,
they have infected no house and have not distributed the disease.
This sort of sanatorium will not only be a great economy, but it will
l)e a great humanity. Massachusetts has such an institution. New
York is now building one, Connecticut has one; in fact, all of the
Eastern States that are ahead of us have them and are saving
money.

Dr. Miller: Has any Health Officer any authority to prevent
the sale of household goods from an infected house where a woman
had died with consumption ? Tlie case I have in mind is one
where tlie wife died with consumption after a sickness lasting a
year, and the husband, after her death, sold the household effects,
and sold her clothing. Is there any danger from that, and have
we authority in the matter ?

Dr. Hurty : It is decidedly dangerous. Your Board can pro-
hibit such a sale unless everything had been disinfected, and they
can prescribe how they shall be disinfected. You can not prevent
it, but your Board can.

Digitized by VjOOQIC

387

Dr. Bence : There is no rule of the State Board of Health to do
that, is there?

Dr. Hurty : No ; but it might be well to pass one.

Dr. Bence: The State Board of Health must promulgate a rul-
ing to that effect. Then the rules and regulations and promulga-
tions must be publidied. In the law as published we have nothing
to enable us to do what you said this man oould do. You can give
advice, but you can not enforce quarantine or isolation in cases of
tuberculosis.

Dr. Hurty: Dr. Miller asked if the clothing and household
goods could be sold. I said his Board has power to issue an order
against that. We do know and can prove that consumption can be
disseminated through infected clothing.

Dr. Boewell : My understanding is that the rules of the State
Board of Health provide that any local Health Board can pass any
ordinance that does not conflict with the rules of the State Board
of Health. I do not pay any attention to it, but just go on and
have those things passed, and after they are done, what are you
going to do about it ?

Dr. Sheppard : I believe it would bo well if the State Board of
Health at its next regular meeting would enact a clause of tliat
kind. You know when we come before the County Boards, the first
thing they say is, "Well, what does the State Board of Health say
about it ?" Then they say they will leave it to them.

Dr. Ross: I believe all the authority we need in a case of that
kind we already have. I believe a County Board has full authority
to pass any rule that does not conflict with the rules of the State
Board of Health and the statute law, to protect the health of the
people of a community.

Dr. Cook: In your judgment, Dr. Bence, is the milk or the
meat from a tuberculosis cow fit for use, whether the disease is
circumscribed or general ?

Dr. Bence: I once heard Dr. Hibberd ask Dr. Bitting this
question : "Has it ever been demonstrated that tubercle bacilli can
pass the digestive organs ?" Dr. Bitting was a little stumped, and

Digitized by VjOOQIC

388

told of the ejxperiments with cows and calves, putting a non-tuber-
culous calf with a tuberculous cow, and vice versa. Dr. Hibberd
said he had asked the same question of one of the most noted bac-
teriologists of the day, and he would not answer it, but promised
to send him some publications bearing on the subject. Now, the
question is whether tubercle bacilli can pass the digestive juices or
not The majority of bacteriologists claim not Looking at it
from that point, I doubt whether milk with tubercle bacilli in it
is very dangerous to the animal economy, or whether flesh from
tuberculous cow is very dangerous to the animal economy. I have
no doubt that the digestive process completely destroys tubercular
bacilli, and that the bacilli that are taken into the system are taken
through the respiratory organs. That, I think, is Dr. Bitting's
opinion. I don't know that tuberculosis is very infectious. I un-
derstand that in the Brompton Hospital for Consimiptives they
claim that in eighteen years they have never had a nurse to contract
the disease. This, too, long before much care was exercised in the
matter of sputum. I think the tuberculosis bacilli will not be very
infectious unless there is good soil for it

There is one thing that is not settled, and that is the position
the Secretaries are going to take on the Louttit bill. I think there
ought to be concerted action. As far as Putnam County is con-
cerned, all teachers are going to get instructions to exclude children
from houses where there is infectious disease, except where there
is measles. I think we should keep them out, and then the men
whose children are kept out will have to bring mandamus proceed-
ings to get them in. We will put the burden of fighting it on them.

I beg leave to offer lie following resolution :

"Resolved, That we endorse the recommendation of the State
Board of Health to exclude children from the public schools and
other public places who come from homes in which there are in-
fectious or contagious diseases.'^

On motion the resolution was adopted. There were no n^ative
votes.

On motion of Dr. Hurty the following telegram was sent to In-
diana's Grand Old Man in Medicine and Hygiene, Dr. James F.
Hibberd, of Ridunond:

Digitized by VjOOQIC

389

Indianapolis, May 27, 1901.
To Dr. Jas. F. Hibberd. Richmond, Ind.:

The eleventh annual conference of State Health Officers send greet-
ings and best wishes to Indiana's veteran Health Officer.

At the next session the following reply from Dr. Hibberd was
received:

Richmond, Ind., May 28, 1901.

Conference of Health Officers, State House, Indianapolis, Ind.:

Your greetings bring gladness to me; may your labors bring gladness
to the people. JAS. P. HIBBErRD.

Adjourned sine die.

Digitized by VjOOQIC

390

THE FOLiLOWING HEALTH OFFICERS WERE IN ATTENDANCE

AT THE ELEVENTH ANNUAL CONFERENCE OF STATE

HEALTH OFFICERS, MAY 27 AND 28, 1901:

1. Carl Proegler ; Ft. Wayne.

2. A. E. Powell Marion.

8. Brose S. Home Bluflfton.

4. Dr. G. E. Hoffman Rochester.

5. Dr. R. BoBWorth Winchester.

6. Geo. E. Sqnier Brookville.

7. S. M. Ried Mnncie.

8. Hugh Cowing ', Mnncie.

9. H. R. Spickerman Mnncie.

10. R. T. Olmsted . : Versailles.

11. G. W. Bence Greencastle.

12. H. W. Millikan Sheridan.

13. M. T. Didlake Monticello.

14. W. J. Hoadley Danville.

15. John Kennedy Paragon.

16. H. W. Ridpath Indianapolis.

17. J. N. Jerome Evansville.

18. R. H. Smith Kokomo.

19. Nathaniel D. Cox Spencer.

20. Bnmham C. Dale Marion.

21. Frank C. Hershey Carmel.

22. Norman B. Beckes Vincennes.

23. O. V. Schnman Columbia City.

24. W. H. Cole Switz City.

25. Geo. W. Shepherd Redkey.

26. Paul J. Barcns. Crawfordsville.

27. J. S. Arwin -. . Colnmbns.

28. G. A. Schnltz Lebanon.

29. D. S. Stanton Portland.

30. John G. Ross Portland.

81. Henry C. Gemmill Markle.

82. L C. Lambert Colfax.

38. Edgar Cox .'. Kokomo.

34. A. S. Dickey Tipton.

85. D. W. Dryer Lagrange.

86. R. A. Jamieson Patriot.

87. Chas. Loomis Florence.

38. J. M. Littler Ingalls.

39. Joel Cook Orestes.

40. S. C. Newlin Anderson.

41. A. S. Tilford Martinsville.

42. H. D. Denant Walkerton.

43. J. N. Reece North Liberty,

44. L. L. Gilmore Monroe City.

46. Chas. E. Gould Rochester.

46. Marcus Spalding Oolitic.

47. Isaac Fry Sandbom.

Digitized by VjOOQIC

391

48. W. H. Sheets Jeflfersonville.

49. J. H. Forrest*. Marion.

60. A. H. Parqnhar Ridgeville.

61. E. Derbyshire Gonnersville.

62. J. H. Carson Brazil.

63. F. S. Hunter . . : Bedford.

64. John N. Taylor Orawfordsville.

66. B. E. Miller Albion.

66. Clark Cook Fowler.

67. E. D. Laughlin Orleans.

68. Jos. Von Osinski Crown Point.

69. F. A. Tucker Noblesville.

00. T. Henry Davis Riclimond.

61. F. W. Fanning Butler.

62. Creo. C. Lewis Madison.

63. S. M. Bennett ' New (Joshen.

64. F. L. Stone Pendleton.

66. Milton L. Humston Goodland.

66. John M. Talbott Terre Haute.

67. William Daniel Oorydon.

68. H. F. Costello Decatur.

69. J. W. Dixon Franklin.

70. W. H. Lane Angola.

71. L O. Beckwith Lewis.

72. J. B. Dolson Pimento.

Digitized by VjOOQIC

PROCEEDINGS AND REPORT

OP THE

STATE BOARD OF HEALTH

For the Year 1902.

Digitized by VjOOQIC

PROCEEDINGS AND REPORT OF THE STATE
BOARD OF HEALTH FOR THE YEAR J90Z

Hon. Winpibld T. Durbik, Governor of Indiana :

The State Board of Health, herewith respectfully presents its
Twenty-first Annual Report for the year ending October 31, 1902 :

The four regular quarterly meetings of the Board for the year
ending October 31, 1902, were held October 11, 1901; January
10, 1902 ; July 11, 1902, and October 10, 1902. Special meetings
were held as follows: In 1902 : March 7, April 25, May 29, June
16. The doings and investigations of the Board for the year are
set forth in the minutes of the above meetings, which are appended.
The fiscal report of the Board is also appended, and we also append
the trtosactions of the annual meeting of the State Health Officers.

VITAL STATISTICS.

The vital statistics which are collected for the calendar year can
not be given until the said year has expired, which will be Decem-
ber 31, 1902. It will then take sixty or probably ninety days in
order to tabulate and analyze said stittistics. These statistics are
collected strictly according to the commands of«the law, and are of
great economic and governmental value. It is with some pride we
inform you that the vital statistical work of this Board has at-
tracted wide attention and praise on account of its accuracy. Un-
der the system adopted every death in the State is recorded on a
separate certificate which is on file in the office of the State Board
where it is available at any time, for the purpose of securing pen-
sions and life insurance and for the settling of estates. There are
daily demands at this office for transcripts of these death certifi-
cates from citizens of the State. The greatest usefulness of these
statistics is found in the information they give of the character,
whereabouts and extent of disease and death. This information,

(396) ^ T

Digitized by VnOOQlC

896

if practically applied^ would increase the healthy wealth, and happi-
ness of our citizens. Unfortunately, however, the appropriation
heretofore given for health work is only sufficient to gather the
vital statistics and meet petty expenses. It is hoped the next
Legislature will permit the practical application of the knowledge
gained from the statistics so that the disease and death rates may
be reduced. We respectfully request, therefore, that as chief
executive, you recommend in your message to the Sixty-third
General Assembly, that proper provisions be made for the prac-
tical prevention of disease and death among the people.

To show the opportunity which offers in this State for the pre-
vention of unnecessary diseases and unnecessary deaths, we pre-
sent a table compiled from our statistics as follows :

Deaths from Preventable Causes in Indiana in 1901.

Consumption 4,569

Typhoid fever 1,198

Scarlet fever 149

Diphtheria 554

Whooping cough 181

Diarrhoeal diseases 1,776

Measles 161

Smallpox 21

8.906

The sum total of deaths means fully ten times as many cases
of sickness and there werO; therefore^ 8,609 deaths and not less
than 86,090 cases of sickness which are classed as preventible.
It is not claimed that it is possible in short order to prevent all
of this awful loss, but it is very certain that it is possible to pre-
vent a large proportion. It will, of course, be admitted by all,
that a life unnecessarily lost by disease is as valuable as one lost
unnecessarily by firearms or railroad accidents. The State is ac-
tive and diligent in the prevention work necessary to prevent
death by murder and accidents, and why should it not be equally
diligent in the prevention work which science and practice show
will prevent much disease and death ? Before leaving the subject
of statistics we wish further to inform you that the United States
Government, recognizing the accuracy and the consequent great
value of Indiana's death records, has requested transcripts of^every

Digitized by VjOOQIC

897

death record in Indiana for the year 1901, and $730.88 has been
appropriated from the funds of the United States Statistical
Bureau to pay for the work of transcribing.

HEALTH LEGISLATION.

The health law commands that the State Board shall annually
make ^'such suggestions with r^ard to legislation as it may deemi
important in reference to the public health." In obedience to
this command, we recommend the creation of a State Laboratory
of Hygiene, a bill for which we present herewith. We also recom-
mend the passage of a quarantine law, a bill for which is herewith
presented. ^

We have carefully studied these two recommendations and we
are very sure that, if the bills as drafted become law, and then
are properly enforced, that benefits will be secured to the people
which will be impossible to estimate.

These reconmaendations are, undoubtedly, in the practical lines
of economy and governmental advancement. We respectfully re-
quest that you endorse and recommend the enactment of these
bills in your message to the next General Assembly.

(Signed) J. H. FORREST,
'I President.

WM. N. WISHAHD,
I Vice-President.

T. HENEY DAVIS^
CLARK COOK,

J. IT. HURTY,

Secretary.

Digitized by VjOOQIC

398

FINANCIAL STATEMENT.

RECEIPTS.

By appropriation, officcf expenses $6,000 00

By appropriation, Secretary's salary. 2.400 00

By appropriation, Chief Clerk's salary 1,000 00

Total 19,400 00

DISBURSEMENTS.
1901.

Nov. 5. American Public Health Association ^00

" 22. George P. McGinnis, postage stamps 50 00

" 30. Maud Hoffman, clerical services 25 00

" 30. Maude Linn, clerical services 45 00

" 30. May Stuart, clerical services 45 00

" 30. Eva D. Campbell, clerical services 45 00

Dec. 31. Maud Hoffman, clerical services 25 00

" 31. Florence Froschauer, clerical services 25 00

" 31. Maude Linn, clerical services 45 00

" 31. May Stuart, clerical services 45 00

" 31. Eva D. Campbell, clerical services 45 00

" 20. George F. McGinnis, postage stamps 50 00

1002.

Jan. 10. J. L. Anderson, traveling expenses. 12 12

" 10. W. N. Wishard, expenses attending Board meeting 10 00

" 10. T. Henry Davis, expenses attending Board meeting 14 80

" 10. J. H. Forrest, expenses attending Board meeting 42 30

" 10. Clark Cook, expenses attending Board meeting 18 50

" 10. American Toilet Supply Co., laundry 2 25

" 10. Central Union Telephone Co., rental and toll 23 65

" 10. Pettis Dry Goods Co., soap 49

" 10. New Telephone Co., rental 10 00

" 10. New Long Distance Telephone Co., toll 1 50

** 10. Western Union Telegraph Co., telegrams 4 51

" 10. Cyrus A. Smith, formaldehyde and generator 10 38

" 10. Wm. B. Burford. printing and stationery 338 29

" 10. H. P. Newman, Treasurer, dues American Medical As-
sociation 5 00

" 10. Journal Applied Microscopy and Laboratory Methods. .. 100

" 10. Editor Sanitarian, subscription 20 00

" 10. Bowen-Merrlll Co., books .' 8 00

" 10. J. N. Hurty, Secretary, traveling expenses 126 19

" 23. George F. McGinnis, postage stamps 50 00

" 31. May Stuart, clerical services 45 00

" 31. Eva D. Campbell, clerical services 45 00

" 31. Florence Froschauer, clerical services 29 00

*' 31. Maude Linn, clerical services 45 00

" 31. Maud Hoffman, clerical services 25 00

Digitized by

Google

DISBURSBMBNTS-CJontlnued.

Mch. 1. May Stuart, clerical services $45 00

1. Eva Campbell, clerical services 45 00

1. Maude Linn, clerical services 45 00

1. Maud Hoffman, clerical services 25 00

1. Florence Froschauer, clerical services 25 00

1. George F. McGlnnis, postage stamps 50 00

1. Lulu Keeler, clerical sen'ices 37 00

7. J. H. Forrest, expenses attending Board meeting 17 60

7. T. Henry Davis, expenses attending Board meeting 14 70

7. W. N. Wlshard, expenses attending Board meeting 10 00

7. Clark Coolc, expenses attending Board meeting 16 75

11. Lieut. McCormlclc, wrapping annual reports 1 50

11. Cai'l Anderson, wrapping reports 4 50

11. New Long Distance Telephone Co., toll 2 85

11. New Telephone Co., rental 10 00

11. New York store, soap 1 01

11. Western Union Telegraph Co., telegrams 2 47

11. United States Express Co., express 22 25

11. Central Union Telephone Co., rental and toll 23 85

11. Wm. B. Burford, printing and stationery 409 96

11. American Toilet Supply Co., laundry 2 25

11. J. N. Hurty, Secretary, expenses 99 81

11. Bowen-Merrill Co., books 9 75

11. J. H. Forrest, expenses attending Board meeting 15 60

11. Clark Cook, expenses attending Board meeting 17 50

11. T. Henry Davis, expenses attending Board meeting 14 70

Apr. 1. May Stuart, clerical services 45 00

1. Eva Campbell, clerical services 45 00

1. Florence Froschauer, clerical services 30 00

1. Maud Hoffman, clerical services 25 00

1. Maude Linn, clerical services 45 00

1. Lulu Keeler, clerical services 40 00

5. Geo. F. McGlnnis, postage stamps 50 00

5. Lulu Keeler, clerical services 8 35

11. Jas. A. E;gan, Treasurer, dues 10 00

11. Edwin Plummer, 5 dozen lantern slides 30 00

11. Wightman & Co., Ltd., subscription 1 83

11. Harry B. Bishop, expenses 6 70

11. A. N. Bell, editor Sanitarian 1 75

16. Eva D. Campbell, clerical services 45 00

25. T. Henry Davis, expenses attending Board meeting 14 10

May 1. May Stuart, clerical services 45 00

1. Maude liinn, clerical services 45 00

1. Florence Froschauer, clerical services 30 00

1. Maud Hoffman, clerical services 25 00

3. George F. McGlnnis^ postage stamps 50 00

29. Dr. W. N. Wlshard, attending Board meeting 10 00

29. Dr. T. Henry Davis, attending Board meeting 14 10

29. Dr. J. H. Forrest, attending Board meeting 24 80

Google

Digitized by VnOOQ

May 31.

31.

((

31.

June 5.

16.

((

16.

July

«(

(«

11.

((

11.

<«

11.

Aug

. 1.

«t

Sept 2.

Oct

10.

400

DISBURSBMENTS-ConUnued.

May Stuart, clerical services $45 00

Maude Ldnn, clerical services 46 00

Florence Froschauer, clerical sendees 30 00

Maud Hoffman, clerical services 25 00

George F. McGinnls, postage stamps 50 00

T. Henry Davis, attending Board meeting 14 20

J. H. Forrest, attending Board meeting 13 15

May Stuart, cl€?rlcal services 45 00

Maude Linn, clerical services 45 00

Florence Froschauer, clerical serA-ices 30 00

Eva D. Campbell, clerical services 45 00

Maud Hoffman, clerical services 25 00

Clark Cook, traveling expenses 70 84

T. Henry Davis, attending Board meeting 14 20

T. Henry Davis, attending American Congress of Tuber-
culosis 53 65

J. H. Forrest, attending Board meeting 15 65

J. Ii. Anderson, expenses 4 67

Western Union Telegraph Co., telegrams 6 80

Wm. B. Burf ord, printing and stationery 476 65

Bowen-MerrlU Co., books 6 00

American Toilet Supply Co., latmdry 2 25

George F. McGinnls, postage stamps 50 00

New York store, soap 88

Dr. N. D. Bray ton, expenses account smallpox 149 01

Central Union Telephone Co., toll and rental 42 40

J. N. Hurty,, traveling expenss 160 ^

Cyrus Smith, 2 boxes culture tubes 5 00

Chas. E. Ferguson, expenses account smallpox 150 50

Van Publishing Co., subscription 2 00

New. Telephone Co., rental and toll 11 80

Maud Hoffman, clerical services 35 00

May Stuart, clerical services 22 50

Eva D. Campbell, clerical services 46 00

Florence Froschauer, clerical services 30 00

Maude Linn, clerical services 45 00

Eva D. Campbell, clerical services 46 00*

Maude Linn, clerical services 45 00

Florence Froschauer, clerical services 30 00

Maud Hoffman, clerical services 35 00

May Stuart, clerical services 45 00

George F. McGinnls, postage stamps 50 00

May Stuart, clerical services 45 00

Eva D. Campbell, clerical services 46 00

Maud Hoffman, clerical services 35 00

Maude Linn, clerical services 45 00

Wm. B. Burf ord, printing and stationery 293 69

New Telephone Co., rental and toll 4 82

American Toilet Supply Co., laundry 2 25

Digitized by VjOOQIC

Oct.

, 10.

10.

((

10.

24.

((

24.

31.

t«

31.

401

DISBURSEMKNTS—Contlnued.

Central Union Telephone Co., rental and toll $6 60

J. N. Hurty, traveling expenses 67 24

United States Express Co., expressage 1 35

Bowen-MerrlU Co., books 5 00

Western Union Telegraph Co., telegrams 3 86

Mary Burke Elast, reporting conference 25 00

T. Henry Davis, expenses attending Board nieeting 14 20

J. H. Forrest, expenses attending Board meeting 12 30

Clark Cook, expenses attending Board meeting 17 50

W. N. Wlshard, expenses attending Board meeting 10 00

B. H. Herman & Co., frame 3 50

H. C. Hendrlckson, plans and specifications 25 00

Cyrus A. Smith, 4 boxes serum tubes 10 00

Smith-Premier Typewriter Co., typewriter 47 75

Wm. B. Burford, printing and stationery 77 97

New York store, soap 1 10

George F. McGinnis, postage stamps 19 64

Maud Hoffman, clerical services 35 00

Eva Campbell, clerical services 45 00

Maude Linn, clerical services 45 00

May Stuart, clerical services 45 00

Total ?6,000 00

2^Bd. of Holth. ^

Digitized by VjOOQIC

MINUTES AND TRANSACTIONS

Indiana State Board of Health,

FOR THE YEAR ENDING OCTOBER 31, 1902.

^^' ,Goo5le

Digitized by VnOOQ I

Digitized by VjOOQIC

FIRST QUARTER,

Noyefnl>er and Decefnl>er^ 1901^ and Jantiary, 1902*

Office Indiana State Boabd of Health,

Indianapolis, Ind., January 10, 1902.

Present, Drs. Forrest, Davis, Cook, Wishard and Hurty.

President Forrest called the meeting to order at 10 a. m..

The minutes of the meeting held October 11, which was the
regular quarterly meeting of the Board for the third quarter of
1901, were read and approved.

Minutes of special meeting held October 24 were read and
approved. 1 <

The Secretary's report for last quarter was read, report waa
adopted and ordered spread of record.

SECEETARY'S REPORT FOR QUARTER.

During the quarter 3,034 letters were received, and counting
bulletins and circulars, over 10,000 pieces of matter were mailed.

The Secretary at his own expense, analyzed 31 waters, 14 sam-
ples of sputum, 17 diphtheria cultures and 2 samples of milk.
This was done in an effort to advance the sanitary interests of the
State.

Sixteen visits were made by the Secretary during the quarter
ending December 31, 1901, as follows:

October 9. Lafayette, to attend the Farmers' Institute, and make an
address on "Sanitation and the Work of the State Board of Health."

October 14. Vincennes, on account of summons to attend court In
trial of Vincennes Water Co. vs. The VIncennes Distilling Co.

October 16. Knightstown, on account of pollution of Montgomery
Creek, by Knightstown Strawboard Co.

^^^ Digitized by Google

.406

October 21. Anderson and Muncie, with Dr. Forrest, to investigate
stream pollution.

October 23. Shelbyville, on account of diphtheria.

October 28. Shelbyville, on account of Inspection of school children
In room No. 1, where diphtheria had originated.

November 1. Lafayette, on account of smallpox.

November 4. Lafayette, on account of Invitation of President Stone,
of Purdue University, to address the students on the importance of vac-
cination.

Nov€fmber 6. Vincennes, account of court summons, to attend trial of
Vlncennes Water Co. vs. Vincennes Distilling Co.

November 12. New York, on account of special sanitary meeting of
the New York Academy of Medicine, and to read a paper by special in-
vitation upon car sanitation.

November 18. Lafayette, account of smallpox In West Lafayette.

November 25. Williamsport, on account of urgent invitation from city
authorities to confer with them concerning contemplated sewers.

November 29. Bedford, to attend Teachers* Institute, an^ deliver an
address upon "Sanitation and the Work of the State Board of Health."

November 30. Rushville, on account of summons to attend court in a
State case.

December 7. Muncie, on account of meeting of Delaware CJounty
Medical Society, having been invited to deliver an address upon "Pood
and Drug Adulteration."

December 18. Plainfleld, account of State Daii*y Association, having
been invited to deliver an address upon "What the State Board of Health
Had Done to Enforce the Pure Food Law."

Full detailed accounts of each one of these visits are herewith
presented.

LAFAYETTE.

On October 9 I went to Lafayette to attend the annual meeting
of the "Workers in Farmers' Institutes.'^ At this meeting the
various individuals engaged in institute teaching gathered to*
gether to confer for the purpose of inii)roving themselves in the
duties which they have undertaken. The meeting lasted for two
days, but I attended only one day. There were four addresses
delivered in addition to tlie usual routine society proceedings*
The^e addresses related to how institutes should be conducted,
and how the various teachers should present the matter which
they have in hand. The meeting was a profitable one and I re-
ceived several good ideas as how to better present the health cause
at the Fanners' Institutes which I might be invited to address.

Digitized by VjOOQIC

407

VINCENNES.

On October 14 I went to Vincennes on account of summons to
court in the trial of the Vincennes Water Co. vs. The Vinoennes
Distilling Co. This is an old suit which has been reported upon
heretofore. It will be remembered that in 1898 I went to Vin-
cennes, made a survey of Wabash River, where it is polluted by
the Vinoennes Distilling Co., and traced by inspection and by
sanitary water analyses, pollution from the distillery to the water
supply. This visit turned out to be entirely unnecessary, for on
account of some difficulty, the case was postponed. I took ad-
vantage of my presence in Vincennes to call upon tlie City and
County Health Officers, to visit the jail, and to advise with said
officers in regard, to sewers in tlie city of Vinoermes, and also in
regard to several minor nuisances.

KNIGHTSTOWN.

On October 16 I went to Knightstown on account of invitation
from the authorities of the place to investigate the pollution of
Montgomery Creek by the Kni^tstown Strawboard Co. I found
the Strawboard Company in question was a very small affair
compared to some of the large works in the State. Its total product
was not to exceed ten tons of strawboard per day. All of the w^te
was allowed to run into Montgomery Creek, and as this creek is
small, it had, without question, produced a nuisance. The com-
plaint was from one fanner only, and the authorities of Knights-
town were strongly in favor of the strawboard works. I met the
farmer, Mr. Morris, who had made the complaint, and also the
strawboard authorities, the Chairman of the Town Board, and
the Health Officer at Kniglltsto^vn. We talkc<l the matter over
and all agreed that if the Strawboard Company would build do-
positing ponds, one of them to bo a filtering pond, with a gravel
bottom, underlaid with tile, and would only permit the filtereil
liquor to run into the stream when the water was low, tliat all
complaints would be removed. The o\^^le^s of the Strawboard
Company promised faithfully to do this and by the report of
Captain Anderson, which is included herewith, it will be seen that
they performed their promises, and that all is now satisfactorily
settled,

Google

Digitized by VnOOQ

408

ANDERSON AND MUNOIB.

On October 21 I visited Anderson and Muncie in company with
Dr. Forrest, to investigate stream pollution. At Anderson, to-
gether with Dr. Forrest, I rode to the American Strawboard Oo/s
plant and we made inspection of the liquors discharged into
White River. We found that the company was discharging some-
thing like 1,000,000 gallons of wash water into the stream daily,
and that this water was carrying altogether too much refuse.
Where it was discharged into the stream, decided unsanitary con-
ditions were produced, and it will be remembered that on account
of verbal report to this effect, the permit to discharge waste water
into White River, which was formally issued to the American
Strawboard Co., at Anderson, was revoked.

From Anderson, we went to Muncie by trolley, and there made
inspection of the Muncie Pulp Mill, and the condition of Buck
Creek, below the mill. We found that Buck Creek, below the
mill, was badly clogged, being filled up with strawboard refuse.
The stream was shallow and the water contained therein was of
a yellow color, and fermentation of the deposits in the stream was
very apparent. The deposits which clogged the stream and which
undoubtedly made a pronounced nuisance, was composed of wood
pulp, which must have proceeded from the Muncie Pulp Co.^s
works. We found upon inspection of the works themselves, that
owing to the introduction of new processes, pulp was not now being
discharged into Buck Creek. We found further, that the permit
of the State Board of Health was being exactly complied with.
The wash waters from the mill, containing almost no pulp at all,
was first discharged into a pond, covering about one and one-half
acres. From this pond the overflow is allowed to flow into the
creek by means of a weir. A handkerchief held in the stream
which flows over the weir, fails to catch any pulp, but the water
itself is slightly colored with the resin from the wood* which is
washed by it. It was our conclusion that the Muncie Pulp Mill,
at the time of our visit, was following fully and completely the
permit of the State Board of Health, and was not discharging
into Buck Creek any liquors or water matters of an injurious
character.

Digitized by VjOOQIC

409

SHBLBYVILLB,

On October 23, on account of urgent invitation from the city
school and health authorities, I visited Shelbyville to inspect the
diphtheria at that point. I found there had been one death in the
family of the Superintendent of the Public Schools, Professor
Tomlin, and that one of the public schools had been closed on
account of the disease. The School Trustees were all present at
our meeting, and requested advice as to how to proceed. I advised
that the supposedly infected schoolhouse be thoroughly cleaned in
every room and disinfected, and that the school be reconvened
on the following Monday. At that time it was further suggested
that all of the children in the schoolroom where the disease broke
out, should be inspected and those found in any way ill, to be sent
home. This proposition was also accepted by the School Board,
and I offered to come the following Monday and, together with the
City Health OflScer, make the proposed inspection.

SHELBYVILLE.

On October 28 I visited Shelbyville to make inspection of the
children in room 'No. 1, school No. 3. There are 30 children
enrolled in this schoolroom; Miss Blair, teacher. The tempera-
ture of every child was taken and in 21 cases, temperature was
found to be abnormal, and in two cases, the temperature was over
101. Both of these children were quite ill and by direct micro-
scopical examination of the throat exudate, diphtheria bacilli were
discovered in the throats of both of these children. They were
immediately taken home by Dr. Kennedy in his buggy and full
instructions given to their parents how to treat them. Four of
the children were found to need bathing badly, and letters to
that effect were given them to be delivered to their parents. In
this inspection I found 12 children who were unquestionably very
catarrhal and all of them had enlarged tonsils, and should receive
treatment. It seems to me quite impossible for children to make
any progress, who are sick, as was the case with these children.
I have learne<l since this inspection that no more diphtheria has
appeared.

Google

Digitized by VnOOQ

410

L.AFAYETTE.

On November 1, on account of urgent telephone requests, I
visited Lafayette to settle the diagnosis of several cases of small-
pox which had appeared at that point. I visited four cases in all,
each being at a different house, and in each instance, found it to
be smallpox. In one place I found the doctor, who had been
attending it, in the room unprotected in his clothing, and was,
therefore, liable to carry the infection with him. He declared
the case was not smallpox, and furthermore, that it was ridiculous
to wear contagious disease suits in order to protect one's clothing
against infection. This physician was told very plainly that he
must obey the rules and the law, otherwise he would have to be
placed under quarantine. He had never been vaccinated and
therefore, I insisted that he submit to vaccination and to disin-
fect his clothes thoroughly, otherwise submit to quarantine for
fourteen days. He accepted the vaccination and disinfection. I
hope that he has not carried the disease to others.

LAFAYETTE.

On November 4 I again visited Lafayette on account of urgent
invitation from President Stone of Purdue University, to give a
talk to the students upon smallpox, and the necessity of vaccina-
tion, and also to vaccinate whoever would submit Upon arrival I
addressed a body of about 400 students, which had been convened
for the purpose described above. I told them plainly that vaccina-
tion was the only prophylaxis to smallpox, described how virus is
propagated, and what constitutes pure vaccine. I also gave a brief
history of vaccination and explained what constitutes true vac-
cination. After the lecture over half of the students submitted
to vaccination, in which work I was assisted by Dr. Littell, County
Health Officer, and by several of the pre-medical class.

VINCENNES.

On November 6, I again visited Vincennes on accoimt of the
court summons, to testify in the case of the Vincennes Water Co.
vs. The Vincennes Distilling Co. There was no postponement
this time and my testimony in the matter was given. This testi-
mony consisted essentially of what I have heretofore reported in
writing to this board. ^ I

Digitized by VjOOQIC

Digitized by VnOOQ I

411

NEW YORK.

On November 12 I visited New York City, to attend the special
meeting of the New York State Railway Surgeons^ Association,
held at the New York Academy of Medicine. At this meeting of
the above named associationj the subject of car sanitation was
exhaustively considered. I was invited to attend and read a paper
upon the transportation of contagious and infectious diseases on
railroads. My paper was well received, and will be published in
the transactions of the society named. Other papers read in the
symposium were: "Car Sanitation," G. B. Conn, M. D., Con-
cord, N. II. ; "Necessity of Disinfection," M. G. Rosenau, M.
D., Director of Hygiene Laboratory, Washington, D. C. ; "Meth-
ods of Difeinfecting Cars," Wm. H. Park, M. D., Board of
Health, N. Y. The general discussion was opened by W. Wyman,
M. D., Surgeon-General U. S. Marine Hospital Service.

LAFAYETTE.

On November 18 I went to Lafayette on account of smallpox,
which had broken out in West Lafayette. Here, again, the diag-
nosis was fiercely denied by certain physicians, and the town was
in some confusion on account of this condition. It was to settle
the question that I was called. I visited five cases of eruptive
disease and found them all to be smallpox. They were pi-omptly
quarantined, and all exposed persons who could be foimd were
vaccinated and disinfected and ordered to report to the town
Health Ofiioer within ten days after examination. Since this visit
to Lafayette, which was the last of three made in October and
November, the disease has steadily progressed. The Lafayette
City Council refused to perform its fimctions as a Board of ,
Health, as commanded to do in the statutes. The City Council
absolutely refused to furnish funds for maintaining quarantine,
paying physicians and the usual expenses incident to stopping
smallpox. As a consequence of this neglect, the disease spread
rapidly and the conditions became a throat to surrounding
states. The outbreak of smallpox is attributable to Lafayette. In
consequence of this condition of affairs, I informed the County
Health Officer of Tippecanoe County, that in accordance witli the
rules of the St^te Board of Health, it would be the duty of the

Digitized by VjOOQIC

412

Secretary of the State Board of Health to take hold of the matter
and manage the case© of smallpox if the city did not attend to
them properly. This information was given to several business
men who immediately became interested and who said they would
see to it that the City Council performed its duty. At this time
strong efforts are being made to stop the spread of the disease.

WILLIAMSPORT.

I visited Williamsport November 25 to confer with the town
authorities in the matter of building sewers. Upon my arrival I
met the Town Board and the Secretary of the County and the
Secretary of the Town Board of Health. We proceeded immedi-
ately to walk over the part of town wherein it was proposed to
place the sewers and also considered conditions which were in
dispute and which both parties had agreed to leave to my decision.
In this instance, a citizen had connected bathroom and watercloset
with a flat bottom stone sewer which was intended solely for storm
water and for draining cellars. Several houses were connected
with this stone sewer by untrapped tile drains, and the use of the
same for actual sewage purposes had produced gases and odors
which had found their way through the tile drains into the cellars
of the houses which were so connected. My decision was that
such a sewer should not be used for transporting sewage unless all
cellar drains connected therewith wore thoroughly trapped, and
unless the mouth of the sewer was carried further down the stream
so that the sewage would not be deposited in the stream
which, at times, becomes perfectly dry within the corporation of
the town. The sewer system which was proposed, was carefully
considered, and was approved in all except one or two minor
» points.

BEDFORD.

On November 29 I went to Bedford to address the Lawrence
County Teachers' Institute upon the subject of school sanitation.
The meeting was held in the Christian Church and there were
300 persons in attendance, the church being well filled. In my
address I explained how that the ordinary schoolhouse which is
ventilated by windows and doors and warmed by a stove, is un-
sanitary and how such a building is actually wasteful of the

Digitized by VjOOQIC

413

school money. I then described and illustrated how a schoolhouse
should be built in order to surround the children with the very
beet sanitary conditions. My talk was certainly well received,
and a vote of thanks was given me. During my stay in Bedford,
I called upon Dr. Hunter, the County Health Officer, and also
upon Dr. Freeman, the City Health Officer. Both of these gen-
tlemen took occaflion to bring up various subjects pertaining to
their administration of local health affairs. These were discussed
and I think satisfactorily settled.

RUSHVILLB.

On November 30 I went to Rushville on account of simimons to
attend court at that place in a case which concerned the State.
The testimony given was altogether hypotheticd, requiring no
investigations or sanitary studies.

MUNCIE.

On December 7 I went to Muncie to attend the regular monthly
meeting of the Delaware County Medical Society, and read a
paper upon food and drug adulteration. There was a very full
attendance of the society, and in my paper I gave an account of
our very excellent food law, and told how necessary it was to have
a labqratory before it would be possible to enforce the same. Some
fifteen articles of food which were adulterated, and some seven or
eight adulterated articles of drugs were accepted and explained.
The society was appealed to to give its aid to securing a Labora-
tory of Hygiene, under the control of the State Board of Health,
which laboratory would be used for enforcing the pure food law,
and for making all kinds of sanitary examinations for the benefit
of the public health ; a resolution was passed thanking me for the
paper and endorsing the recommendations I had made. The mem-
bers pledged themselves to give their individual and collective aid
in securing a State Laboratory.

PLAINFIELD.

On December 18 I went to Plainfield to attend the annual .
meeting of the State Dairy Association, and deliver an address
entitled: "What Has Not Been Done to Enforce the Pure Food

Digitized by VjOOQIC

414

Law." In this address I fully explained that while we had one
of the best food laws of any state, still there had been no enforoe-
ment of the same, because of lack of funds^ and because of the
necessity of a laboratory. Many questions were asked and a resolu-
tion was passed by the society to the effect that the laboratory
should be established and that the State Board of Health should
have an ample and proper appropriation with which to enforce the
pure food law.

SMALLPOX AT CRAWFORDSVILLB.

On December 30 I received an urgent telephone message from
Dr. J. N. Taylor, Health Officer of Crawfordsville, to come to
that city to settle the diagnosis of certain cases of eruptive disease.
Being disabled on account of lameness due to an accident on the
street car, I was unable to go, and thereupon asked Dr. Chas.
E. Ferguson to make the trip for me. On the morning of Decem-
ber 31 he went to Crawfordsville and reports concerning his visit
as follows :

Upon arrival, I was met by Dr. Taylor, City Health Officer, together
with Dr. Barcus, County Health Officer, and Dr. Dennis, physician. We
visited the following cases: Esther Clement, Just outside the city limits;

Ott WlUlver, Elmore, and James Stevens, who lived within the

corporate limits. Miss Clement was not seized with the prodromal symp-
toms until three weeks after she had returned from I^afayette, Ind. The
other three cases, In as many families, and in different parts of the city,
have not been out of Crawfordsville in a number of months. The source
of infection is denied, but probably proceeded originally from Lafayette.
The cases are all mild and are practically convalescent. One of the news-
papers, the News-Review, is In favor of suppressing the facts, but the
Mayor and Council, whom I met in the evening In the regular session, did
not like this stand. The Council unanimously agreed to support the City
Board of Health in suppressing the disease. Drs. Taylor and Barcus are
certainly most efficient and excellent officers, and should unquestionably
have the confidence of the best people In their community.

REPORT OF VISIT TO SHELBY COUNTY TO INVESTIGATE CON-
CERNING DIPHTHERIA AND SCARLET FETVER.

Various complaining letters have been received to the effect that
Dr. J. B. Stewart, Health Officer of Shelby County, had many
times failed to establish quarantine and to take proper action
when cases of diphtheria and scarlet fever were reported to him,
and it was thought it would be right and proper to have an investi-

Digitized by VjOOQIC

415

gation mada Aooordingly, Captain Anderson, Chief Clerk, waa
instructed to visit Shelby County and discover, if possible, if
there was any foundation for the statements made against Doctor
Stewart Captain Anderson accordingly visited Shelby County
December 7 and he reports aa follows :

I visited Dr. T. O. Kennedy, City Health Officer of ShelbyviUe. ' He
told me that he attended a child in the family of Mr. Phares living outside
the corporation of ShelbyviUe about the first week in November, 1901.
The child had diphtheria and the fact was reported to Dr. J. B. Stewart,
by mall, but no attention was paid to the report. Quarantine was es-
tablished by Dr. Kennedy by informing the people of the law which for-
bade them leaving their premises and mingling with other people during
the prevalence of the disease. Dr. Kennedy also reported that Dr. Stew-
art, in company with Dr. Jones and another physician of ShelbyviUe, vis-
ited the child which Dr. Hurty had examined and which was proven to
have diphtheria, because the diphtheria organisms were demonstrated
by the miscroscope. This child. Dr. Stewart and another physician pro-
nounced free from diphtheria and also carded the local paper to that
effect

Dr. Kennedy further said that "Dr. Stewart has never paid any atten-
tion to the cases of communicable diseases that he had reported to the
said Stewart at any time." Dr. Kennedy further testified that other phy-
sicians have told him that their reports were treated in the same manner
by Dr. Stewart

Dr. Phares, of ShelbyviUe, had a case of diphtheria in Marlon T^own-
ship which he reported to Dr. Stefwart, but no attention was paid to his
report I attempted to verify this statement of Dr. Kennedy's by caUing
upon Dr. Phares, but failed to find him. Dr. Ray, formerly of Fairland,
was seen in his office. He said that his practice had been very free from
epidemic diseases during the last winter. He had two cases of measles
last spring when he was located at Fairland^ but had quarantined them
promptly and confined the disease to one family. He reported the case
to Dr. Stewart, who sent him the necessary quarantine cards. Dr. Ray
said that Dr. Stewart did not visit the cases or pay any attention to them.

Dr. Snyder, of Fairland, stated that he had two eases of diphtheria In
the family of Jacob Helm, and one child died from the disease. The
cases were reported to Dr. Stewart by telephone and he told Dr. Snyder
to put up cards. Dr. Stewart did not visit the cases or pay any further
attention to them. There was a small epidemic of sore throat in the town
and vicinity at that time (last of October and first of November), com-
prising nearly fifty cases. He did not make another report to Dr. Stew-
art, as no attention was paid to hie first report. Dr. Ray thinks that most
of the cases of sore throat were really diphtheria. Dr. J. Sherfee, of Fair-
land, said that there had been an epidemic of tonsUitis this faU among
his patients, but that he had had no cases of diphtheria. Upon my return
to ShelbyviUe, I tried to find Dr. Phares, but failed to do so and returned
to Indianapolis at 12:15 that night

Digitized by VjOOQIC

416

The following letter and the reply of the Attortiey-Gfeneral eX*
plain themselves:

Indianapolis, November 20, 1901.

Mr. Wm. li. Taylor, Attorney-General, City:

Dear Sir— The Health Law of 1809 requires that all Health Boards
''shall take prompt action to arrest the spread of Infectious and contagious
diseases." It also empowers the State Board of Health to pass rules for
the enfcMTcement of the act. , The present rules require that infectious
diseases, like smallpox, shall be quarantined by Health Officers. The
quarantine is obviously for the benefit of the people, not for the afflicted
person. Now the question arises: When a person is quarantined on ac-
count of smallpox or other dangerous transmissible diseases, is not, re-
spectively, the town, if in a town, the city, if in a city, the county, if
without city and town boundaries, liable for all reasonable expenses neces-
sary for maintaining the quarantine? Respectfully,

J. N. HURTY.

Secretary.

Indianapolis, December 17, 1901.

Dr. J. N. Hurty, Secretary State Board of Health:

Dear Sli>-You state that the Health Law of 1880 requires that all
Health Boards "shall take prompt action to arrest the spread of infectious
and contagious diseases," and that it also empowers the State Board of
Health to pass rules for the enforcement of the act. You say that the
present rules require that infectious diseases, like smallpox, shall be quar-
antined by Health Officersi, and that the quarantine is obviously for the
benefit of the people, not for the afflicted person, and you ask: "When a
person is quarantined, on account of smallpox or other dangerous trans-
missible disease. Is not, respectively, the town, if in a town, the city, if in
a city, the county, if without city and town boundaries, liable for all
reasonable expenses necessary for maintaining the quarantine?"

As a general proposition, wherever a municipal offlcer is required by
law to discharge a particular duty on behalf of the municipality he repre-
sents, that corporation is liable for the expense necessarily incurred in
the performance of the act

It would be idle to empower a county, city or town Board of Health
to establish quarantine for the purpose of the protection of the public
health, were not some provision made for bearing the necessary expense of
the quarantine.

It is undoubtedly the duty of the public to provide for the Indigent,
as well as to protect itself from contagious diseases, and the fact that a
person who is not a pauper is afflicted with a contagious disease does not
cast upon the public the entire charge and expense of the treatment of
the disease. Only so much of this expense Is cast upon the public as Is
necessary for its own protection. Beyond this, whatever Is required for
the patient should be borne by himself. If his circumstances justify It

Generally, only the expenses necessary for the protection of the pub-
lic, where a quarantine is enforced, should be borne by the public, and

Digitized by VjOOQIC

417

inasmuch as it is extremely difficult to establish any general rule as to
what expenses are required solely for the protection of the public, and
what are solely for the protection and benefit of the patient, it would be,
in all cases, wise for the Health Officers, in establishing and enforcing
quarantine, to arrange, in the case of counties, with the Board of County
Commissioners, and, In the case of other municipalities, with the proper
fiscal officers, in advance of the expenditures as to what funds might be
required for the protection of the public.

I refer you to the case of lioard of Commissioners of Jay County v.
Ferticb, 18 Ind. App. 1, which discusses this proposition at some length.

I have the honor to be, very truly yours,

WILLIAM L. TAYLOR,

Attorney-General.

SMALLPOX.

Dr. Hiirty reported tliat he had visited the Governor, and re-
quested that aid be given tJie Board from the General Epidemic
Fund for the purpose of carrying on the fight against smallpox.
The fact was detailed that within ten days, messages had been
received from twelve different points in the State requesting aid
from the State Board of Health. From each of these points the
report was presented that there was difference of opinion expressed
among local physicians as to whether or not the disease was small-
pox. This difference of opinion and indecision on the part of the
medical profession introduced demoralization into the work of pre-
vention. It was asked that the State Board of Health send a
representative to make diagnoses and settle this question, so that
the local authorities could proceed with the enforcing of the rules
governing such cases. The Governor announced that he would
take the matter under consideration and would speedily arrive at
k conclusion as to what was to be done. It was then proposed that
tlie Board should visit the Governor upon this same subject, and,
if possible, make it plainer to him and urge early action on his
part. Accordingly, the Governor was called upon and the whole
subject gone over again. It is very probable that permission to
continue the fight against the disease will be speedily granted.

The following circular w^hich marks the first step toward per-
fecting the fonn of death records was sent to 'all County Health
Officers, December 10, 1901:

27-Bd. ot Health. r^ t

/Google

Digitized by VnOOQ I

418

Official Circular.

Dear Sir— Notice Is hereby given you as a Health Officer in the State,
that commencing January 1, 1002, a new form of Certificate of Death will
be used, a copy of which Is enclosed. This new form is in accordance
with that used by the United States and all registration States, and is
adapted for the sake of uniformity. This, it Is plain, will make It possible
to better compare all State mortality statistics, a matter of great impor-
tance. You will cease to use the old form of certificate after January 1.
1902, and It is your duty to so inform the physicians within your juris-
diction and supply them with the nc^v form. Direct that all old certifi-
cates be destroyed on January 1, 1902, and not used under any circum-
stances.

County oflacers will supply all city and town oflflcers and deputies in
their respective jurisdictions.

County officers must see to it that all their subordinates are supplied
and that the public and medical profession are informed as to this change.
The whole matter will most certainly be gladly published everywhere as
news of public imiH>rtance and officers should see to It that their local
newspaiK^rs ai^ fully infonntHl of this Important change.

J. N. HUUTY, M. D.,

By order of the State Board of Health. Secretary.

The Trustee of Washington To\viiship, Marion County, called
at the office and reported that diphtheria had prevailed in his own
and adjoining townships, and that it was his opinion that proper
preventative measures had not been enforced. lie asked that an
investigation be made by this Board. Accordingly Captain Ander-
son was sent to AUiscmville and Castleton to examine into the
matter. His report follows :

Secretary State Board of Health: November 27, 1901.

In pursuance to your verbal Instructions I visited the village* of Allison-
ville this day. and have the honor to submit the following report:

1 aiTived at Castleton, the nearest station on the L. K. & W. K. U. to
Allison vllle, at 7:Ii5 a. m., and called on Dr. A. Wadsworth. He reiwrted
the general health good with the exception of a few cases of the grippe;
no epidemic diseases of any character In his practice or neighborhood, to
his knowledge.

I found Dr. i\ T. BIrket, Health Officer, of Castleton. confined to his
bed with appendicitis and gastralgla. He had bet*!! sick five weeks. Dr.
Birket reported one death from diphtheria in his practice and that case
had been quarantined and properly carded as soon as recognized. Con-
firmed by Dr. Wadsworth. He knew of no cases at this time. Procured a
rig and drove to Allisonvllle, one and one-half miles west of Castleton.
where I inspected the schoolhonses and premises. I found as follows, viz.:

Township Trustee, Jas. V. .Tohnson.

School Director. Albert Koberts.

Neither of these otliceis had visited the school since it was opened
this fall.

Digitized by VjOOQIC

419

This school Is under the supervision of the Health Officer, at Broad
Ripple, Dr. Bates.

Name of teacher, H. A. Cummlngs.

The school building is brick, built in 1895, faces the east and consists
of a vestibule with cloakrooms on each side and one main room. Dimen-
sions of outside, vestibule 12x20 feet, main room 36x28 feet. The location
is good, being on high rolling ground, sloping east and west from the build-
ing. It has no basement, but is built up about eighteen inches above the
surface of the ground, with iron ventilators in base. The room is ven-
tilated from the transoms and windows. Dimensions of rooms on inside:
Schoolroom, 34i^26%xl4 feet; cloakrooms, each al)out 6x10 feet; vestibule,
9x10 feet. The floors were oiled and the room seemed neat and clean.

There were two privies in the yard, back of the building, with a high
tight board fence between them. They are 51 feet from the building to
the front of the privies. There are four seats in each and the vault is
about 4x7 feet and 6 feet deep. They were clean and no bad odor coming
from them. The teacher reports that they are scrubbed and disinfected
whenever needed. Carbolic solution is used for disinfecting. The build-
ing is heated by a large natural gas stove and was very comfortable. The
thermometer showed 69 degrees Fahrenheit. The water is obtained from
a driven well over 100 feet deep in the schoolyard southeast of the school
building and has an jron pump in it. There is a small wooden trough
about two feet long that catches the drip and carries it away from the
well that far. It is about 130 feet from the privies and on the opposite
slope of ground. The ground is high and slopes away from the school -
house in all directions, with a good gravel subs^oil. I would consider the
water supply good and wholesome. There are 36 pupils enrolled and an
average attendance of 31.1.

The teacher reports one case of croup and a few colds as the extent of
sickness in the school to date. There are none sick now.

The building was disinfected before school began. The building and
surroundings are clean and in excellent condition. The floors are oiled
and cleaned by damp sweeping. The schoolroom is nicely papered. Black-
board across the west end of a dead black. Four windows on each side
and two at the east end with outside shutters to each and inside blinds on
the south side. The pupils seem bright, the room well ventilated and
no close smell in the room. The seats are proportioned to the age of the
pupils. I talked with Ricd, whose daughter, Mrs. Stoops, died of diph-
theria at his house and where the disease first appeared. He says that
he does not think she had the diphtheria, but that it was pneumonia
which caused her death. He said that no one else took the disease from
her, but also stated that the house was quarantined and after her death
was thoroughly disinfected before any one was allowed to enter or leave
it. Mrs. Smith's child, who now has the disease, has never been in their
house since his daughter's death and has no idea as to how it contracted
the disease, as the family left the village before his daughter's death
and did not return until three weeks after it. Mr. Smith's house is carded.
The attending physician is Dr. Bates, of Broad Ripple. Dr. Bates stated
that he was unable to trace the source of infection of the Smith family.
There were no other cases in Allisonvllle. jas. L. ANDERSON,

Chief Clerk Vital Statistics.

Digitized by VjOOQIC

SECOND QUARTER.

February, March and April, 1902*

SPECIAL MEETING.

Office Indiana State Board of Health,

Indianapolis, Ind., March 7, 1902.

Present: T)rs. Forrest, Davis, Cook, Wishard and Hurty.

The meeting was called to order at 10 :30 a. m.

The object of the special meeting was announced to be : To con-
sider the report of the Board to the Governor for 1901 ; to consider
the Michigan City situation; the smallpox situation throughout
the State and also to advise the Secretary in regard to the offer
to him of the position of Superintendent of the Hygiene Exhibit
at the Louisiana Purchase Exposition to be held in St. Louis,
Mo., in 1903.

MICHIGAN CITY.

December 27 information was received by telephone from
Michigan City that a severe epidemic of winter cholera existed at
that place. My informant. Dr. Tillotson, said he believed the
outbreak to be due to sewage which had been introduced into the
water supply. He explained there were two intakes to the water-
works, one reaching about half a mile out into the lake and an-
other a few hundred feet, opening into the creek. The latter in-
take was put in as a precaution against fire, Ix^cause it was known
tliat lake intakes sometimes freeze up. In the event of the freez-
ing of the long intake, then water could be pumped from the
creek. On the 21st of December, without any warning, the en-
gineer at the waterworks turned in the water from the creek, and
within twenty-four hours, hundreds of people were prostrated

^421)

Digitized by VnOOQlC

422

with, severe diarrhoea, attended with pain and having many of
the symptoms which reminded of cholera. It was for this reason
the disease was called winter cholera. Dr. Tillptson urged that
the State Board of Health investigate the matter, for he declared
the city authorities were wholly indifferent and did not care how
many of the citizens were made sick. Tie also accused the city
authorities of being incompetent in this matter. After this, letters
were received from various citizens of Michigan City, requesting
aid from the State Board of Health, all of them declaring that the
local authorities seemed to have no interest in the matter and were
incompetent. One of our correspondents said they were corrupt.
Finally a petition was received which was dated February 19,
and which is appended to this report. This petition is signed by
Dr. R. W. Godfrey, the Secretary of tlie City Board of Health,
and also by all of the physicians, save one, in Michigan City. It
is also signed by many citizens. In answer to this petition.I went
to Michigan City February 24 to investigate the state of affairs.
With Dr. Brose S. Horn, I first visited the city building and in-
quired for the Engineer and Mayor. The clerk in charge toid me
that neither of these officials were in and that he did not know
where I could find them, nor when I would l)e able to see them.
From here I went to investigate the waten^'orks. From Dr. Home
and Warden Reid I learned the present works were opened in No-
vember, 1900, and had a capacity of 4,000,000 gallons per day. At
the present time 2,500,000 to 3,000,000 are pumped each day.
There are two 24-inch intakes; one leads into the lake, 2,800 feet
from the pump-house, and the otlier leads to the creek, a distance
of about 2,500 feet. I found the intake in the creek, where it was
surrounded by rotten wooden work in a state of decay. I noticed
a goodly quantity of sewage fungous growing on the wooden work
in the neighborhood of this intake. A large sewer, which is the
main sewer of tlie city and which carriers all the sewage of the
prison, empties into the cret^k, al)out three squares above the creek
intake. The engineer informed me that the intake leading to the
creek was opened Saturday, Deceml>er 21, and kept open five or
six days. They were compelled to open it because anchor ice
filled the lake pipe.

From tlie works I drove up the creek to inspect the sewer. It is
a large sewer, empties directly into the creek, as stated before, and

Digitized by VjOOQIC

423

delivers a very large volume of sewage. Near its mouth is to be
seen plainly in the water an immense amount of accumulations,
and sewage fungus, even at this time of the year, is found grow-
ing vigorously. I then called upon Drs. Tillotson and Blinks.
Dr. Tillotson said winter cholera commenced Sunday night, De-
cember 22, on himself, wife and grandson. These were his first
casas. He said water had an amber color and pronounced taste
on Sunday morning. He further told me that at the car factory,
in the casting foundry, all the men were taken down. He told
further of a Mr. C. W. Black, employed in the casting foundry at
the car works, who lives out at Eastport, and who uses well water
at his home. He drank the city water at the car factory and w^
sick. No other members of his family were affected. Chas.
Cloud, nephew of Black, presented the same history. Dr. Tillot-
son said he interviewed eight country people as to whether or not
they had had "winter cholera." He learned in this interview
that no cases had appeared in the country surrounding Michigan
City, except one, and that w^as a girl who had been to town and
drank city water. Both Drs. Tillotson and Blinks express the
opinion there were at least 2,500 cases from the 21st to the 30th
of December. Dr. Tillotson said he intendewed doctors as to the
occurrence of winter cholera in the country, and all reported no
cases. No deaths had occurred from jthis winter cholera. The out-
break gradually subsided, but many patients were left with gastric
and intestinal disorders. Dr. Tillotson said the mains w^ei-e not
blown off for some days after the creek water was turned off and
the lake water again introduced. Dr. Tillotson had had no cases
of typhoid fever. Dr. Blinks had one case of typhoid. He made his
first visit January 1, and traced it to the city water. Both Drs.
Tillotson and Blinks are decidedly of the opinion the creek w^ater
in the city mains pumped into the same for several days, com-
mencing December 21, was the cause of tliis outbreak of "winter
cholera" and also the cause of the typhoid then prevailing.

Dr. J. B. Eogers was seen at his office, and informed me that
the winter cholera first commenced in his own family. He had in
all not less than thirty cases, and estimated there were not less tlian
2,000 cases in all. The outbreak lasted a month, the effects being
somewhat lasting, leaving intestinal indigestion. Dr. Rogers ex-
presses the positive opinion that the public water supply was the

Digitized by VjOOQIC

4l>4

cause. He has had three cases of typhoid fever since the introduc-
tion of the pollution into the city mains, and three of these cases
were probably due to the water.

Dr. Drescher. This lady physician told me she was thoroughly
convinced that the water supply was the cause of the epidemic of
winter cholera. She had not less than tw^enty cases, and then, on
February 28, had four cases of typhoid fever. All of these pa-
tients drink city water. She had had no well-defined typhoid cases
within the last year, except these just named. She expressed the
opinion there were probably not less than 2,000 cases.

Dr. H. W. Wilson. This gentleman stated he had practiced
medicine ten years in Michigan City, and fully believed the epi-
demic of winter cholera due to sewage in the public supply. All
his winter cholera patients drank city water, and ^^re taken down
so suddenly after drinking it that they themselves believe it to be
the cause. He had had only a few cases of well-defined typhoid
in his ten years' practice, but had had two cases since which were
possibly typhoid. Both of those patients drank the city water. He
thinks Uiere were over 2,000 cases of winter cholera. lie says in
his square the four families using water from his deep well were
entirely free from the disease, and three families on the north
side of his square using the public water were attacked. His
horse refused to drink the water Saturday morning, February 22.
Dr. Blinks, who was seen after the first inten'iew above detailed,
explained that he refused to drink the water iKXjause of the smell
and was, therefore, free from an attack of winter cholera. He
said tlie water smelled and tastc<l slightly of tar and gas, and he
knew tlie gas works emptieil into the sewer, and concluded, there-
fore, the water was polluted with sewage. No sickness like this
winter cholera at the present time has existed at any time. At
the factory of tlie King Seeding Co. the 200 employes, who are
supplied with water from a deep well, were not made sick. All
of these employes also drank well water, none of them being sup-
plied with hydrant water. The GOO employes of the Hitchcock
Chair Co. are supplied with dcn^^p well water, and they present the
same history as those employed by the King Seedin*!; Co.

I did not call upon Dr. W. R. Godfrey, Health Oflieer, because
his physician told me that Dr. Godfrey was very old, very infirm

Digitized by VjOOQIC

•425

and at tliat time quite ill. He also said the old gentleman could
not be made to understand clearly everything that was said to
him. This coming from his o\\ti physician, I thought it wise not
to bother him, especially as he had signed the petition, dated Feb-
ruary 19, which sets forth the opinion of the signers that the epi-
demic of typhoid fever, diarrhoea and bowel trouble which had
prevailed in Michigan City was caused by introducing sewage into
the public supply.

In the evening I was invited to attend a meeting of the citizens
of [Michigan City. I was introduced to two ministers, several atr
torneys and several good business men. There were also present
five physicians. In this meeting the situation was thoroughly dis-
cussed, and the opinion seemed to be to Uie effect that the people
of Michigan City were quite helpless, that they were in the hands
of the officials, and they did not appreciate that a great harm had
Ix^en (lone to the city and who seemed not to care whether disease
and death entered the town. Some of the speakers used very
strong language, some of the expressions Ix^ing extraordinarily
strong. The Rev. Mr. Wilson freely expressed the opinion that
unless the State Board of Health took hold of this matter and or-
dered the removal of the crook intake, that the awful conditions
which had just been experienced would again visit Michigan City,
lie said the Mayor was also seci-etary of the water company, and
he believed that this official did not care for any other interests ex-
cept his own. Being called upon to express an opinion before this
meeting, I told thorn it was my belief that the epidemic which had
been so plainly descril)ed by the physicians was due to poisons
which were introduced into the water supply from the sewage-
laden water of the creek. I further expressed the opinion it was
to be deeply regretted that the city officials and some others did
not niore fully appreciate the gravity of the situation. I informed
them the citizens of ^lichigan City had complete control, and
surely could secure from the authorities everything that was neces-
sary in the premises. While the State Board of Health undoubt-
edly had power, under the law, to take hold of this question, and
to order the removal of the intake pipe from the creek, still I
thought it would be loath to do so because the conditions did not
threaten other communities or the people in the immediate neigh-
Digitized by VjOOQIC

426

borhood. Only the citizens of Michigan City were affected, and
surely they were able to right the wrong conditions.

On February 27 a document was received, signed by E. J.
Bower, an attorney of Michigan City, who was made secnetaiy of
the meeting described above. This document is appended hereto,
following the petition first spoken of.

On March 4 a further document was received from the Board
of Health of Michigan City, and this also is appended. I append
also a letter from E. J. Bower, attorney, which follows the com-
munication from the Michigan City Board of Health. This letter
explains itself.

I recommend that it would l)e best for the State Board of Health
not to take positive action in this matter at the present time, but
to advise the local health authorities to remove, without delay, the
intake of the waterworks which reaches to the creek.

Michigan City, Ind., February 10, 1902.

To the Honorable Body, the State Board of Health:
Gentlemen—

Whereas, This city is just recovering from an epidemic of typhoid
fever, diarrhoea and bowel trouble, which has caused great suffering,
siciiness, and, in several instances, to a large proi>ortion of the people of
this city, occasioned, we believe and are fully convinced,, from the use
of impure and filthy water, which was, on the 21st day of December, 1901,
turned in from our harbor tiirough an emergency pipe, into the water
mains of the city (through which the city receives its supply of pure water
from Lake Michigan) by officers having in charge the pumping station,
without notice or warning to the public, and

Whereas, The water in the harbor is polluted by sewage from the
State Prison and city, into which they empty their flith and vUeness,
rendering said harbor water unfit for domestic use, and so long as said
enaergency pipe is connected with the harbor and pumping station, the
same will remain a menace to the lives and public health of the citizens
of this city, as it permits the waterworks officials to use said harbor water
at their pleasure, hence the lives and health of the public are In constant
Jeopardy. Now

Therefore, We, the undersigned citizens of Michigan City, Ind.. do
hereby petition and pray that your honorable Board will take immediate
action to compel the removal of said emergency pipe from said harbor,

Digitized by VjOOQIC

427

and disconnect the same from said pumping station, and tlius remove said
nuisance and tlie danger of a re-occurrence of said dread epidemic.

Respectfully submitted.
W. R. Godfrey, M. D., Secretary Board of Health, Michigan City; A.
G. TiUotson. M. D., H. W. Wilson, M. D., E. G. Blinks. Jno. J.^
Kerrigan, M. D., J. Nelson Ledbetter, M. D., B. Rubin, M. D., M.
L. Drescher, M. D., Alva Spinning, M. D., J. B. Rogers, M. D.,
Frank R. Warren, M. D., Whitefield Bowers, M. D., P. V. Martin,
M. D., John Blackman, E. J. Wrobes, Rev. E. Sevlarzcls, William
H. WMlson, R. W. Street, Henry K. Booth, Rev. J. H. Cissel, Charles
H. Purdy, C. J. Robb, Henry W. Johnson, H. E. Hitchcock, A. C.
Gause, E. Morris, A. N. Gittings, John M. Dunlop, N. V. Cole, C.
Elliott, R. R. Nafe, E. W. Lindemann, Otto Kloepfe, Secretary L.
C. Drug Association; Aug. Oppermann, C. H. Oppermann, F. M.
Breckllng. H. Chuby, Otto Klopsch, U. Culbert, F. A. Long, L. G.
Kramer, President Laporte County Drug Association; Chas. H.
Ritter, C. J. Dohn, C. A. Cline, L. L. Woods, H. A. Root, lyouis
H. Sieb, Mrs. Minnie Leeds, A. F. Earl, G. S. Van Deusen, J.
Cassidy, Edw. J. Bower, Attorney, Wm. Ohrming, Jr., W. P. Burns.
John C. Zahm.

Michigan City, Ind., February 25, 1902.

At a meeting of the citizens of the city of Michigan City, Ind., called
at 4:30 o'clock in the ofllce of I^. J. Bower, in said city, for the purpose of
meeting the Secretary of the State Board of Health, Dr. J. N. Hurty, and
to discuss and determine the cause of the present epidemic of typhoid
fever, diarrh(pa and bowel trouble, prevalent in the city, and to adopt
measures to prevent a re-occurrence of the same, the following proceedings
were had:

Meeting was called to order by Dr. A. G. Tillotson, and Mr. H. B. Mor-
ris was chosen Chairman, and E. J. Bower, Secretary pro tem.

The chair then called on the physicians present, for statements and
opinions on the subject before the meeting, and an informal discussion
followed, participated in by Drs. Tillotson, Blinks, Martin and Home, in
which they gave as their opinion, that said epidemic was caused by the
use of Impure and filthy water, tunied into the water mains on the 21st
day of December, 1901, at the pumping station in the city, through an
emergency pipe connected with the harlwr and said pumping station.
Then followed a general discussion by the citksens present.

Dr. J. N. Hurty, Secretary of the State Board of Health, being present,
was then called on for an opinion and statement of his investigation in the
matter, and responded, condemning the present waterworks system, and
recommending the removal of the emergency pipe connecting the harbor
with the pumping station.

The Secretary then read a petition to the State Board of Health, pre-
sented and signed by alwut fifty of the citizens of the city, asking that

Digitized by VjOOQIC

428

said Board take immediate action to compel the removal of said emergency
pipe, and the same was presented to the Secretary, Dr. J. N. Hurty, of
said Board.

The following resolution was then passed:

Resolved, That the matter of the removal of the emergency pipe
connecting the harbor and the pumping station in this city, be and the
same is hereby referred to the State Board of Health, asking that said
Board take immediate action to bring about the removal of said pipe, be-
lieving that the local Health Board will not act in the matter, and that
this is the proper method to pursue.

Motion was then made and seconded, that Charles H. Purdy b6 elected
permanent chairman of these meetings. Motion carried.

Motion was then made and seconded, that E. J. Bower be made perma-
nent secretary thereof. Motion prevailed.

The chair then appointed the following named persons, as a standing
committee, viz.: Dr. A. G. Tlllotson, Dr. E. G. Blinks, Dr. Martin, Mr. U.
Culbert, J. E. DeWolfe, Rev. Wm. H. Wilson, Rev. H. K. Booth.

Motion was then made to adjourn, to meet Friday evening, February
28, at 7:30 o'clock. Motion carried.

B. J. BOWER,

Secretary pro tem.

Michigan City, Ind., March 3, 1902.
To the Members of the State Board of Health:

Gentlemen— The members of the Board of Health of this city desire
to make a plain statement in regard to the water and typhoid fever agita-
tion which is now going on in this city, and which, we understand, is to
be brought to your attention at a special meeting called by your Secretary
for that purpose. It is our desire that we be heard, and inasmuch #s Dr.
Hurty did not visit us or the local Health Office while here, we take this
as the only manner in which we can get the facts before your honorable
body.

The true facts are that there is no more typhoid fever in Michigan
City this winter than there was for the same period of time a year ago.
From September 1, 1001, to March 1, 1902, there were seven deaths re-
ported from typhoid conditions. Two of these were reported as tubercu-
losis of the bowels, one case was reported from Coolspring Township,
three miles distant from the city, and two others occurred at the Prison,
so that the actual number of deaths from regular typhoid in the city proper
during the six months stated above was two. Now, for the same length
of time there were reported to the Board a total of eighteen cases of
typhoid in the city. One year ago, or from September 1, 1900, to March
1, 1901, there were reported the total of twenty cases, showing less cases
reported this year with all the talk of epidemic, than there was In'lfMK).

This agitation regarding the typhoid situation here grew out of the
fact that last December there was an epidemic of winter cholera here,
and it has been said that as many as 2,000 persons were sick; but Investi-
gation shows that there was not one-third that number afflicted. About
the same time the city waterworks pipe leading into the lake a half mile,
and which supplies the water for the city, became clogged with ice, and

/Google

Digitized by VnOOQ I

429

to prevent possible destruction by fire a supply of water was drawn from
the harbor until the ice could be cleared away. It is claimed further that
the use of this harbor water caused the winter cholera. The local Board
Investigateti this matter, and found a divided sentiment among the physi-
cians. To be on the safe side in any event, the Board, two days later,
adopted a resolution asking the Council to determine upon certain signals
to be used by the waterworlcs engine?ers to warn people if there should be
necessity for recourse to the harbor pipe again in the future. The mem-
bers of the Board also tools pains to ascertain if the winter cholera was
entirely due to the use of this bad water, and they, as well as the physi-
cians, found as many cases or more, among people who had not used the
water than among the i-egular patrons of the water company. In fact,
the epidemic was as general in the country round about and in the out-
skirts of the city b^ond the water limits as it was in the downtown dis-
trict, so that it is at least a mooted question whether it was the water or
the peculiar atmospheric conditions prevailing at that time.

One particularly sad case which has caused all this typhoid agitation
is the death on February 6 of Miss Purdy, a young lady of this city, who
died while attending school at Oxford, Ohio. The circumstances attending
her death have been taken as the basis of all the false reports circulated
against the Board and the city. The young lady's death was certified to
the Board of Health by her Oxford physician as being caused by broncho-
pneumonia and chronic disease of the heart, the cause of death being given
as heart failure. No typhoid fever was mentioned in her case. The orig-
inal report of this case is now on file in the oflice of Dr. Hurty, and he
could have investigated this case in Indianaix>lis if he had desired to
do so.

The members of the Michigaii City Board can not understand why Dr.
Hurty did not call on them to investigate the reports which brought him
to this city. He never came near any one of the Board, did not visit the
office of the Secretary to find out how many deaths had occurred from
typhoid, or how many cases had been reported. His presence here was
only learned through the local and Chicago papers after he had gone away.
While the Board can survive his "snub," they do not want to rest under
a pack of barefaced lies which the Secretary as the agent of the State
Board was bound to investigate impartially If he would be judged as an
unbiased official. He could at least have inspected the records of the
Board, and then he would not have been misled into making some of the
remarkable statements attributed to him by the Chicago papers.

The Michigan City Board is perfectly willing and able to meet the
health conditions hei-e, and when they can not do so, they will be glad
to avail themselves of their right to call on the State Board, but if the
Secretary must get busy at the beck and call of every one, he should in-
vestigate both sides of the situation, and not take the word of a few who
seem desirous of magnifying an ordinary condition into one which is
grossly untrue, and which does this Board and the city of Michigan City
a manifest wrong. Very respectfully,

CHARLES WALTERS, President,

C. A. KRUEGER, Treasurer,

W. R. GODFREY, M. D., Secretary.

Michigan City Board of

Digitized by ^

mhgle

430

Michigan City. Ind., March 5, 1902.

Dr. J. N. Hurty, Secretary State Board of Health:

Dear Sir— We notice through the local paper that the local Board of
Health has sent to the State Board a statement of the health condition
here and in which they undertalce to censure you for your acts while here,
and ridicule the attitude taken by the good people of the city. We wish,
however, to call the attention of the Board to the fact that the local Sec-
retary signed the petition of the people which was presented to you and
that it is our opinion that this last petition was drawn by the Mayor and
presented to them for their signature.

We wish to assure you that the attitude of the people is unchanged
and are willing to lend you all possible support.

Very respectfully,

E. J. BOWER.

The report for 1901 to the Governor was then taken up. Re-
ferred to a committee composed of Drs. Wishard and Hurty, with
instructions to review the report as written by Dr. Hurty, to
make such changes as might seem proper and then send it by mail
to each member of the Board for signature.

The Michigan Qity matter was fully discussed and considered,
and Dr. Davis offered the following:

Moved by Dr. Davis: The Secretary is directed to notify the
petitioners of Michigan City that the local Health Board has am-
ple authority to abate the condition of ill health complained of and
all local resources must be exhausted before the State Board
should act.

Carried.

Digitized by VjOOQIC

SECOND REGULAR MEETING FOR THE
nSCAL YEAR.

Office Indiana State Board of Health,

Indianapolis, Ind., April 11, 1002.

Present: Drs. Forrest, Davis, Cook and Hurty.

The meeting was called to order by President Forrest at 10
a. m.

Minutes of the last regular meeting were read, also the minutes
of the special meeting held March 7, 1902. Both were approved.

REPORT OF SP:(^RKTARV FOR QUARTER.

All of the orders issued by the last regular and special sessions
have been executed. Permits and resolutions were issued.

During the months of January, Febniary and March the office
force has done extra work, wdiich was necessary to make up the
tables for 1901. I am glad to say these tables* are now nearly fin-
ished, auvl that the rest of the copy for the report of 1901 will be
ready in another week. During the quarter the Secretary, at his
()wn expense, has done the following laboratory w^ork:

Twent3'-.seven spiitums examined, of which 9 were positive and 18
negative; 22 diphtheria cultures examined, of which 18 were positive and
4 negative; 14 water analyses, all but two of which showed pollution and
were condemned; 4 millv analyses, 3 contained formaldehyde.

Fourteen visits were made, as follows :

January 11. Huntin8:ton, account lecture on Iiygiene before the Hunt-
ington County Farmers' Institute.

January 15. Lafayette and Crawford.sviUe, account smallpox.

January 20. Winchester, account lecture on hygiene l)efore the Ran-
dolph County Farmers' Institute.

February 4. Veedersburg, accouht smallpox.

February 17. Fortville, account smallpox.

^^" - ,Goo5le

Digitized by VnOOQ I

432

February 18. Salem, occonnt lecture on bygieiie before Salem Farm-
ers' Club.

February 21. Carmel, account lecture on hygiene before the Hamiftou
County Farmers' Institute.

March 4. Lebanon, account lecture on hygiene, by the Knights of
Pythias Association.

March 8. Shelbyville, account smallpox.

March 18. Anderson, account public lecture on hygiene, under auspices
of Harvey Medical Societj-.

March 10. Oreencastle, account smalliwx.

March 21. Terre Haute, account hygiene lecture before students of
State Normal School.

March 25. Greensburg, account two lectures before Greensburg High
School.

March 2J). Batesvllle, account smallpox.

April 5. St. Paul, account schoolhouse insi)ection.

The following is a coinpIet<i account of these visits:

IIUNTIXGTON.

On Janiiar}' 11 I visite(^l Ilnntington on account of an invita-
tion from the Farmers' Institute, and delivered a lecture upo!i
^'Hygiene and Sanitary Science." The said lecture was delivered
in the afternoon to an audience which completely filled the oj>era
house, and I think it met with favor, because resolutions of ai>-
proval and thanks were passed. At the close of the lecture Mr. D.
Burkett, a farmer living near Huntington, gave full information
in regard to a nuisance in the form of a poultry house, and asked
that the Health Department give him relief. Mr. Burkett was
fully informed how to procee<l, and I have since learned that, upon
application to the County Health Board, the nuisance was abated.

LAFAYETTE AND CRAWFORDSVILLE,

On January 15 I visited Lafayette and Crawfordsville, on ac-
count of smallpox prevailing at these places. The immediate
cause of going to Lafayette wsxs the fact that the Chicago health
authorities requested special information from this Board, con-
cerning the prevalence of the disease at Lafayette, so as to deter-
mine whether or not quarantine should be established. Upon arri-
val at Lafayette, I ^vaited upon the City Health Officer, Dr.
Tilson, and secured a full account of the situation. He told me
the City Council had refused to make an appropriation with which

Digitized by VjOOQIC

43a

to figlit smallpox and he was, therefore, compelled to do the very
best he could under the circumstances. He said the physicians
of the place gave their warmest support and encouragement to the
work of prevention, and that at the time I was there, there were 38
case© in 13 quarantined houses. Dr. Tilson reported that he and
other physicians continually recommended vaccination. Dr.
Ileman Spalding, representing the Chicago Board of Health,
visited Lafayette the same day, but I did not meet him because
I left for Cra\\rfordsville on the train which brought him from Chi-
cago. On account of my reix)ii: of the exact conditions at Lafay-
ette, and having expressed the opinion that no menace to Chicago
existed at that point, the Chicago authorities did not establish
quarantine.

At Crawfordsville I met Dr. Taylor, Health Officer of that
place, also Dr. Barcus, Health Officer of Montgomery County.
Dr. Taylor had requested me to come to Crawfordsville that advice
and direction might be given and also confirmation of diagnoses
already made. I visited five families all under quarantine and in
each one typical cases of smallpox w^ere found. Through Dr.
Taylor's efforts, the city w^as constructing a smallpox hospital at
the time I was there, and it was occupied two days later. To this
hospital all cases of variola were promptly taken and vaccination
was practioed w^ienever the individual would permit. Thorough
disinfection of houses infected by the disease was also performed.
Within tw^o weeks from this time, as since learned, smallpox was
completely driven out of the city of Crawfordsville.

While there I made a visit to the new abattoir. Crawfordsville
and Indianapolis are the only cities in Indiana which, by
s]X3cial ordinance, require that animals intended for food pur-
poses shall 1x5 slaughtered in a sanitary way. The abattoir at
Crawfordsville is a model in every respect, and the city authorities
deserve great praise for having established such an institution for
the protection of the health of the people.

WINCHESTER.

January 21 I went to Winchester because of a special invita-
tion from the Farmers' Institute of Randolph County, and de-
livered a lecture upon ^^Hygiene and Sanitary Science." The

28- Bd. of Health. ^ ,

Digitized by VjOOQIC

434

meeting was hel4 in the court room of the courthouse and the at-
tendance was so large that stxinding room could not be secured. I
feel confident the lecture was appreciated and effective, because
resolutions of appreciation and approval of the work of the State
Board of Health were unanimously passed.

VEEDERSBURG.

On February 4 I visited Veedersburg on account of variola at
that place. The Health Officer, Dr. F. A. Shoaf, had especially
urged that a visit be made and advice given. On arrival at Ve^
dersburg I found two cases of smallpox in two different families.
There had been much dispute among the physicians as to the diag-
nosis of the disease, and it was mostly for this reason that Health
Officer Shoaf called for assistance. After seeing the cases, I met
the Mayor and the City Council and gave them full directions
how to stop smallpox. These authorities were unanimous in their
determination to stamp the disease out I have since learned tbat
free vaccination was offered and that rigid quarantine was placed
upon every ca.se of variola that developed, vvhicli in all amounted to
three cases. The disease, therefore, did not last long in Veeders-
burg.

^ FORTVIT.LE.

February 17 1 visited Fortville on account of smallpox at that
point, and because Health Officer Stewart and the chairman of
the Town Board requested that aid and advice be given. At Fort-
ville I found 7 cases of smallpox in five families, and as usual, the
local physicians were disputing as to the diagnosis. This point
being settled, quarantine was established and the Board was in-
duced to offer free vaccination to the people. I have since learned
that the measures adopted proved effective, for only a very few
cases developed afterwards.

SALEM.

February IcS I went to Salem to address the Salem Farmers'
Club upon the subject of "Hygiene and Sanitary Science." A
special invitation was extended to me and I met with the most
cordial reception. The meeting was held at the house of Wra.
Lindley, al>out four miles north of Salem. There were present 12

Digitized by VjOOQIC

435

mon and 12 women, heads of 12 families. I enjoyed an excellent
country dinner and in the afternoon' delivered my paper. As
usual, upon these occasions, resolutions of thanks and appreciation
were offered.

CARMEL.

February 21 I visited Carmel to address the Hamilton County
Farmers' Institute upon "Hygiene and Sanitary Science." The
lecture was given at night in the Friend's Church, to an audience
which completely filled the building. Lantern slides were used
to illustrate the lecture and afterward numerous questions were
asked by members of the audience. I am 'confident the visit to
Carmel was attended with good results, for resolutions of appre-
ciation and endorsing the work of the State Board of Health w^ere
unanimously passed. As I was compelled to stay all night, not
being able to return until morning, I next day visited the Carmel
school building and made a sanitary inspection. This is an eight-
room brick building, built in 1887. It has no basement and is
heated by large ventilating heaters. It seems in this instance,
these heaters are not effective, for Dr. Horshey, Health Officer of
the towTi, and Superintendent Retherford, stated that in cold
weatlier the temperature of the downstairs rooms frequently fell
as low as 40 degrees. The upstaire rooms were always comfortably
warm and no complaint was made in regard to them. None of the
rooms are proi:)erly and sufficiently lighted. The ventilation is
simply by windows and doors and by means of the ventilating
heaters which do not work. This sclioolhouse, therefore, is not
properly lighted, ventilated nor warmed, and is unsanitary. The
average attendance, as reported by Superintendent Kotherford, is
hardly 70 per cent.

LEBANON.

On March 4 T went tx) Lebanon to deliver a public lecture on
^^Hygiene and Sanitary Science" before an audience invited by the
Knights of Pythias. The meeting was held in the Knights of
Pythias Hall, every seat being occupied. The lecture drew forth
many inquiries from citizens in the audience, which were answered
to the best of Tny ability.

Digitized by VjOOQIC

436

SHELBYVILLE.

March 8 I visited Shelbyville on account of smallpox, being in-
vited and urged to come by Dr. Thos. Kennedy, local Health
Officer and the Mayor of the city. The reason for asking help from
the State Board of Health was because the County Health Officer,
Dr. Stewart, had denied the existence of smallpox and the City
Health Officer, Dr. Kennedy, was having very great trouble in es-
tablishing quarantine. I visited two houses where cases werje under
dispute and found, in both instances, well pronounced discreet
cases of smallpox. My decision to that effect was given and" after-
ward I waited upon Dr. Stewart and told him that the cases must
be considered as smallpox, for they were actually so, and that he
must remove his objections. Dr. Lynch, who had been employed as
smallpox physician for the city of Shelbyville, told me of a case
in the country which he had reported to Dr. Stewart, County
Health Officer, but which had not been quarantined. Upon in-
quiry from Dr. Stewart I found that the accusation was true and
Dr. Stewart's excuse for not establishing quarantine and enforc-
ing the law was that he was very- busy. Dr. Stewart's attention
was called to the rules and also to the fact that he should perform
his public duties which he had assumed, before he discharged any
private business. He promised to do so hereafter and to establish
quarantine promptly whenever occasion demanded.

ANDERSON.

On March 18, upon invitation from the Harvey Medical Society,
which is an organization of the city physicians of Anderson, I
went to that city to deliver a lecture uix>n "Tuberculosis and Its
Prevention," in the First ifethodist Church. A large audience was
present. The lecture was illustrated by lantern slides and, upon
its conclusion, many questions were asked by citizens in the audi-
ence, and answers given. Before the audience was dismissed, reso-
lutions favoring the creation of a State Hospital for Indigent
Consumptives and also favoring the legislation necessary for the
suppression of consumption, were introduced by Dr. Norris, and
were unanimously adopted by the meeting.

Google

Digitized by VnOOQ

437

GREET^ICASTLK

On March 19, on account of an urgent telephone message from
Dr. Preston, Health OflSoer at Greencastle, I went to that city to
investigate some cases of smallpox, the diagnosis of which was
under dispute. I visited two houses and found in each of them,
typical cases of discreet smallpox. The disease was declared and
quarantine was established.

TERRE HAUTE.

March 21 I went to Terre Haute upon invitation of President
Parsons, of the Indiana State Normal School, to deliver a lecture
upon ^*School Hygiene" to the students. The lecture was given in
the Assembly Room of the Normal College. The audience was
large, filling fully four-fifths of tlie hall. After the lecture many
questions were asked by the pupils present, which I think indicates
that some interest in the subject was aroused.

GRBENSBURG.

March 25 I visited Greensburg upon invitation of Superin-
tendent D. M. Geeting, of the Public Schools, to deliver two
lectures upon ^*Public Hygiene." My audience was composed of
tlie high school pupils and those of the grammar grade and filled
the Assembly Hall of the high school building. My first lecture
was entitled "Public Hygiene" and the second "Personal Hy-
giene." In order to arouse as much interest as possible among die
pupils, I offered a prize of $2.00 for the best w^ritten abstract of
both lectures and $1.00 for the second best written abstract of the
lectures. In due time the pupils who entered the competition re-
ported and the first prize was awarded to Miss Ethel Crume, and
^he second to Miss Marietta Stewart.

BATES VILLE.

March 29 I visited Batosville because of a telephone message re-
ceived from Health Officer Gibson of that place. He represented
that smalli)OX existed in the neighborhood of Batesville, which was
being diagnosed as chickenpox, itch, etc., and in consequence effi-
cient quarantine could not l)e established, and he feared the disease
would be furthered in every direction. On arriving at Batesville

Digitized by VjOOQIC

438

I was met by Drs. Gibson, Eliott and Ziteke. Together we visited
two families a few miles out of Batesville. In the first family, that
of John Seifert, were found 6 cases of smallpox. Two of the cases
were in older daughters, one being 20 years old and the other 18.
Both of these cases were typical, the 18-year-old daughter having
the disease confluent in various places upon her face. The four
younger children, all under 10 years of age, were having the dis-
ease, but so mildly as to be almost unrecognizable, except as asso-
ciated with the unquestionable cases. At the house of Mr. Homig,
we* found a child in the second day of the prodromal period, and
an older child broken out, having passed through a marked pro-
dromal period. As the father had unquestionably had the disease
in severe form, then being in the desquamitive stage, there was
no question about the cases in hand. At the house of Mr. Homig,
we met six physicians of the neighborhood, two of whom, Drs.
Berry and Patterson, claimed the eruptive disease was not small-
pox. All of the others Avere agreed that smallpox was the disease
in hand.

As per the order of the Board at its last meeting, I wrote to the
Secretaries of the four States bounding Indiana, asking their opin-
ion regarding the propriety of calling a meeting here at Indian-
apolis of the Boards of Health of Illinois, Ohio, Michigan, Ken-
tucky and Indiana, to consider the smallpox epidemic which now
so well covers the United States. Answers have been received
from all as follows:

Office State Board of Health,
Springfield, 111., April 8, 1902.

J. N. Hurty, M. D., Secretary Indiana State Board of Health, Indianapolis,
Indiana:
My Dear Doctor— A conference such as suggested by you in your favor
of the 5th Inst, could not but be productive of good results, even though
much were not accomplished. I am in favor of such a meeting, and will
be very glad to attend. It would be practicable for me to be in Indianapo-
lis any time between April 24 and May 7.

Very truly yours,

JAMES A. EGAN,

Secretary.

Digitized by VjOOQIC

439

Office State Board of Health,
Bowling Green, Ky., April 5, 1902.

Dr. J. N. Hurty, Secretary, Indianapolis, Ind.:

Dear Doctor— I will be very glad to attend the m-eetlng and do any-
thing in my power to assist you. We have the disease well in hand in
Kentucky now, but have a large unvaccinated population for the disease
to feed upon at every fresh importation. I am trying to have an order
issued by our State Board of Education to prevent the attendance of per-
sons at any school, as either teacher or pupil, without a certificate of re-
cent vaccination. This would assist us greatly in the country -districts,
where comparatively little vaccination has been done, after four years of
preaching and pleading.

Advise me of the dale of tlie meeting as soon as it has been fixed, as
I am making engagements for a lot of work.

\ory respectfully,

J. N. McCORMACK,
Secretary.

OflSce State Board of Health.

I^nsing, Mich., April 7, 1902.

J. N. Hurty, M. D., Secretary State Board of Health, Indianapolis, Ind.:

Dear Doctor— Your letter of April 5, relative to a conference of the
Boards of Health at Indianapolis for the discussion of the subject of
smallpox, and asking my opinion as to whether such a conference should
be called, and whether I would be able to attend, has been received.
Please accept very cordial thanks for it. I am of the opinion that such f\,
conference would be a good thing, but it is doubtful that I can attend.
However, I shall put the subject l)efore the Board at its next meeting,
which will occur April 11. Very respectfully,

HENRY B. BAKER,

Secretary.
P. S.— In Michigan the character of the people, and of some of the
Health Oflficers. where smallpox gains headway, is such that they can
not be reached by a campaign of education, which is really about the only
way to have general vaccination. The disease Is not recognized, nor re-
ported promptly. H. B. B., Sec.

Office State Board of Health.
Columbus, Ohio, April 7, 1902.

Dr. J. N. Hurty, Secretary of State Board bf Health, Indianapolis, Ind.:

Dear Doctor— Your letter of the 5th inst. relative to a smallpox con-
ference at Indianapolis has just been r(»ceived.

"There is wisdom in counsel," and I am a bdiever in. conferences.
I am not spre, however, if vaccination is our only remedy for the present
epidemic (and I believe it is our only effective remedy), that anything could
be said at this conference that would materially help present conditions.
The warm weather is approaching, and we will no doubt have quite a

Digitized by VjOOQIC

440

diminution in the number of cases of smallpox. The summer time, there-
fore, will not be our most favorable time for urging vaccination. It is the
most favorable time for quarantine measures; and, while I fear that the
disease is too widely prevalent to be stamped out by quarantine measures,
it is possible that by the combined effort of several States we could eradi-
cate most of the centers of infection within our borders.

Personally, it will be difficult for me to attend a conference on account
of other engagements. The principal one is my engagement with the
Legislature. By this I mean that we have four or five bills, one of which
is of very great moment to us, pending, which require constant watching
on my part. The Legislature will probably be here until the latter part of
April, and possibly the first of May. I am expecting to go to Nerw York
the first of May, to be gone for several weelts. The Legislature would not
interfere if the conference were held on Saturday, or Friday afternoon
and Saturday. However, our Board has a conference with the Sui>erlu-
tendents of Schools on Friday and Saturday. April 18 and 19. We have a
meeting of our Board In Cincinnati on the 2:M of April, and the next day
will meet with the Ohio Society for Prevention of Tuberculosis.

If the conference were held on Friday afternoon, April 25, I could,
perhaps, come, and would hope that some of the members of our Board
could come with me. If you call a conference, however, do not consider
my plans in fixing the time. If I am unal)le to come, some one or more
of our members would doubtless be there.

Yours truly,

C. O. PROBST,

Secretary.

ALLEN COTTNTY MEDICAL SOCIETY.

The Allen County Medical Society, on January 23, hold a
symposium on tuberculosis. Tlie paper of the evening was read
by Dr. B. Van Sworingen, the same being discussed by many
members of the Society. The Secretary, Dr. , com-
municated these facts to the State Board of Health and sent a
copy of resolutions passed unanimously by the Society as follows:

Whereas, The provision by State government of sanatorlums for the
reception and care of tul>ercuIous persons has become an aciinowledged
necessity for the better protection of the public against tul)erculosis in its
various forms, and,

Whereas. Several states already possess such sanatoriums while Indi-
ana has taken no steps toward providing for the establishment of such an
institution, therefore, be it

Resolved, First, That the Allen County Medical Society recognizes the
urgent necessity for an adequate institution designed for the exclusive care
and treatment, both hj^gienic and medical, of tuberculous persons in the
State of Indiana, the said institution to be erected and maintained by the
State government.

Digitized by VjOOQIC

441

Second, That this Society shall at once, bj' correspondence and other-
wise, seek to enlist the active co-operation of other Medical Societies and
l)odies and of the public pretjH throughout Indiana to the end that a sana-
torium commensurate with the importance of the subject sought, be au-
thorized by legislative action, the same to be erected in some suitable loca-
tion in the mountainous part of the State.

Thu'd. That copies of these resolutions be transmitted to all other
Medical Societies in the State, to medical colleges, to the medical press,
and the local daily press, to the Governor and members of the General As-
sembly; and that a persistent agitation of this subject be maintained in
order that public opinion may be so influenced as to secure favorable action
by the next Legislature toward the more effectual prevention and control,
by approved methods, of one of the most destructive diseases to which
mankind is liable.

THE MARION COUNTY MEDICAL SOCIETY.

This Society held a symposium upon tuberculosis March 18,
Dr. L. C. Cline reading the principal paper. After discussion, the
following resolutions were passed and the Secretary, Dr. Theodore
Potter, communicated the same to the State Board of Health :

Whereas, The provision by State governments of sanatoriums for the
reception and care of tuberculous persons has been an acknowledged
necessity for humanity's salie and for the better protection of the public
against tuberculosis in its various forms; and,

Whereas, Several states already possess such sanatoriums, while Indi-
ana, one of the live States of the Union, has taken no steps toward pro-
viding for the e8tal)lishnieiit of such an institution; therefore, be it

Resolved, That the Marion County Medical Society recognize the urgent
necessity for an adequate institution designed for the exclusive care and
treatment, both hygienic and medical, of tuberculous persons in the State
of Indiana, the said institution to l)e erected and maintained by the State
governmont.

2. That this Society shall at once, by correspondence and otherwise,
seek t<J enlist the active co-operation of other Medical Societies and bodies,
and of the public press throughout Indiana to the end that a sanatorium,
commensurate with the importance of the object sought, be authorized
by legislative action, the same to be erected in some suitable location.

3. That copies of these resolutions be transmitted to all other Medical
Societies in the State, to medical colleges, to the medical press and to the
daily pi^ss, to the Governor and members of the General Assembly; and
that a persistent agitation of this subject l)e maintained in order that pub-
lic opinion may be so influenced as to secure favorable action by the next
I/Cgislature toward the more elT«»ctual prevention and control, by approved
methods, of one of the most destructive diseases to which mankind is
liable.

I again suggest to the Board that consideration be given to
appointing an Advisory Board of physicians of the State, said

Digitized by VjOOQIC

442

Advisory ISoard to confer and advise with the State Board of
Health in regard to its public health work.

Resolved, That at the next regular meeting, that the members
respectively present a detailed plan concerning the appointment,
duties and character of an Advisory Coiincil to tlie State Board of
Health.

Dr. Davis introduced the subject of National Tuberculosis Con-
gress which meets in New York May 14 and 15, and after full
discussion the Secretary was ordered to prepare a paper, giving
the statistics of Indiana in regard to tuberculosis and an account
of all that has l>een done by the State Board of Health in the line
of the prevention of this disease and to then attend the Congress
^and present said paper and make a full report to the Board of the
meeting.

Digitized by VjOOQIC

SPECIAL MEETING.

Office Indiana State Board of Health,

Indianapolis, Ind., April 25, 1902.

Called to meet representatives of the Kentucky State Board of
Health, and to attend the Annual Conference of the State Health
Officers. ^

Present: Drs. Davis, Cook and Hurty. Dr. Davis presided. -

There were present from Kentucky: Drs. J. N". McCormack,
Secretary of the Kentucky State Board of Health, and Wm.
Bailey, a member of the same. These gentlemen complained that
smallpox was certainly being carried from Indiana into Kentucky
and they asked that Indiana take strong action to prevent the
spread of the disease and presented the following letter :

Loulsvme, Ky., AprU 25, 1902.

Dr. J. N. Hurty, Secretary State Board of Health, Indianapolis, Ind.:

Dear Sir— Under instructions from the State Board of Health of Ken-
tucky, Dr. Bailey and myself are on a tour of investigation of smallpox
conditions in Indiana. Complaint has been made that this disease exists
in nearly all of the counties bordering on the Ohio River, and that in many
instances the officials of such counties are making little or no effort to pro-
tect their own citizens or the people of Kentucky. We are astonished that
the disease has assumed almost epidemic proportions in nearly every part
of your State, smallpox existing In 60 of the 92 counties. It wUl be our
duty to make a full and frank report of this state of affairs to our Board,
and unless prompt steps ai-e taken to bring the disease under control, we
will recommend that Kentucky establish a quarantine at the Ohio River,
and that no person be permitted to cross without a certificate of recent suc-
cessful vaccination, and that the person has not been recently exposed to
smallpox. We will regret exceedingly to adopt measures which seem so
harsh against a neighboring State, but importations of smallpox from Indi-
ana to Kentucky have been so frequent in the past, and the expense en-
tailed upon the municipalities and counties thereby has been so great, that
we feel that justice to our own people will demand it. I think it proper to
give you and the business and traveling public of Indiana full notice of

(443) ^ T

/Google

Digitized by VnOOQ I

444

the results of our investigations^ first in the hope that such action may be
taken on your side as will make quarantine unnecessary, or, failing in this,
that all interested may prepare for It

Very respectfully,

J. N. McCORMACK, M. D..
Secretary State Board of Health of Kentucky.

The letter was received and the matter taken under advisement,
after informing the gentlemen that the Indiana State Beard of
Health had no funds at its command to combat smallpox.

The members also attended the Annual Conference of State
Health Officers on the same day, and acted with the same.

Digitized by VjOOQIC

THIRD QUARTER.

May^ June and July*

SPECIAL MEETING.

Office Indiana State Board of Health,

Indianapolis, Ind., May 29, 1902.

Called to consider the smallpox quarantine declared by Ken-
tucky and to confer with the Governor at his request.

Present: Drs. Forrest, Davis, Cook, Wishard and Hurty.

The meeting was called to order at 10:15 a. in.^ and quickly
adjourned to the Governor's parlor. The quarantine proclamation
of the Kentucky Board was discussed and all phases of the situa-
tion considered, and it was finally arranged that the entire Board
should go to Louisville the next day, meet the Kentucky Board
and sec if the quarantine could not he annulled.

SPECIAL MEETING.

Office Indiana State Board of Health,

Indianapolis, Ind., June 16, 1902.

Present : Drs. Forrest, Davis and Ilurty.

Called by the President to couisider the smallpox situation.
After deliberation the following order was made :

Ordered: The Secretary shall visit the following counties:
Clay, Daviess, Sullivan, Pike and Grcone, and s<m? to it that the
law and the rules regulating the management of smallpox be made
effective. lie shall report daily to the President as to the status
of smallpox in the State as far as known. He shall also visit such
other places as in the judgment of the Secretary is necessary.

Adjourned.

(440)

Digitized by VjOOQIC

THIRD REGULAR MEETING FOR HSCAL YEAR.

Office Indiana State Board of Health,

Indianapolis, Ind., June 16, 1902.

Present: Drs. Forrest, Davis, Cook and Hurty.

Called to order by President Forrest at 11 a. m.

Minutes of the last Regular Meeting, also of the Special Meet-
ing held April 25 ; also of the Special Meeting held May 29, were
read and approved; also of the Special Meeting held June 16 were
read and approved.

REPORT OF SECRETARY FOR QUARTER ENDING
JUNE 30, 1902.

During the quarter, the Secretary made thirty-four visits, as
follows:

April 6. St. Paul.

April 17. Columbus, Ohio.

April 21. Gaston.

April 24. Plainlield.

May 1. SuUivan.

May 3. Clarks Hill.

May 9. Marion.

May 20. Bvansvillc.

May 24. Greensburg.

May 27. Louisville.

May 30. Louisville.

June 2. Kvansville and Boouvilic.

June 3. Caunelton and Rockport.

June 4. Huntingburg and Englisli.

June 5. raoli.

June 6. French Lick.

June 7. Campbellsl)urg, Saltillo and Orleans.

June 8. Richmond.

June 10. Lafayette.

June 12. North Vernon.

June 10. Rocki)ort. .

(446)

Digitized by

Google

447

June 18. Petersburg.

June 10. Washington.

June 20. Bloom Held, Switz City and Lyons.

June 24. Hartford City.

June 30. Knightstown.

Full reports of these visitvS are given herewith:

ST. PAUL.

Upon invitation of Dr. C. L. Howard, Trustee and Health
Officer, of St. Paul, I visited that place in order to confer with
the officer nanie<l, in regard to the sanitary conditions of his town
and in regard to tlie schoolhouse. On arrival, I met Dr. Howard
and together we discussed the best plans for draining the town,
also several minor unsanitary conditions. Finally the schoolhouse
was surveyed. It was a very old structure, unfit in every way
for school purposes. The inhabitants of the town were all agreed
upon this point, and it was only'asked that the building be con-
demned by the State Board of Health in order to make possible
the securing of a new building. It will be quite unnecessary to
here include all the details of this bad structure because it was
recently consimied by fire and a new building must now be con-
structed.

COLUMBUS, OHIO.

The. State Board of Health and Superintendents of Schools of
Ohio held a s^xjcial meeting on April 18-19, for the purpose of
discussing questions relating to school hygiene. The Secretary
was invited by the Ohio authorities to be present and take part
in the discussions. There were fifteen papere read and discussed.
All of these papers related purely to school hygiene. Their titles
were as follows :

**IIow May Schoolliouse Construction be Best Regulated?"
"Ksseutlal Requirements for a Sanitary Seliool Building."
"The Inadequate Teaching of Hygiene in the Public Schools."
**Medical Inspection of SchooLs."

'*To What Extent is the State Morally Bound to Provide for the Phy.s-
Ical Welfare of School Children?"

"Is there Mental Overcrowding in the Public Schools?"
"Evils of the One Session Plan for High Schools."
"Visual Hygiene In Public Schools."

Digitized by VjOOQIC

44S

"When and How Should Schoolhoiises be Disinfected?*'

*'IIow Often and in What Manner Should S<»ho<)l houses be CleanetV?'*

*'School Board Constituencies."

"Shouid there l)e Pliysical Ke<iuirements for School Teachers?'*

Tlie nieotiiig was exceedingly profitable and I am sure that
mnoli important knowledge was gained Avhich I hope to put to
profitable use in our State.

GASTON.

April 21. I was called to Gaston by a telephone message from
the President of the Town Board of Trustees. He stated that an
eruptive disease existed at that point which one doctor had pro-
nounoed to be smallpox and all the otlier doctors declareil ^it not
to be smallpox. Some of the cases were very severe and the people
of the town were highly excited and demanded the scn^ices of
the State Board of Health. As Gaston is in Delaware County, I
telephoned to Dr. Cowing, Health Officer of that county at Muncie,
asking him to meet me the following day at Gaston. He readily
agreecl to do so. Upon arrival at the town named, I met Dr.
Cowing and t^jgether with Dr. Mitchell, and other resident phy-
sicians, called upon several of the eruptive cases. All of them
were found to be smallpox. One case was confluent and the
patient was seriously ill. The physicians who had contended the
disease was not smallpox changed their opinions after full con-
sideration of the evidence which was presented. We were then
told that the disease had prt vailed in that part of Delaware
County since January and the total number of cases by estimate
• was probably in the neighlx)rliood uf 500. Dr. Cowing imme-
diately quarantined all jx^rsons having any eru]>tive disorder what-
ever, and gave orders to the local Health Officer and the local
authorities to enforce the rules of the State Board of Health
goveniing smallpox. As usual, vaccination was urge<l as the only
effective prophylaxis.

PLAINFIKLI).

April 24. Dr. Amos Carter, by telei)hone, informed this office
that an eruptive disease had appeared at the State Reform School
for Boys, at Plainfield, and requested the advice and direction of
the State Board. iriK)n arrival, 1 examined six eruptive cases

Digitized by VjOOQIC

449

and found them all to be smallpox. Dr. Cartel* had pronounced
all the cases to be variola, but to make sure, wished to have his
diagnosis confinned. An abundance of vaccine was ordered pur-
chased and vaccination and re-vaccination of every boy in the
school was ordered. The six cases were isolated and the institu-
tion placed under quarantine. For three weeks no person was
allowed to go in and out of the school except the physician, and
to bring in tlie mail and the necessaries of .life. I am glad to be
able to rei)ort that only four more cases appeared and within three
weeks the disease was entirely stamper! out.

SULLIVAN.

May 1. Dr. Thixtun, Health Officer of Sullivan County, in-
formed the State office by telephone that an eruptive disorder
existed in the northern part of his county. He stated he was
having ti'oublc to convince the people that the said eruptive dis-
order was smallpox. lie also had trouble to convince physicians
of this fact. He appealed to the State Board of Health and
demanded its advice and direction. Upon arrival at Sullivan, I
met Dr. Thixtun, and rode with him to Shelburn. At this point
(ught cases of smallpox were found in eight separate houses. Two
of these were very severe, and one of them, a babe, died the after-
noon of the day I was there. The autliorities of Shelburn were
instructed as to their duties, and their willing promise secured
that said duties would be fulfilled. From Shelburn we rode to
Hymera. At this point five cases were foimd in four houses.
The place is not incorporated and, therefore, is under the juris-
diction of the Trustee and came directly under the jurisdiction
of the County Health Officer. Quarantine was established and
all of the usual instnictions and directions given. A feature of
this visit was the fact that I was called upon to give a short
lecture to a body of miners which were gathered together, and
recpiest^d that infonnation be given them in regard to smallpox.
After my talk a number of them consented to l>e vaccinated, but
it was first necessary for me to vaccinate myself in order to set
the example. Dr. Tliralls, a most efficient and excellent physi-
cian, also vaccinated hinij^olf and seconded all I said u])un the sub-
ject of smallpox and its prevention.

29-Bd. of Health.

Digitized by VjOOQIC

450

CLARKS HILL.

May 3. Ilealtli Officer Dr. Helfrich by telephone informed
this office of the existence of an eruptive disease in his town. He
stated that other physicians denied the same to be smallpox and
he knew that it was smallpox. He requested aid from the State
lioard. On arrival, I visited five families, and found four cases of
smallpox in two families, and in three of them found unques-
tioned chicken pox existing in very young children. The diagnosis
of the Health Officer being confinned, the local authorities imme-
diately gave orders that the rules of the State Board of Health
should be thoroughly enforced. They also empowered the Health
Officer to purchase vaccine and vaccinate every person free of
charge who would permit.

MARION.

May 9. Upon invitation of Professor iloore, Superintendent
of Public Schools of the city of Marion, T visited that city and
addressed the teachers upon the subject of "School Hygiene."
Ninety teachers were present. The talk was forty-five minutes
long and was most kindly received. It is my hope and Mief tliat
the health cause was advanced by this visit.

BVANSVILLE.

May 20. As C'hairiuan of the Committee on State Medicine
and llygieiie, T visited Evansville to deliver the Annual Report
of said committee before the Indiana State Medical Society.
The session of the Society extended over two days. Numerous
papers upon medical subjects were read and discussed and the
report referred to was as follows:

Report of Committee on State Medicine and Hygiene.

State Medicine— The Legislature has not been in session since the last
r(»i)ort of this committee was made, and therefore there are no changes to
i-ecord in the various laws relating to State medicine. There has been
some litit'ation in the lower courts in various parts of the State under the
medical law, the pharmacy law. food law and health law, but not under
the den till law. The Stiprerae Court has made final decisions In two In-
stances under the nii dical law, in one instance under the food law, and in
two instances under the health law, as follows:

Digitized by VjOOQIC

451

Hurley v. Eddingfield.— This case came from Montgomery County. Dr.
Eddingfield was applied to to render medical service to Mr. Hurley, who
proffered the usual fee. Dr. Eddingfield refused to respond, giving no
reason for refusal. The suit was i>y the heirs of Hurley and for $10,000
damages, they alleging that Hurley's death was due to the refusal and
neglect of Eddingfield. The court decided there is no obligation on the
part of physicians to enter into a contract contrary to their will. In
other words, physicians do not have to treat the sick unless they want to.

Baker v. Hancock.— In this case, Henry W. Baker sued Dr. George S.
Hancock for damages on account of malpractice and wrong diagnosis,
and is Interesting as deciding the legal status of a specialist. The com-
plaint was upon the hypothesis that Dr. Hancock did not exercise that
degree of skill required of his profession. No charge of unskillfulness or
lack of education was made In the complaint. In the lower court the
decision was in favor of the doctor, but the Appellate Court reversed. In
its judgment, the court says:

"It is averred in two paragi'nphs of the complaint that the appellee
*was making a specialty of the treatment of cancer, and held himself out
to the public as a specialist in the treatment of said disease of cancer, by
advertising in the public press, and by other public notices thereof.' A
specialist, as the term is here used, is understood to mean a physician or
surgeon who applies himself to the study and practice of some particular
branch of his profession. Scientific investigation and research have been
extended and prosecuted so persistently and learnedly that the person
affected by many forms of disease is of necessity compelled to seek the
aid of a specialist in order to secure the results thereof. The local doctor,
in many instances, himself suggests and selects the specialist w^hose learn-
ing and industry have given him a knowledge in the particular line which
the general practitioner, in rural communities especially, has neither time
nor opportunity to acquire. Small v. Howard, 128 Mass. 131. Being em-
ployed because of his peculiar learning and skill in the specialty practiced
by him, it follows that his duty to the patient can not be measured by
the average skill of general practitioners. If he possessed no greater
skill in the line of his specialty than the average physician, there would be
no reason for his employment; possessing such additional skill, it becomes
his duty to give his patient the benefit of it. The appellee, if he held
himself out as a specialist in the treatment of cancer, was bound to bring
to the discharge of his duty to patients employing him as such specialist
that degree of skill and knowledge which is ordinarily possessed by phy-
sicians who devote special attention and study to the disease, its diagnosis
and treatment, having regard to the present state of scientific knowledge.
This is the degree of skill which, by* holding himself out as a specialist,
lie represented himself to have: and it does not He with him to assert,
after securing employment and compensation on that basis, that his rep-
resentation was not true. The instructions given by the court upon this
sul)ject did not correctly express the law.

"The judgment is reversed, and cause remanded, with instructions to
sustain motion for a new trial, and further proceedings, consistent here-
with."

Digitized by VjOOQIC

452

Martin v. Board of Commissioners of Montgomery County. Appellate
Court, June 18, 1901.— This case Is of interest to physicians, for it decides
that the secretary of a county board of health can not employ physicians
in the name of the county for health work, nor can he directly abate
nuisances, for both of these powers belong to boards of health, and secre-
taries are simply executive officers. Physicians, in order to collect at law
for services rendered a county, must show a valid contract with the com-
missioners, or must show a law providing for such services and providing
compensation.

State v. Beil, 157 Ind. 25.— In this case the board of health of Bluffton
had ordered, as a health measure, the school board to have all the school
children vaccinated, upon penalty of exclusion from school. The school
iK)ard refused to act. and mandamus proceedings were brought in the
Wells County Court. E. C. Vnughan, Judge, refused to issue a mandamus,
and the Supreme Court decided lie erred, and commanded that the man-
damus be issued. This does not decide that, since the passage of the
Louttit amendnunt to the school law. that l>oards of health have power to
enforce the vaccination of school children, for this discussion comes under
the old law l)ef(>re the passage of said amendment. It will be necessary
to have yet another case before the Supreme Court to settle the status of
the Louttit amendment.

Iseuhour v. State of Indiana.- This case was appealed from Marion
County to the Supreme Court, and the judgment of the lower court was
sustained. This case involved the question whether or not the Legisla-
ture could give the power to the State Board of Health to pass rules and
ordinances fixing food and drug standards and specifying adulterations.
In regard to tliis matter the court says:

"The hnv says the State Board of Health 'shall prepare ruies and
ordinances when and where necessary, regulating minimum standards of
foods and drugs, defining specific adulterations, and de<'laring the proper
methods of collecting and examining drugs and articles of food.' From
this provision it is agreed that in substance this is an attempted delegation
of legislative power to the State Board of Health. The obvious purpose
of tlie provision last quoted was to commit to a body of learned and scien-
tific experts the duty of preparing such rules, and prescribing such tests,
as may from time to time, in the enforcement of the law, l>e found neces-
sary in (leternilning wliat combinations of sul)stances are injurious to
liealth. and to what extent, if at all, adulterations or deteriorations of
foods and drugs may go without injuriously affecting the health of the
coiisunier. That which is required of the State Board of Health has no
semblance to legislation. It merely relates to a procedure in the law's
execution for a reliable and uniforili ascertainment of the subjects upon
which the law is Intended to operate."

PRCXJRESS IN SANITARY SCIENCE.

The progress of sanitary science for the past year has kept pace with
previous years. Tlie most prominent advance is the final proof in Ha-
vana, by destroying mos(iuitoes and their larvtp, that yellow fever may be
so controlled. Tliat yellow fever is distributed solely by insects, princi-
pally uK^sciuitoes of a particular variety, namely, Stegomyia fasciata, has

Digitized by VjOOQIC

453

l)een further proven by exact experiments conducted in Cuba by Drs.
Walter Reed, James Carrol and Arlstides Agramontl. The International
Sanitary Congi*ess, in session in the city of Havana, February 15 to 20,
1002, advocated the formation of antileprosy leagues, under the patron-
age of the government therein represented, with the object that the people
be educated in every possible way of the progress that the disease Is mak-
ing and the methods of preventing its increase.

The congress further advocated tliat knowledge concerning how ma-
hu'ia is propogated should be spread among the people, and especially
should it be imparted to school children. It was also advocated that the
American repul)lic8 establish leagues against tuberculosis, similar to those
existing in some of these republics and in the island of Cuba, with the
object that with a united effort the propagation of the disease would be
diminished.

SCHOOL SANITATION.

The medical inspection of school children for the pm*pose of eliminat-
ing those who are diseased, and thus prevent school epidemics, is no longer
counted an experiment. Its efficacy is thoroughly proven, and it now re-
mains for those school authorities who desire to save school moneys and
promote the public happiness to Install as quickly as may be the medical
inspection of school children. At no place in Indiana is medical inspec-
tion of school children practiced, but there is great progress in the matter
of erecting sanitary school houses. To aid all that is possible in this most
important matter, the State Board of Health has had plans and specifica-
tions prepared for a one-room sanitary school house, and these are fur-
nished free to all trustees who will accept them. At this date, 33 of these
plans have been distributed. There is no need for delaying in this work,
and It is therefore recommended by yonr committee that a law should be
passed requiring that all school houses built after the going into effect of
the law shall conform to all sanitary requirements, and said requirements
should be carefully laid down in the law. Such a law could be made
self -en forcing by simply adding a section making invalid all bills incurred
by authorities in constructing buildings which did not conform to the legal
requirements. The urgent necessity of such a law appears from the fact
that many school houses exist where the children have their feet frost-
bitten while sitting at their desks, where also bad lighting and I)ad ven-
tilation causes malnutrition, nervous disorders and diseases of the air pas-
sages. Probably 00 per cent, of the school houses of Indiana are so un-
sanitary as to cause a loss of 20 per cent, of the school money.s. Inasmuch
as these unsanitary buildings, through their depressing and ill-health
causing influences, prevent study and progress of the pupils, and cause
inefficiency in the teachers.

HEALTH OF THE STATE.

The state Board of Health now secures very accurate mortality sta-
tistics, but the morbidity statistics are as yet very imperfect. In order to
seciu'e a more or less reliable expression of the extent of illness, the State
Board of Health sends each month to every county what are called dis-

Digitized by VjOOQIC

464

ease prevalence cards. These cards are filled and returned by healtli
officers, and the information thus gained, taken together with the facts
concerning deaths, furnish a means of determining the health of the State.
In 1900 there were reported 35,453 deaths, a rate of 14.8 per 1,000. In
1901 the reports gave 30,544 deaths, a rate of 14.52. By this comparison,
there being 1,091 more deaths in 1901 than in 1900, the health of the State
was therefore worse in the former year than in the latter. But this Is
subject to error, for it is plainly possible to have an increase in total
sickness with a decrease in deaths as between certain periods. In this in-
.stance, however, the morbidity data for the two years shows more sick-
ness in 1901 than existed in 1900. The two sources of Information, there-
fore, force the conclusion that both sickness and death were greater in
1901 than in the preceding year.

SMALLPOX.

The most prevalent, highly infectious disease since the last report to
this society, excluding tuberculosis, pneumonia and dlarrhoeal diseases,
was variola. One year ago attention was called to the fact that many phy-
si(;ians were unal)le to diagnose atypic smallpox, and persisted in calling
it chiekenpox, even when it became virulent and typical among adults. It
thus happens that probably as many cases of variola escaped being re-
ported as were reported. The total number of cases reported for the
twelve months ending April 30. 1902, w^as 8,004, or an average of 722 in
each month. The total deaths reported as directly due to smallpox was
21, making only 0.24 per cent. There is much evidence pointing to the con-
clusion that not a fcAV smallpox deaths were reported ia» due to other
causes, and it is also known that many cases of smallpox were complicated
with pneumonia, and so smallpox was the chief but not the immediate
cause of death. For the reasons given, the real extent and mortality of
this disease in Indiana will never be known; and our records must simply
say. smallpox, mostly in a typical form and mild, with astonishingly low
mortality, prevailed throughout the year. The disease has, however, cost
the people enormously. When in severe form, which was probably In
about 10 per cent, of the instances, the patient lost not less than three
wc»eks' time, and in hundreds of instances townships have been called
upon to furnish medical attendance and necessary supplies. Added to this
is the loss to l)usiness on account of alarm, and also the cost of imposing
<iuarantine and disinfection. At the lowest estimate the cost to the State
in four years could not have been less than .$2,000,000. With rare excep-
tions the health authorities have not had tlie support of the people In the
efforts put forth to stay smallpox. In only eight counties out of the sixty-
rive invaded has it l»een possible to secure appropriations from the county
councils, to be used for fighting infectious diseases. The greater propor-
tion of cities and towns have acted promptly in furnishing means for
putting out tlie lire, but a few. suffering from stupid government, have
(lone nothiiiLT. The State Board of Health has l)een called upon for aid and
direction 270 times, but it has such meager funds, and there being only
one State liealth ollicer, it has only been possible to reply in most Instances
by letter and with a few smallpox circulars. Had a few thousand dollars

Digitized by VjOOQIC

455

been available for fighting smallpox when it first appeared, and had the
people lent an attentive ear to wholesome preventative instructions, fully
one million and a half of the two million dollars lost could have been
saved.

TUBERCULOSIS.

Far worse, and far more expensive than smallpox, is the ever present
"great white plague." In li)01 this disease caused 4,645 deaths. Of this
number 3,364 were from the pulmonary form.

It appears that in 1900 13.07 per cent, of all deaths was from tubercu-
losis, and in 1901 the percentage was 12.55, or, expressing the conditions
in another way, tuberculosis caused one in every 7.6 deaths in 1900, and
one in every 7.9 in 1901.

A study of the mortality for 1900 and 1901 show^s that deatlis from
tuberculosis begin to rise rapidly at 15 years of age and reach a climax at
25. From 25 to 30 it is almost equally destructive, and begins to decline
at 45. The fact that the disease causes the most deaths from 20 to 25 in-
dicates that school life, which Is just over, is a causative factor. Foul air
being the first and greatest cause of consumption, and as so many school
rooms have foul air from lacli of ventilation, it seems reasonal)le to believe
that the schools play a not Insignificant part In producing consumption.

There is no State hospital or sanatorium for consumptives in Indiana.
The facts and arguments for such an institution are overwhelming. There
are 1,013 townships and 95 poorhouses in the State. There is an average
of two consumptive patients in each poorhouse, a total of 190. On the
average there is one consumptive in each township being cared for by
township relief. At the lowest estimate, therefore, there are 1,200 con-
sumptives being cared for all the time in Indiana. Every one of the pa-
tients Will die, will be buried at public expense, and will infect the house
he occupies. If the deceased is a parent, children will almost certainly be
left to be cared for at the public expense. If all of these were cared for
at a State sanatorium, 25 per cent, would be cured and preserved to their
families.

As to sex, the pulmonary tuberculosis deaths are divided as follows:
Males, 1,705; females, 2,464. The percentages are: Female*. 59 per cent.;
males, 41 per cent. Of the females who died of pulmonary tuberculosis in
1901, 1,353 were between the ages of 15 and 35. Eighty-two per cent., or
1,109, were mothers. Counting an average of two children to each one,
there was, therefore, produced by tuberculosis, in 1001, 2,218 orphans,
and many of these have become public charges. This phase of the tuber-
culosis question is certainly most important, for the unnecessary making
of orphans Is bad business.

To this date no society for the prevention of tuberculosis has been or-
ganized in Indiana, but the State Board of Health, the Allen County Medi
cal Society, the Huntington County Medical Society, the Marlon County
Medical Society, the Wayne County Medical Society and the Delaware
County Medical Society, have all urged through official resolutions that a
State sanatorium for indigent consumptives be established by law.

Digitized by VjOOQIC

456

TYPHOID FEVER,

Typhoid, the fifth disease, caused 1,108 deaths in 1901, and by lowest
estimate there were 15,000 cases. Large as the figures 'are. they record
an improvement over the preceding year, when there were 1,.'520 typhoid
deaths, and at least 17,500 cases. We think it probable that this disease
will continue to decrease, for the people are now quite generally alive to
the fact that the infection is borne to them in water. The fact that typhoid
is water-borne was at first the target of paragraphers, and the exponents
of the truth were termed cranks, but now all know the truth, and, by this
standard, all are cranks.

The State Board of Health each month sends to those houses which
have suffered death from typhoid fever a pamphlet upon the subject, which
gives an account of the cause of the disease and its prevention in plain
language.

DIPHTHERIA.

The diphtheria deaths are decreasing. In 1900 this disease caused G80
deaths, and in 11K>1 the number fell to 554. This is a decrease of 19.2 per
cent It is likely the gi-eator proportion of this decrease Is due to the in-
creasing use of antitoxin, but some of it is certainly due to better care of
children by parents, and greater care in the schools. By ages, diphtheria
was most destructive in 1901 between 5 and 10, and NDvem!)er was the
most fatal month.

MISCELLANEOUS, 1901.

The three well known children's diseases, namely, whooping cough,
measles and scarlet fever, killed a totnl of 491. as follows: Whooping
cough, 181; measles, 101: scarlet fever. ISl. The most feared of these
maladies, scarlet fever, was the least fatal. Cancer as a cause of death
is close to typhoid fever, as there were l,Hl,"5 deaths from cancer and 1,198
from typhoid fever. Diabetes caused 204 deaths; acute articular rheuma-
tism lO;?, and anemia and chlorosis 789.

Diseases of the nervous system and organs of sense caused a total of
4.494 deaths.

Diseases of the circulatory system caused 2,.'V28, and diseases of the
digestive system caused 4,585. It is probable that less strenuouslty of life
would reduce the deaths from the above causes.

I>astly. "old age" caustnl 1,2(J5 deaths, which is only .'?.4 per cent, of
the total.

GKEENSBURO.

May 24. A single ca»se of eruptive disease appeared in Greens-
burp, May 17. The diagnosis was in doubt and appeal was made
to the State Board. Upon arrival, I met Dr. liiley, loeal Health
Officer, who took me to see the case. It was plainly smallpox and
fortunately it had been treated as such, for quarantine had been
maintained and tlie people in the neighborhood vaccinated. I met

Digitized by VjOOQIC

4;>7

the Mayor at Dr. Riley's office and urged that vaccination be
practiced and free vaccination oflFered to the people. The
Mayor promised that this should be done, and also that the rules
of the State Board of Health concerning smallpox should be ener-
getically enforced.

LOUISVILLE.

May 27.^ On this date I went to Louisville to meet with the
Kentucky State Board of Health, to confer in regard to the quar-
antine' which the said Board threatened to place against Indiana-
The Board met in the Gait House and every courtesy was extended
to me as representative of the Indiana State Board of Healtli.
Dr. Matthews, President of the Kentucky Board, announced in
effect as follows:

"Smallpox has prevailed in Kentucky for almost six years. We
received our first cases from Tennessee and the far south. It has
cost the state to date about $500,000 for quarantine, and an
untold sum on account of disturbance of business. We have fought
this disease constantly and yet it still prevails in our state. We
have lately, through investigation, discovered that a great many
cases have come to us from Indiana, and we have further disr
covered that in the southern part of Indiana the disease exists to
an unusual degree. We have also discovered that the health au-
thorities of Indiana are apparently not working as they should to
control the disease. We are informed directly by the Indiana
State Board of Health that the central authorities are inactive be-
cause of lack of funds. We propose to protect ourselves against
invasion of the disease from Indiana, and, therefore, it is sug-
gested that the Kentucky State Board of Health shall declare a
quarantine against Indiana, the same to go into effect Sunday,
June 1, 1902."

After this announcement, I was called upon to speak and in
effect said :

"I do not believe that Kentucky is in any greater danger from
Indiana than Indiana is from Kentucky. No doubt cases of
smallpox have been received into Kentucky from Indiana, and I
am very certain that many cases have come into Indiana from
Kentucky. It has been announced by the Health Officer of Louis-
Digitized by VjOOQIC

458

ville that 70 odd cases exist at this time in his city, and he has
further announced tlmt probably 90 per cent of the people have
been vaccinated. We have it upon the word of the Health Officers
of Clark and Floyd counties that no cases exist in the last
named county and only three in the first named. It is true there
are 21 cases in the prison, but those are not counted because they
are so perfectly isolated from the world and because it is absolutely
impossible for tlie infection to get to the outside world from the
pris(^n. Under such conditions I would say, that the people of
Kentucky, eejiecially in the neighl)orhood of Louisville, have not
near as much to fear from Indiana as Indiana has to' fear from
Kentucky.

"I officially request that the quarantine proclamation proposed
\ye not issued."

The subject was discussed by Dr. McCormack, Dr. Bailey and
other members of the State Board. I was then politely informed
that the Board would go into executive session and, of course, with-
drew, and returned to Indianapolis. The Kentucky Board issued
its proclamation which, with letter of transmittal, is given below.

On May 30th, in accordance with correspondence, Drs. Cook,
AVishard and the Secretary went to Louisville to hold a conference
witli the State Board of Health of Kentucky to officially request
that the quarantine be annulled and present ordinance to sustain
our request. It will be remembered that on May 20 a special meet-
ing had been called by the Governor and that all members were
present except Dr. Cook. It was then and there agreed that this
visit should be made. Upon arrival in Louisville we, in due time,
met the Kentucky Board and the situation was thoroughly dis-
cussed. Dr. Wishard presented the argument on behalf of the
Indiana Board and, after answering many questions, the Kentucky
Board of ITealth went into executive session. When they reached
adjournment we wore informed that the date of quarantine had
Ix^en y)ost]x>ned ten days in order to give the Indiana State Board
of ITealth time to retuni and renew efforts to suppress smallpox.
A special meeting was held upon the train c<^ming home. The
record of this meeting is in the form of a report to the Governor
:i< follows:

Digitized by VjOOQIC

459

Indianapolis, Ind., May 30, 1902.

Hon. Winfield T. Durbin, Governor of Indiana:

Dear Sir— The Indiana State Board of Health respectfully reports that
on May 30, 1902, a conference between the Kentucky State Board of
Health and the Indiana State Board of Health was held at the Gait House,
in Louisville, Ky. The Kentucky State Board was represented by Dr.
Jos. Matthews, President, Dr. J. N. McCormack, Secretary, and Drs. Wm.
Bailey and C. Mayer. The Indiana Board was represented by Dr. W. N.
VVishard, Vice-President, Dr. J. N. Ilurty, Secretary, and Dr. Clark Cook.
The object of the conference was to consider a quarantine proclamation
against Indiana, issued by the Kentucky State Board, to take effect June
1, 1902. The said proclamation was as follows:

Quarantine Proclamation of Kentucky Against Smallpox in Indiana.

"Louisville, Ky., May 27, 1902.

"Whereas, This Board has reliable official information that smallpox
exists in epidemic form in a majority of the ninety-two counties of the
State of Indiana to the extent of some 800 or more cases, and that it ex-
ists particularly in the counties bordering on the Ohio River opposite Ken-
tucky, and that persons with the disease, or who have been exposed to
it in Indiana, are constantly coming into and spreading this loathsome dis-
ease in Kentucky, and

"Whereas, We learn, upon inquiry, that the health authorities and
medical profession of Indiana have been powerless to restrict the spread of
the disease for months for lack of funds, and that the fiscal authorities
have persistently refused and still refuse to recognize the danger to their
own citizens, or to those of other states, or to permit the use of funds
especially appropriated for the suppression of such epidemics; and

"Whereas, In consequence of such divided authority and parsimony,
such conditions prevail in Indiana as to constantly and seriously threaten
the health, lives and business interests of the people of Kentucky, and to
impose additional and wholly unnecessary burdens upon our taxpayers,
without hope of present or e\'en promise of future relief.

"Now, therefore, be it known. That the State Board of Health of Ken-
tucky, in the exercise of authority vested in it by law, and in the solemn
discharge of public duty, hereby declares and issues its proclamation of
quarantine against the State of Indiana, and each of the Inhabitant's
thereof, and establishes the low- water mark on the Indiana shore as the
boundary line of such quarantine, and it hereby forbids any person from
the State of Indiana to pass such quarantine line, or to enter the State of
Kentucky in any other way, who does not procure and exhibit, before
doing so, a certificate from some duly authorized health official of Indiana
or Kentucky that such person has been successfully vaccinated within the
past five years, or is otherwise immune from smallpox, and it forbids any
railroad bridge, electric or other transportation company, or any steamboat,
ferryboat or other public or private craft or conveyance, or any company
or Individual owning, operating, managing or controlling the same, or any
one of them, to bring, or permit to be brought, as either passenger or em-

Digitized by VjOOQIC

400

ploye, any person from any point or place In Indiana to any point or place
In Kentucky, who does not hold the certificate hereinbefore required: Pro-
vided, That this regulation shall not apply to passengers on through trains
who do not stop over at any point in Indiana.

"The municipal and county health and civil officials, of jurisdictions
bordering on the Ohio River and its tributaries, or having other travel
connections with Indiana, are hereby authorized and instructed to enforce
the quarantine regulations herein imposed, and such additional regula-
tions as they may dfom necessary for the protection of their respective
jurisdictions; and the health and police and other peace officials of such
municipalities and counties are hereby made Health Inspectors for the en-
forcement of these regulations.

"This proclamation of quarantine shall take effect and be in force
from and after noon of June 1, 1902, and until officially annulled hy this
Board.

**I)one by order of the Hoard.

"J. M. MATTHEWS, M. D., President.
•J. N. McOORMACK, M. 1)., Secretary."

At the conference the Kentucky Board was informed that the author-
ities of Indiana were re:idy and would immediately take vigorous action
to stamp out smallpox, and respectfully requested that the proclamation
be annulled. After respectfully hearing our statement, the Kentucky
State Board of Health went Into executive session, and, in due time, pre-
sented the following as its action:

"Whereas, The Indiana State Board of Health brings an official mes-
sage from the (Jovernor of the State of Indiana that from this time on the
executive officer and deputies will be In tlie field compelling all county
and municipal Boards of Health to conduct an active campaign against
smalli)ox, and that it will give first attention to the counties bordering on
Kentucky; and

"Whereas, This Hoard lias now and always has had full faith in both
the ability and desire of the Indiana State Board of Health to protect its
own people and those of other States from pestilence and feels assured
that every promise above recorded will be fulfilled; therefore,

"Ordered: That the proclamation of quarantine against the State of
Indiana, issued May 27, 1902, to go into effect at noon June 1, 1902, be and
is hereby suspended for ten days from noon, June 1, 1902, and if, upon or
before the ten days have expired, the Indiana State Board of Health gives
official assurance that the €»pldemic is under control within their borders,
the proclamation avIII be annulled.

[Signed.] "JOSEPH MATTHEWS, President.

"J. N. McCORMACK. Secretary."

In the light of all facts we recommend and request:
First. Inasmuch as arrangements and plans made at the beginning of
the year will consume our entire appropriation, we respectfully request
you to supply from the contagious disease fund means sufficient to pay
the costs incident to enforcing the law relating to the suppression and con-
trol of contagious and infectious diseases.

Digitized by VjOOQIC

4ni

Second. In order to quickly and thoroughly control the epidemic, it
is propoHod by the State l^ard to issue a proclamation to all subordinate
boards within whose jurisdiction smallpox exists, commanding them to
proceed without delay to search out and make strong efforts to control all
cases of smallpox found, and also that they shall take such steps as are
proi>er or take such specitic steps as may be recpiired by the State Board
to prevent recurrence of smallpox.

Third. We will require the State Health Officer, so far as he possibly
can, to personally visit the localities which the board may select, and see
to It that the State Health I*aw Is enforced and our orders are complied
with.

Fourth. If at any time it appears that it is Impossible for the State
Health Officer to personally visit all places requiring attention, then one
or more deputies, as may be necessary, will be appointed and required to
enforce the health laws and the orders of the State Board.

Fifth. -We will purchase vaccine and supply the same to the State
Health Officer and deputies, to ho used in emergencies and under such con-
ditions as we may deem wise.

Sixth. Itemized bills for all expenditures will be presented to the
(fOA-ernor for his approval and for payment.

Respectfully,

J. H. FORREST, President.

WM. N. WISHARD, Vice-President,

CLARK COOK.

T. HENRY DAVIS.

J. N. HURTY, Secretary.

The following letter, to tnlfill the ideas advanced in the action
of the Board and report of which immodiatcly precedes, was sent
to the officers of the following counties: Orange, Franklin,
Adams, Perry, Spencer and Sullivan:

Dear Doctor- We have sent from this office a letter of instruction to
your County Board of Health. The said letter has been addressed to the
Auditor of your county and he will present it to the County Board of
Health. The letter amounts to an order, Imt Is most kindly and gen-
tlemanly expressed. It tells that your Board must, without delay, enforce
the law and the rules of the State Board of Health. The law is quoted
as foUows:

"It shall be tlie duty of all Boards of Health to protect the pu])lic
health by the removal of causes of disease when known, and in all cases
to take prompt action to arrest the spread of contagious and infectious
diseas(»H. and to abate and remove nuisances dangerous to the public
health, as directed or approved by the State Board of Health, and to per-
form such other duties as may from time to time be reciuired of them
by the State Board of Health, pertaining to the liealth of the people."

Y(mr Board is then told to formally order its Secretary to enforce the
rules of the State Board and empower him to employ guards and furnish
supplies when necessary and also to furnish him with a deputy if neces-

Digitized by VjOOQIC

402

sary. We know you are well informed as to your duties and what should
be done. One thing is certain, smallpox shall be suppressed. If your
Board refuses to act or if your County Council refuses to make a proper
appropriation for tlie expenses, you must promptly inform this office, and
either legal proceedings against the Boards will be instituted or else quar-
antine against the county by the State will be enforced. I enclose here-
with a certified copy of the rules of the State Board of Health. Please
pn'serve this certified copy very carefully, indeed. Do not let it go out of
your possession and be ready to furnish it to the court if at any time it
is necessary.

Let us hear from you upon receipt of this letter and if you do not under-
stand its purport and your duties, please inform us.

Very sincerely yours,

Secretary.

Indianapolis, June 9, 1902.

To the County Board of Health:

Gentlemen— The State Board of Health wishes to suggest as follows:
At your meeting to consider what action is necessary to suppress any
smallpox which might now exist or might hereafter appear in your county,
that you pass an order requiring your Secretary to fully and completely
enforce the rules of the State Board of Health. An estimate of what the
cost might possibly be should be presented to the County Council, and
that body petitioned to malve the appropriation. We wish most courteously
to call your attention to the commands of the law to all Boards of Health.
The words of the law are as follows:

**lt shall be tlie duty of all Boards of Health to protect the public
health l)y the removal of causes of disease, when known, and in all
cases to take prompt action to arrest the spread of contagious and in-
fectious disease, and to abate and remove nuisances dangerous to the pub-
lic health, as directed or approved by the State Board of Health, and to
perform such other duties as may from time to time be required of them
by the State Board of Health pertaining to the health of the people."

By formally ordering your Secretary to enforce the rules of the State
Board, and c^ii>owering him to employ guards and furnish supplies when
necessary, and also to furnisli him with a deputy, if necessary, you will
meet all the requirements of the State Board. We know that the proper
way to prevent smallpox is to have every one to vaccinate, but there are
many people impractical and unscientific and will not adopt this well-
proven method. Nevertheless, your Board should supply pure vaccine to
the County Health Officer, and to any deputies you may employ, and offer
to vaccinate free of charge every one who will permit it to be doae. In
this way a very large number of persons will be rendered Immune and
will not have the smallpox, and that will be accomplishing a great deal.
To make plain to you how very efficient vaccination is, we will say that
the State Health Officer has repeatedly seen children who were vaccinated
as a requirement to enter school, taking care of parents and older brothers
and sisters who had the smallpox. The children, of course, went free
from the disease.

Digitized by VjOOQIC

463

We further inform you that prompt and energetic action on your part
must be taken as the law commands, otherwise it will be the duty of the
State Board of Health to either quarantine the county which does not act
or bring the matter before the courts for consideration. It would indeed
be unfortunate if the State authorities were compelled to quarantine any
county, and this we most exceedingly desire to avoid.

We hope this communication will be received in the kindly spirit in
which it is oCfered. JNO. H. FORREST, President.

J. N. HURTY, Sefcretary.

EVANSVILLE.

June 2. Boonvillo, (?aniieltx>n, Rockport, Huntingburg, Eng-
lish, Paoli, Fronch Lick, Canipbellsbui^, Orleans.

Upon special order of the State Board of Health, I visited the
above named towns in accordance with our promise to the Ken-
tucky State Board of Health to take extra precautions against the
spread of smallpox, and I insert here my full report of experience

in the cities and towns named.

June 7, 1902.
To the State Board of Health:

Gentlemen— I have the honor to make a complete report of all my
hivestlgatlons into the smallpox situation in southern Indiana. I visited
the following counties: Posey, Vanderburgh, Warrick, Spencer, Perry,
Crawford, Dubois, Orange and Washington.

As heretofore reported, both Posey and Vanderbiu-gh counties are in
admirable shape. Not a case is kndwn at the present time in Posey
County, and the Health Officers there are alert and provided with ample
funds and the moral support of their Boards and the people. At Bvans-
vlUe I met County Health Officer W. S. Pritchett, City Health Officer
W. H. Gilbert, and special smallpox physician, J. H. McCutcheon. There
is an arrangement between the city of Evansville and the county of Van-
derburgh by which all cases of smallpox are cared for at Joint expense.
About three miles from Evansville a smallpox hospital has been estab-
lished. It is a very large frame building and was once the county in-
firmary. Every facility is afforded at this place to care for all cases of
smallpox. On June 2 tliere were nine cases in the pesthouse, seven of
them to be discharged by the 4th. The three officers above named united
in declaring that not less than 30 per cent, of all their cases of smallpox
had come from Kentucky. Since October. 1901. the County Council of
Vanderburgh County had appropriated Jfl 4,000, and there had been since
that date 294 cases and no deaths.

On the afternoon of June 2 I arrivcnl at Boonville, Warrick County,
I immediately called upon Dr. T. Wright. County Health Officer, and with
him called at the office of Dr. D. A. DeForest. The County Commissioners
were in session and we called uiwn them and the subjin^t of smallpox in
Warrick County was thoroughly considered. The County Health Officer,
Dr. Wright, had in the beginning reported that his Board cf Health and
the County Council were giving him full and satisfactory support. The

Digitized by VjOOQIC

404

#
iiiouibors of the Board of Health aAked many questions and in the end
said they would energetically enforce every measure necessary to keep
down smallpox. It was the a^i-eed testimony of Dr. Wright and Dr. De-
Forest that fhe prevailing type of smallpox was veiT mild and that only
a very small percentage of the cases were severe. The greatest trouble
experienced was to secure reports from physiciaus. for many refused or
neglectwl to report smallpox, and many, also, were unable to diagnose
it, for they denied that the eruptive disease now prevailing was small-
pox. It was remarked by Dr. Wright that if such physicians could make
a court believe that they were conscientious in their opinion, that it would
be impossible to punish them for neglect to make reports of cases of small-
pox which they diagnosed as chlckenpox.

I did not go to Newburg. which Is a small town In Warrick County,
on the Ohio River, but instead telephoned to the Health Officer, Dr. O. A.
I^ett from Boonville. He emphatically stated there had not l)een a case
of smallpox in Newburg since May, lfX>l. Dr. D. A. DeForest, w^ho was
sitting in the room while I was telephoning, spoke u\) and said: **I saw
four cases in Newburg 'in May, with Dr. Lett: It is true that Dr. I>ett
would not acknowledge they were smallpox, but I have had the dise^s*^
and have lived with it and I know they were smallpox." I continually
find such situations as the above.

For Boonville itself. Dr. DeForest, the Health OffletT, reported that
smallpox first appeared in May, ICKU. There had been lOG cases to date;
two cases were in the city at that time, .Time 2. Both were In quarantine.
Vaccination was not general in the town, but he had noticed it was very
effective where it had been practiced. The Town Board had given good
support at all times and he knew j)ositively that he would have all
the support needed in the future. In tlie whole county there have been,
since March, 11)01, 182 cases, and two deaths to June 1, 1902. The death
of a well-known man at Folsomville, from confluent smallpox, made
vaccination general in that locality. One of the men employed to bury the
deiid man had had smallpox, but on account of his exiK)sure contracted it
a second time, and the second attack was much more severe than the
first. 1 regard conditions in Warrick County as very satisfactory.

Fiom Boonville I went direct to Cannelton, the capital of Perry
County. From the records of Dr. C. T. Hendei-shot, who is County Health
Officer, I found there had ])een seven cases of smallpox rei)orted In the
county in May, and at the time of my visit, the afternoon of June 3, there
were* six cases. These were under quarantine and being looked after
properly. Dr. Hendershot said: "The County lV)ard of Health does not
support me. The County Council appropriated .$.S50 for health work for
11)02. This was exhausted on April 1. Since then I have proceeded on
my own r(sponsi])ility and have incurred bills to the amount of about
jpiOO. The Auditor only laughs when he is requested to convene the Board
of Health and th(* County Council for the purpose of considering health
affairs. The County Court on May 31 acquitted Dr. F. A. Evans, of
Tell City, who was charged with failing to report a case of smallpox
and to wliich unreported case over fifty cases were traced. This failure
to convict has had a demoralizing effect upon the situation." Dr. C. Ek
Cox, Health Officer of Cannelton, reported there was one case in the city

Digitized by VjOOQIC

4G5

ill May and none on the afternoon of June 3 when I saw him. He says
he has full support of the local Board and that the Mayor is deeply inter-
ested in the work and he will answer that Cannelton will always do its
duty if ever smallpox appears. The city has no pesthouse. I visited the
courthouse and tried to see the Auditor, Mr. Fenn, who resides at Tell
City. Mr. Fenn had telephoned that he probably would not be at his
otnce that day and no one knew where to find him. The Deputy Auditor
told me he did not know of any health orders or health action taken by
the County Board of Health, and it was true, as Dr. Hendershot said, that
^3r)0 had been appropriated for health work in 1902, and that it was ex-
hausted on April 1. Not being able to find the Auditor, I called up the
l^rosecuting Attorney, Hon. Philip Zoercher. He promised me that he
would see to it that the County Board of Health and the County Council
would speedily be called together and that he would advise them, as
Prosecuting Attorney, to Immediately make right provisions for the en-
forcement of the law in regard to the suppression of infectious and con-
tagious diseases. Mr. Zoercher is certainly in hearty sympathy with dis-
ease prevention work and I am. confident that he will perform his promise
and bring Perry County to right action at an early day. I left word with
Dr. Hendershot, Health Oflflcer, to report immediately when his Board
acted. At Tell City, which is in Perry County, I met Dr. Wm. Cluthe,
who is ex-offlcio Health Officer and also Dr. C. H. Mason, who is the
present Health Ofllcer. The first gentleman resigned his ofllce April 14,
"because local authorities gave no support and because of newspaper
abuse and abuse of anti-vaccinationists." Dr. Mason was appointed June
1, and there was no town health record from April 14 to Jime 1. Dr.
Cluthe was enabled to state there had not been less than seventy-six cases
of smallpox in Tell C3ity between November 25, 1901, and June 1, 1902.
Dr. F. A. Evans, who, as stated above, had been acquitted in the County
Court of the charge of not reporting cases of smallpox, lives in Tell City.
Both Dr. Cluthe and Dr. Mason united in saying that Dr. Evans was still
giving trouble and would probably continue. I proposed to Dr. Mason
that we call the Town Board together and have a complete understanding.
He assured me this was now unnecessary, for the recent agitation
throughout the State had brought him assurances that the Town Board
from now on would be very active in the suppression of smallpox and
would give all funds which were necessary for that purpose. Dr. Cluthe
seconded Dr. Mason in this statement, and so I did not see any of the
members of the Town Boiird of Tell City. Dr. Mason is an active, ener-
getic man and is deeply interested in the work he has in hand.

From Tell City I went to Troy, which town is also in Perry County.
Dr. R. T. Veneman is Health OfiScer of Troy. He reported that not a sin-
gle case of smallpox to his knowledge had occurred In Troy. He attribute*
this result to the fact that prompt restrictive measures were taken when
the disease appeared at Tell City and at Cannelton. He has the very best
support from the town authorities and promises that If smallpox invades
Troy, it will be vigorously fought. These assurances of Dr. Veneman
made me conclude It was altogether unnecessary to see his Board, and, as
time pressed, I took the train and went to Rockport.

3a-Bd. of Health.

/Google

Digitized by VnOOQ I

466

I arrived In Rockport on the afternoon of June 3, and Immediately
called upon the County Health Officer, Dr. J. H. Johnson. He was not In
his office and so I next called on Dr. J. M. Daily. Health Officer of- the
town. Dr. Dailey reported there were no cases of smallpox in Rockport
in May. There had been thirty cases since January and none at this
date, June 3. He reported further that the Town Board had not given full
and satisfactory support and that he had done some up-hill work. To-
gether with Dr. Daily, I visited Dr. E. D. Khrman, who is a memt)er of
the Town Board. After talking the matter over thoroughly. Dr. Ehrman
promised positively that as a member of the Town Board, and as also the
head of the Committee on Health Affairs, that every necessary sanitary
step would be taken to light smallpox whenever it appeared In Rockport.
These assurances were sufficieftt and I made no further investigations in
regard to the town. Subsequently I found Dr. Johnson, and together with
Dr. O. Baumgaertner, his deputy, discussed the situation in Spencer
County. These gentlemen concurred in the statement that the County
Board of Health has not given adequate support. The Board had listened
to their pleadings, but at no time had It taken any special action, and the
records would so show. The County Council had appropriated the salary
of the Secretary and nothing more. The health service in Spencer County
has certainly been more or less demoralized. Dr. Johnson, who Is now at
his post, left the town February 1 and did not return until the last of
May. He appointed Dr. Baumgaertner as his deputy to act in his absence.
There Is a legal tangle as to whether or not this could be done under the
law, and it may be that Dr. Baumgaertner's acts are not legal. I do not
know that this has had anything to do with the non-action of the County
Board of Health and the County Council. Deputy Auditor H. B. Bruner,
whom I found in the Auditor's office, says to his positive knowledge the
County Board of Health has taken no action in regard to suppressing
contagion and that no special orders have been issued. Drs. Johnson and
Baumgaertner presented the records, which show that over 200 cases of
smallpox have been reported In Spencer County in the last two years.
Eighty per cent, of these have been reported by the two officers named
and not by the practicing physicians. "Indeed," said Dr. Johnson, **we
have not had the support of the physicians. Many of them do not re-
gard this disease as smallpox and will not report We have spoken about
the matter of prosecution to the County Attorney, but he has discour-
aged us and we felt it was useless to make affidavits when the County
Attorney was opposed to prosecutions." It would have been Impossible
to call the County Board of Health together, because two of them were
out of the State for a few days, and so 1 directed Dr. Johnson that he
should demand of the Auditor, so soon as the absent members returned,
that he call a meeting of both the Board of Health and the County Coun-
cil, to make proper provisions for fighting smallpox. I also directed Dr.
Johnson to give me proper information Avhon the Boards were called to-
gether and also to report fully as to what was done. I have not at this
(lute, June 7, hoard from Dr. Johnson. At Lincoln City, In Spencer Coun-
ty, I learned from a citizen of Bradloys, wlio positively refused to give
his name, that smallpox liad existed off and on for two years In the neigh-
borhood of Midway and Oakland. He also declared it had been at Chris-

Digitized by VjOOQIC

407

ney, Enterprise and Newton ville. I also know this to be true from the
statement of Dr. T. Wright, of Boonville. I think the citizen of Bradleys
w^ould not give his name for fear of criticism or perhaps something worse,
for he said: "I do not want to he whitecapped." From all the informa-
tion gained during this l^ip and from letters and reports presented to the
State Board of Health for the last two years, I am prepared to say that
the health service in Spencer County has been badly demoralized, that the
Health Board has not enforced the law nor taken any action and that the
County Council has not furnished means for enforcing the law. I recom-
mend that the authorities of Silencer County be plainly informed that un-
less they proceed without delay to heartily enforce the law concerning the
management of infectious and contagious diseases that they be proceeded
against as the statutes provide.

From Rockville I went to Huntingburg, Dubois County, arriving there
at 2 a. m. In the morning I called upon Dr. G. P. Williams, Health Offi-
cer. He told me there had been two cases of smallpox in his city in April
and none at that date, June 4. He said that the Town Board gave him
full support. He did not want In a single particular, and that he would
answer for it that "Huntingburg would fight smallpox to a finish when-
ever it appeared." This was, of course, sutflcient assurance, so far as
Huntingburg was concerned. Dr. Michaels was not in Jasper, but had
gone to Petersburg on business. His deputy told me over the telephone
that the County Board of Health had taken interest in health matters and
had issued orders that prompt action should always be taken to sup-
press smalli>ox. He also said the County Council had appropriated all
the money the Health Officer had asked for. There had been, only three
cases of smallpox in Jasper since January 1, and they had been promptly
taken care of. There had been twelve cases in the whole county in April
and only two cases In May. At Birds Eye, in January and February,
there had been quite an outbreak of the disease, forty cases appearing.
Prompt quarantine and vaccination of all who were exposed and disin-
fection had been practiced and the disease was at an end at that place
before the middle of March. It is very evident that health affairs in Du-
bois County are in excellent condition.

From Huntingburg I went to English. There I met Dr. C. D. Luckett,
who is (bounty Health Officer. He said he had not had a case of smallpox
in Crawford County In t«» years. I called his attention to one which was
at Marengo that very day and he said that the same had come in from
Vincennes, but would be immediately sent out of the county, I also
called his attention to the fact that the Kentucky authorities reported
smallpox In Alton, also In Leavenworth, his county. He said he had no
report in regard to it, and did not l>elieve that it existed. Dr. Luckett
said he had the full support of liis County Board and that the County
Council has "only appropriated my salary," and has not glvefn a penny
for disease prevention nor for fighting epidemics. He thought that vac-
cination Is quite general and that the people are heartily In favor of doing
all that is necessary to prevent infectious and contagious diseases. I
asked him how he would get along without money if called upon to fight
smallpox. He said he would go ahead and do what was necessary, for
he was confident that the bills would be met and if they were not met

Digitized by VjOOQIC

408

he would pay them himself. As for the town of English, he reported that
the authorities are heartily in favor of combatting smallpox and all other
preventable diseases. He said further that the Town Board had called
him before it and told him plainly he should loolc sharply after all cases
of smallpox which might appear and that he should vaccinate c^-'ery per-
son free of charge who would be vaccinated. He could not tell how
many he had vaccinated, but It was certainly a goodly number. He
assured me It was not necessary to visit Marengo, because, as County
Officer, he could report that the authorities of that place were more than
willing to flght smalpox. I was a little dubious about Alton and Leaven-
worth, but found I could not make these two tgwns under at least three
days on account of the distance and no railroads. Dr. Luckett promised
he would look after them himself and would visit them and make report
From English I telephoned to Corydon and talked with Dr. Wm. Daniel.
Health Officer of Harrison County. I have the greatest faith in Dr.
Daniel, for he is certainly an intelligent and highly efficient officer. He
told me there were at that time, June 4, four cases of smallpox at Ramsey,
all under quarantine, and that all exposed persons had been vaccinated
and directed how to deport themselves. From a recent canvass of his
county he was able to say there were no other cases known. He also
assured me that the County Hoard of Health gives him its fullest support
and there is an appropriation of $5(K) for disease prevention for 1902.
He also said that with but very few exceptions, the people and news-
papers gave him hearty support. The physicians have been twice notified
that they shall report all cases of eruptive disease which may come undw
their charge. He believes the order is being complied with, for he has
been called upon to visit some very mild cases which he knew were not
smallpox. He had very recently visited Lanesvllle, New Middleton.
Mauckport, Laconia, Valley City and Cloverdale. All were incorporated
towns and all had Health Officers, and in each place the authorities were
fully alive to the necessity of coml>atting infection and contagion and
had ordered their i-espective Health Officers to be prompt and energetic
in their health work. This was very satisfactory so far as Harrison
County was concerned and I did not go over to Corydon.

From Knglish I rode to Paoli, a distance of about twenty miles. The
first place 1 stopped was at Fargo, which is about seven miles from Eng-
lish, and Is situated in the southern part of Orange County. At this place
there is a store, two houses and an abandoned mill. The keeper of the
store is named Benton Standifer. 1 asked him in regard to the health of
the community and he said there was a little consumption and everyljody
al)out there had been having the "eetch." I asked him how long the
"eetch" had prevailed and he said for over two years. He had had it
himself, and, pointing to one of two girls who were standing at the coun-
ter, remarked, "She has it now." The girl started to run, but I quickly
stopped her and requested that slie permit me to examine her face. Her
forehead showed i)lainly the i>eculiar and characteristic marks which are
left by smallpox. She told me that it had been three weeks since she
first broke out and that her first symptoms were a slight chill, followed
with fever for two days. The marks left on the forehead were alone
enough to tell what the disease had been, and the other Information

Digitized by VjOOQIC

469

gained clinched the conclusion. In driving by the mill, which was very
dilapidated, I observed through an open place Ave men playing cards.
I left the store and went down to the mill. There I addressed the gentle-
men pleasantly and talked to them about the old mill. They seemed to be
pleased to give me answ^'rs. One of the men wore a soldier's hat with
crossed muskets on the front. He was a soldier and had been to Cuba,
and his name was Billy Cummins, being well known in that neighborhood.
He was the spokesman for the group and so I asked him if he knew any-
thing of the •'eetch" which Mr. Standifer said prevailed in that com-
munity for the last two years. He replied that he had seen a great deal
of it, and that he was not afraid of taking it because he was vaccinated.
He did not call it smallpox, but winked when he remarked about the
vaccination. I asked him to show mo his vaccination, which he willingly
did and it was new and characteristic. One of the men who was playing
cards had a pustule upon his chin and two upon his forehead. I asked
permission to examine him carefully and was able to decide that he had
smallpox at that time, l)ut did not tell him that such was the case. I then
examined the others in turn and found they all had had the "eetch" and
that said *'eetch" was without doubt smallpox. Cummins told of a man
whom they all knew, and whose name he mentioned, but I did not write
•It down and have now forgotten, who had the "eetch" so severely as
to be In bed for over two weeks. Cummins, In telling of it, said "he was
a sight— so swollen you never would have recognized him." This man, he
said, was now quite recovered. *

From this point 1 drove on eight miles to Youngs Creek, which is
also in Orange County. At this place I met Dr. H. P. Meyer, who said:
"There has been right smart of 'eetch' around here for a year. The peo-
ple were not much sick and they did not seem to take It from each other
unless they slept together.*' He well described the disease so that I could
readily tell lie had been dealing with mild smallpox. I did not enter into
an argument with him upon the subject, for probably there would have
been no end of it. I went over to the store and there were five middle-
aged women. I asked one of the women if she had any knowledge of the
"eetch" which had existed thereabout. She looked at the other women
and then looked at me and said, "I ain't saw no eetch." I then asked one
of the other women and got essentially the same reply. About that time
Dr. Meyer walked Into the store and said, raising the head of the woman
1 first spoke to, "This woman had the 'eetch' 1 told you of," She was
covered with confusion, but I did not take" advantage of it more than to
ask her how long she was sick. She said that she had not been sick at
all, but after close questioning I brought out the fact that she had felt
badly for two days and could not eat on account of a sick stomach. On
the third day she broke out with pimples and then felt better. She had
been over the attack for fully ten days and there were only left a very
few marks upon her forehead. On my way from Youngs Creek to Paoli
I stopped at two farmhouses, making inquiry of the occupants, but with-
out discovering any positive and unquestionable evidences of the exist-
ence of smallpox.

Arriving at I'aoli I immediately called upon Dr. C. L. Boyd, Health
Officer. He greeted me very cordially and said: '*! have just answered

Digitized by VjOOQIC

470

a teldgram from Governor Durbin, asking about smallpox In my coun-
ty." I immediately Inquired, "What did you say?" and he replied, "I
told him, no smallpox reported in Orange County." I then remarlced that
he should correct his statement, for I had found one case at Fargo and
had discovered unquestioned evidence, proving that a great deal of small-
pox had existed in the region through which I had passed. I also asked
him what he knew of Northwest Township, and he told me that smallpox
had been up there, he was quite satisfied, but he had not visited the
region and only knew from a few reports he had received. He said he
had told Dr. Purkhiser, who wrote him upon the subject, that he did
not know of any smallpox. I closely scanned the face of every person
I passed in Paoli, but did not discover any one presenting any marks
which would warrant closer examination. I called at the office of Drs.
Lingle and Lindley, in Paoli, and found neither of them in, and did not,
therefore, gain any information. I stayed all night at Paoli, and in the
morning, at the courthouse, met the County Commissioners, who were in
session. These gentlemen received me with the greatest coiu-tesy and
we discussed the whole situation. I told them what I had found in the
southern part of their county and they were very much surprised. They
asked me many questions and our conference lasted for two hours. They
promised me that they would energetically and heartily enforce the rules
of the State Board of Health concerning the care of infectious and con-
tagious diseases and nothing more could be asked. Dr. Boyd had told
me that his Board was always ready to give him any support he might
request The County Council had appropriated $290 for health work in
1902, and that $240 of this was for the secretary's salary and $50 for ex-
penses. I am very certain that from this time on there will be greater
vigilance in Orange County, and if smallpox comes again it will be
promptly dealt with.

At 10 o'clock, on June 5, I left Paoli for French Lick, and in the after-
noon at 2:30 was joined by Dr. Boyd, from Paoli. Before Dr. Boyd's
arrival I had called upon Dr. Wm. E. Ryan, who said that he had not
seen any eruptive cases whatever except syphilis. He was positive he
knew what he was dealing with and X have no doubt that he did know.
When Dr. Boyd arrived, we called on Dr. J. A. Toliver, Town Health
Officer, and talked the situation over with him. He told us that Lloyd
Kimmel, who kept a store and restaurant northwest of the Wells Hotel,
had called on him for some medicine to allay itching and burning. Mr.
Kimmel had said that his wife had a "breaking out" and she suffered very
severely. Dr. Toliver furnished medicine, but what it was I do not
know. I then said we would have to go and see and examine the patient,
and accordingly we all three visited Mr. Kimmel's house. We found Mrs.
Kimmel in the papular stage of smallpox. She said she "eetched" and
burned all over and that she had been very sick for three days with
fever, pains all over her body and nausea. She further told us that when
the "breaking out" came she felt better. All of this is characteristic of
smallpox and I know positively the good woman had the disease. All of
the children, six In number, had had the disease; two of them were pret-
ty well marked, am', tlie rest bore scarcely any marks at all. The mother
was the last to tr.k.* It and she must have had considerable resistance,

Digitized by VjOOQIC

471

for she had nursed the children through their illness. Mr. Kimmel had
not yet been attacked and probably will not be because he has upon his
arm a characteristic scar. Said scar is at least ten years old, and I be-
lieve that vaccination has protected him this far. We inquired at the
drug store? and at several places and of several people if they Itnew Of any
one who was sick with a breaking out. We could not learn of any other
cases, and, of course, our visits ended. That night I left French Uck
for Campbellsburg by way of Orleans. It only remains to be said that
Dr. Boyd is now better informed in regard to his county than ever be-
fore.

I arrived at Campbellsburg from French Lick June 5, late at night,
and immediately called on Dr. S. K. Luckett, Health Officer. We also
called up by telephone Dr. Purkhiser, Health Officer of Washington Coun-
ty, who lives at Salem. Dr. Purkhiser told me that smallpox existed in
the neighborhood of SaltlUo, and in that neighborhood in the northeastern
part of Orange County. Dr Luckett assured me there was not a single
case of smallpox in Campbellsburg at that time. He expected to be able
to keep it out by quarantine and by disinfection. On June 6, in the morn-
ing, I inspected the schoolhouse at Campbellsburg, because of letters from
the principal and from a merchant at that town, asking that the old un-
sanitary schoolhouse be condemned for the benefit of the health of the
pupils. I made a thorough sanitary survey of said schoolhouse and every-
thing pertaining thereto will be reported in detail to the State Board of
Health.

By 9 o'clock I was in Saltillo. There I found smallpox in the family
of Mr. S. P. Mills. There were six in the family and all had it. Mr.
Mills did not believe that he had smallpox, his father. Dr. Mills, havhig
assured him it was chickenpox. The wife of the young man was very
ill and was in bed, the disease having the upper hand. Mr. Mills then
said, "If this is smallpox, we have plenty of It around here, and there are
many cases of the same in Orange County." I did not see Dr. Mills, be-
cause he was away from his office making a call. Aa he evidently does
not know smallpox, an interview would probably have been of little
worth.

From Saltillo I drove through Northeast Township, Orange County.
The first stop was the house of Mr. John Brown. I went in and found
Mrs. Brown at home. She told me her name was Mrs. £711 Brown, and
my driver, Mr. W. F. Banks, of Campbellsburg, told me that there was
no "Eli about it," that her name was plain John Brown, and that the
woman, before marriage, was named Miss Maudlin, and that he knew her
well. I can not understand why Mrs. Brown represented herself as Mrs.
Eli Brown, if Mr. Banks is correct. Mrs. Brown told me that she had
not had the "breaking out," but the marks upon her forehead told me
plainly that she had had an eruption. A close inspection was not made
because she would not permit it. At Mr. Frank Ingram's, In the same
township, the whole family, three in number, had evidently had small-
pox. At Mr. James Freed's, a family, six in number, all had had it very
bad. This is their own testimony. Mr. John Grissom, in the same town-
ship, four in family, had all had it, recovering in May. The last house
at which I inquired I met Mrs. Betty Taylor, living within about three

Digitized by VjOOQIC

472

and oue-half miles of Orleans. She assured me she did not know of any
"breaking out disease," and then she said, **I do not believe it Is small-
pox." How she happened not to know and yet have an opinion is a mat-
ter for wonder. Mrs. Taylor had marks on her forehead which looked
very much like those left by smallpox. When asked about these marks,
she would not answer. It seems established, therefore, that smallpox
has existt'd in Northeast Township of Orange County for some time, and
that the physicians, when called, have? been unable to diagnose It. Fortu-
nately, no deaths have occurred, but there have been severe cases, as was
Instanced in Mr. John Grissom*s and Mr. James Freed's families.

Arriving at Orleiaus, I called on Dr. R. E. Baker, Health Officer; also
upon Dr. E. D. Tvaughlin, ex-member of the State Board of Health. Dr.
Baker told me that alwut Christmas a girl (could not remember her
name) came from Louisville to visit Mrs. Abel Murray, wife of the hotel-
keeper. The Louisville girl developed smallpox, was Isolated, and the
people in the house were all vaccinated, and no other cases occurred at
Orleans. The Louisville girl went to l!;eipsic. Northeast Township, and
then, shortly, many cases appeared in that township ana at Saltillo.
How it was that Dr. Boyd, County Health Officer, missed all of this, I
do not know. Dr. Baker informed me as follows, and 1 took dow'u his
words and read them back to him: **My Town Health Board doi'S not
give hearty support. Last winter I had a case of diphtheria. The fam-
ily was very poor. I quarantined the family and furnished them sup-
plies, and in the end had to pay for them, as the Town Board would not
do so. Most doctors do not care about health affairs, for people do not
care much. We have no pesthouse. I have thought I would resign l>e-
cause of the antagonism and abuse which follow^s my efforts to help
others."

At 12 o'clock 1 left Orleans, via Mitchell, for Indianapolis, and arrived
here at o:40 p. m. on Friday, June f5.

Respectfully submitted.

Secretary.

Indianapolis, Ind., June 9, 1902.

Dr. J. N. Hurty, Secretary State Hoard of Health, Indianapolis:

Dear Sir— I have read with interest and satisfaction your report of
the 7th Inst, giving your observations and conclusions of the conditions
existing in the counties of Posey, Vanderburgh, Warrick, Spencer, Perry.
Crawford, Dulwis. Orange and Washington as relates to smallpox. In
the nine counties visited, if I figure correctly, there are 21 cases of small-
pox at the present time, or at the time of your visit. My conclusion is
not clear, nor is your statement, as to the number in Spencer County,
which I have placed at nil; but 1 in Orange Count.^, and none in Dubois.
This is indeed a very gi-atifying sliowing. The daily reports from Dr.
Ferguson are also quite satisfactory for all the counties, excepting
Franklin, and I have not as yet received his final report relative to the
disposition upon the part of the coimty authorities to assume control
and eradicate the disease. During your absence I wired some thirty
counties concerning the number of smallpox cases each had. None of

Digitized by VjOOQIC

473

these counties you were expected to visit, but, in one instance, tliat of
Orange County, I liad advice, as you mention in your report. 1 took
occasion to write to Dr. Boyd at Paoli, iuforiuiug him nicely, but firmly,
that the matter must be handkni promptly and effectively, or that such
steps as should be deemed necessary by the State Board of Health and
myself would be taken to suppri'ss the disease in his county. I have done
likewise with Franklin ('ounty, and shall today act accordingly with
Spencer County. While you were in the field, I called upon Dr. Clark
Cook to visit Lafayette. His report is enclosed herewith, together with
the monthly report for May made by Dr. Littoll, County Health Ofiicer,
and a communication addressed to you. You may please return to me
the letter from Dr. Cook. I transmit to you herewith two letters from
Sullivan County, which would indicate that some effective measures
should be put in force immediately in that county, and I suggest that you
give the matter attention at once. In all of your visits I would have
you impress upon those in authority, when it shall become necessary,
that the State Board of Health and myself are acting in entire accord
and harmony; that our disposition and intent is to adopt such measures,
even if it shall become necessai-y to invoke the aid of the law, looking
to the eradication of smallpox at as early a date as possible; that there
is no desire to create alarm, nor to do anything unseemly that might
attract attention to, or injure the trade of localities, but that we are de-
cided that smallpox must be eliminated from our State. I will this day
reinforce your efforts l)y writing a letter to Sullivan County, and 1 wouid
suggest that you visit this county, and also that you keep in close touch
with the counties you have already visited, and see that such measures
are adopted and carried out that will bring about the desired result
For your information, 1 hand you herewith a letter this day received from
Dr. Cowing, of M uncle, which indicates that they are determined to do
whatsoever they can to control the situation existing In that county. It
is the exception in the information I have received from the counties
where they are not likewise disposed, and the exceptional cases are the
ones we should look after, as well as give encouraging words to those
who are Inclined to be up and doing at all times. With reference to
Adams County: On last Friday I wrote to Dr. Davis, of the Board,
asking him to visit that county. Dr. Ferguson was also requested to do
likewise. So far, I have no report from either one of them. I also
wrote Dr. Forrest, asking him to give immediate attention to his own
county (Grant), from which report came to me that the disease was
spreading slowiy. 1 firmly ])elieve that, in a quiet way, we may accom-
plisii what we desire, and have the assurance that the State is rid of
the disease. I have on my desk this morning a copy of a letter written by
the Vice-President of your Board to Dr. J. N. McCormack, Secretary
of the Kentucky State Board of Health. Some Information has come to
me (and which you also secured on your trip) that, in my opinion, should
be conveyed to the Kentucky authorities in a nice way. That is. that
several localities have been infected from Kentucky. Dr. Ferguson
makes the statement that in Boone County, Kentucky, there is no quar-
antine; two counties in our State, Dearborn and Switzerland, make this
report. You also mention a case in Orange County that came from

Digitized by VjOOQIC

474

Louisville. I think it would be well to apprise the authorities south of
the river of the information we have derived through visits, and that
it would be well for ^hem to look to their own back yard before com-
plaining too loudly and seriously of their neighbors. This, as I say, may
be done in a way devoid of oifense. It is a very serious proposition for
one State to advertise to the whole nation that they propose to quarantine
against a neighboring State, and especially when conditions in their own
State need looking after equally as much as the State against which they
contemplate such action. I repeat, it is the exception and not the rule
where our people have not been alert. There have been honest differences
among the profession as to the nature of the skin eruptions. I call to
mind a case in French Lick. The doctors' names are mentioned, and I
am advised that one of them, at least, is a high-grade physician of Rush-
vllle. TLoy decided the case was "itch." and took it upon themselves
to treat it, and in five days, it is stated to me, they had the skin clear.
The patient was a servant girl in the Wells House, and she was seen
on the streets by two members of my party. Doubtless Kentucky has
the same confusion among its physicians.

I would suggest that you make visits to the counties of Clay, Greene,
Sullivan, Daviess and Knox. The first reports 14 cases, the second 14
cases, the third 28 cases, the. fourth 25, and the latter 27, since May 23.
I shall write to the counties this day, reinforcing yoiu: personal efforts.

Respectfully,

WINFIELD T. DURBIN,

Governor.

Indianapolis, June 9, 1902.

Hon. Winfield T. Durbin, Governor of Indiana:

Dear Sir— I acknowledge receipt of your communication of June 9,
and am thankful to know that my report was satisfactory to you. Your
pardon must be asked for not stating iu my report the number of cases
of smallpox which the Doputy Health Officer of Spencer County stated
existed in May. He stated the number was 10, and that 2 on June 3
had just l)eeu reported. I had these facts plainly written in my notes,
but for some cause which I can not explain, I missed them in my report
to you. As to Orange County, you will find, ui>on rereading, that I re-
ported finding 2 cases, one at Fargo and one at French Lick. The let-
ters you have from Sullivan County, and also one I have received from
Mr. Law, Indicate a worse condition than I supposed existed there. Dr.
E. D. Thixtun, Health Officer of Sullivan County, is an active, compe-
tent and conscientious man. I was at Sullivan on May 1, and with him
rode through the northeastern part of the county. We found several
cases of smallpox at Sheldon, and there I witnessed one death from the
disease, arriving there about teii minutes before dissolution. The^ pa-
tient was a child not over two years old.

From Sheldon we rode to Hymora, and there we foimd smallpox in the
houses of five miners, one case in each house. All were placed under
quarantine, and the Trustee notified to furnish supplies if they were
needed. Dr. Thixtun informed me that his Board gave him no support.

Digitized by VjOOQIC

476

and that the County Council had not furnished any funds for fighting
smallpox or other Infectious diseases.

The President and Vice-President of the Board have directed that
orders shall be issued to the County Boards of Health of Sullivan, Spen-
cer and Franklin Counties that they shall proceed without delay to en-
force the rules of the State Board of Health concerning the manage-
ment of smallpox. Since Dr. Ferguson has reported in regard to Adams
County, I will also serve the order on the officers there. The order is
to be followed up with prompt action, If it is necessary to do so. These
directions of the officers of the Board were not given me until after 6
p. m. on Saturday, and although I worked continuously all day Sunday,
and so far today, I have not been able to get the orders out as directed,
but will get the orders out yet tonight, and. forward to Dr. Forrest for
his signature.

I have a postal card from Dr. Hendershot, Health Officer of Perry
County, informing me that his County Board of Health and the County
Council have been called together and will meet on Tuesday. June 10.
He says that he has the energetic support of the Prosecuting Attorney,
Mr. Zoercher, and I am confident that all will go well in that county.
Over the telephone, on Saturday, the Auditor of Spencer County told me
he would call the County Board of Health and the County Council to
meet immediately, and requested that I send typewTitten instructions as
to what should be done. I promised to do so, and they will go forward
tonight. The Fi-anklin County Auditor also promised, over the telephone,
to call the County Board of Health and County Council together to take
action for the suppression of smallpox. He did not ask for instructions,
nevertheless a kindly letter will be sent, suggesting what the State Board
thinks should be done.

You surely are right in thinking that I should go to Sullivan County,
and I will leave here for Sullivan tomorrow night. It probably will be
necessary for some one, and I would suggest Dr. Ferguson, to go to De-
catur County and stay there until action is taken, or at least until full
assurances of activenoss will be given. I wish to say that I never yet
have failed to secure action from County Boards of Health when the
effort was kindly and persistent. From what Dr. Ferguson says, how-
ever, I fear action will have to be taken against the authorities in Ad-
ams County. I visited that county last fall, met the officials and plead
with them to enforce the law and the rules concerning infectious dis-
eases. The Board, I believe, would have acted at that time if it had not
been that four of the prominent physicians were insistent that the dis-
ease was not smallpox. As they had several typical cases, where not a
single link in the chain of evidence that they were smallpox was missing,
it seems strange that these physicians should not make the correct diag-
nosis. They would not meet the case point to point, but would remain
silent, and in the end walk away, shaking their heads. I detail all of
this to make plain as possible a serious difficulty met In the field.

In regard to informing the Kentucky Board of Health that we have
not a few cases from their State, I will say that Dr. Wlshard will meet
both the President and Secretary of that Board In Saratoga on Tuesday,
and he told me he would politely inform those officials that Indiana was
much indebted to Kentucky for not a little of her smallpox, and would

/Google

Digitized by VnOOQ I

476

(!ite the Instances of which he has notes. It is certainly true, as you
say, "a very serious proposition for one State to advertise to the whole
nation that they propose to quarantine against a neighboring State, and
especially when conditions in their own State need looking after equally
as much as the one against which they contemplate such action."

I took esseutially this ground at I-rOuisviUe on May 27. when I put
forth every effort to persuade the Kentucky Board not to act, as it sub-
sequently did.

I note your suggestion that I make visits to the counties of Clay.
Greene, Davi(*ss and Knox. I am exceedingly willing to do this, and
even quite anxious to go, but my desk is burdened "with correspondence,
and I have also on hand the analyzing and classifying of the reports and
statistics for May. Knox probal)ly needs little attention because the
Health Officer at that point. Dr. Lyman Beckes, Is a very efficient man.
and I know positively he is flghtiug very hard, and that he has pretty
good support from his Board. It will take at least four days to go over
Clay, Greene and Dnvless, and I would suggest, also, that Pike be added,
for I know from correspondence that disputes exist in that county, and
I presume, as usual, the eruptive disease w^ould be found to*l>€ smallpox.
All of this was presented to Dr. Wishard, and he directed that a deputy
should bo sent to those counties on account of the reasons detailed above,
and which would make it Impossible almost for me to go.

May I take this occasion in writing to deny that I have had any-
thing to do with the partisan articles In the Indianapolis Sentinel? On
Siiturday over a half column was printed in that paper, iTor which they
had not a single statement from me, as I refused absolutely to answ^er
iny of their questions. With characteristic disregard of all proprietiea
a great deal of matter was nevertheless "built up." I can not well ex-
press the resentment I feel for such gross misrepresentation.

I return herewith the letters concerning smallpox which were ad-
dressed to you, and which have given me valuable information.

With respect. I am, very truly yours.

Secretary.

Indianapolis, Ind.. June 10. 1902.
Dr. .7. X. Ilurty, Secretary State Board of Health. Indianapolis:

Dear Sir— Acknowledging your letter of Dth Inst., and replying to that
part relative to the visitations of the several counties I mentioned to you In
my communication of yesterday, I think It best that your desk work
should. If necessary, accumulate while you are in the field, as the condi-
tions existing now and by reason of the action of the Kentucky Board of
Health In suspending the enforcement of the quarantine until July 1.
we do not want to give them an opportunity to say "we sent a boy to
mill," as It were. In sending men Into the field. I think It best for you
to visit the counties indicated in my letter, as well as the additional
one you mention— Pike County. I am just In receipt of a letter from Sul-
livan County, which 1 transmit to you for your information, after which
please return to this office for file.

Very truly yours,

WINKIELD T. DURBIN,

Governor.

/Google

Digitized by VnOOQ I

477

Indianapolis, June 13, 10<)2.

Hon. Wlnlield T. Durbln, Governor of Indiana:*

Dear Sir— Your oommunication of June 10 was received on tlie lltii.
l>ut tliat day I was at Lafayette. On the 12th, I was compelled to answer
a subpoena to the court in Jennings County, and this is the first oppor-
tunity I have had to return reply.

The injunction case in the Tippecanoe County court, brought to pre-
vent the city from establishhig a smallpox hospital within the corpora-
tion, was finally settled by a compromise, the city promising to build a
permanent pesthouse, and praying for the privilege of using an old brick
residence which was available for the purpose, and which was within
the city, until the new house would be ready for occupancy. The city
authorities are now fully aroused to the situation. The City Health
Oflacer has been commanded to be active in disease prevention work,
and he is supplied with a deputy in the person of Dr. Washburn, who
is to especially give attention to smallpox cases. The county authorities
have also acted, and Dr. Littell, the County Health Ofllcer, says that
now no excuse exists for inactivity upon his part. I know that Dr.
Littell understands the situation and is exceedingly willing to work.
While at Lafayette I visited those houses which were quarantined for
smallpox. Some of the cases were very severe, but most of them very
mild. A singular fact appeare<l in one family which was composed of
twelve persons. The father was the first to have the disease. He very
likely acquired it in some of his wanderings. Tlve older children and
mother acquired the disease in due time, but the infant resisted infec-
tion for four weeks, and finally was the last to come down with the dis-
ease. We continually find hiauy strange conditions associated with small-
pox.

I note your statement that you think it best that my desk work
should go unattended to for the present and that I take the field again.
Just before Dr. Wishard's departure, he looked over the correspondence
upon hand, and, discovering a great deal of it related to smallpox and
demanded immediate answers, and also seeing plainly that the routine
primary work of disease prevention was suffering, he directed that a
deputy be sent to Daviess, Pike and any other counties which needed
attention. These directions had been complied with before your letter
was received.

Dr. Nelson Hraytou Is now in the field making inspections under ex-
plicit, written directions from this Board. No more competent person
could be found to perform this work. A telegram was received yester-
day from the Ilealtli Otticer of Sullivan County, saying that $500 had been
appropriated for fighting smallpox. Dr. Thixtun I know very well, and
he certainly Is a man well adapted for the work he has undertaken.
Now that he has support. It will be but a short time before we have most
favorable reiwrts from his county.

As to smallpox during the coming months In Indiana. I wish to say:
By quarantine and Isolation we will be able to put It out from time to
time, but it will return again and again to each locality It has visited
until the greater projwrtion of the unprotected are attacked. This is the

Digitized by VjOOQIC

478

past history of the disease In every country and in every epidemic.
Vaccination is the only true prophylaxis. In a word, this Is the scien-
tific and practical prevention to apply, and until it Is applied we must
expect repeated outbrealfs of the disease. Finally, the major portion of
the people will have had smallpox, and then, of course, It will depart,
to return when another unprotected generation appears.

I return herewith the letter from Dr. Thlxtun which you kindly sub-
mitted. . Very sincerely yours,

Secretary.

LiAFAYBTTE.

June 10. On account of si)ecial request from Dr. Tilson,
Health Officer of Lafayette, seconded by the request of the Mayor,
I went to that city to visit some cases of eruptive disease to
decide whether or not they were smallpox. On arrival, I met Dr.
Tilson, and we visited in all 15 cases. Evei'y one of the cases
wore nnquestioned smallpox. Some of them were very severe.
Lafayette had been vers' tJirdy in taking action in the line of pre-
venting the disease. It was, therefore, necessary to meet with the
City Attorney, the Mayor and the memlx^rs of the health commit-
tee of the council. The necessities of the case were gone over very
thoroughly and what was necessarj" to l)c done was carefully dis-
cussed. The city authorities announced they would immediately
supply a pesthoupe, would establish tvn infe<!tious disease -service,
would purchase vaccine and do all things else necessary to sup-
press tho disease.

NORTH VERNON.

June 12. I was subpoenaed by the Court of Jennings County
to appear at North Vernon on the al)ove date, in order to testify
as an expert, in the cavse of the Seymour Water Co. vs. The City
of Seymour. The questions asked were whether or not the east
fork of WTiite Rivt^r, receiving sewage from many towns and
refuse from many factories, was a fit source of water supply for a
city or tow^n. Further <|uestions were asked to the effect if such
water would not likc^ly produce disease. In all, some twenty-five
hypothetical questions were asked. All of this relates purely to
sanitary matters, and it seems pro])er to state at this point, that
I gave it as my opinion, and also the opinion of the State Board
of Health, that the streams of Indiana in no instance furnished
water which was fit for a public supply unless the same was
purified by filtration.

Digitized by VjOOQIC

479

VISIT TO PIKE COUNTY.

To tbe State Board of Health: Petersburg, June 18. 1902.

I arrived at Petersburg at 10:31 a. m., Wednesday, June 18, 1902.
T. W. Basinger, M. D., is County Health Officer; J. T. Kime, M. D., Town
Health Officer. Dr. Bnslnger said: "The County Board of Health has
never sat as a Board of Health, and has never issued an order as sneh.
The County Council has appropriated my salary, but not a cent for dis-
ease prev«'ntion. A good blank book was purchased In 1899, in which
to record minutes and orders of the Board, but to date only the reports
and recommendations of the Health Officer are to be found therein."

Smallpox appeared at Petersburg February 14, 1901. Cases reported
to date, 52, with no deaths. Dr. Basinger says: "I believe as many more
occurred and were never reported. Some doctors fail to recognize small-
l>ox, even In typical form. No orders concerning the suppression of
smallpox have been issued by the Board. I have gone ahead and en-
forced the rules of the State Board as best 1 could, establishing quaran-
tine and vaccinating all who would permit me."

Mr. W. H. Scales, Auditor of Pike County, said: *'No health rules
or health orders have ever been issued by the Board of Health of Pike
County, and the County Council has never appropriated any funds to be
used in public health work, except the salary of the Secretary." At this
time there are four known ca.ses of smallpox in the county, all under
quarantine. I visited Algiers, a postofflce, tive miles from Petersburg,
with Dr. Basinger, and saw one case of unquestioned variola. It was in
a man-Mr. Inglad. Eight in the family. The six children and wife have
been vaccinated and all quarantined. I think it most probable every one
in the household will be attacked, for the vaccination is probably too
late. There have been seven cases at Algiers.

Dr. Basinger was directed to call a meeting of the County Board of
Health next Saturday, and read them the letter of the State Board of
Health as to their duties and powers, and informing them that action
must be taken to enforce the rules of the State Board, and that the
County Council be called together to make what appropriation seemed
nrcossary to pay the expenses incident to suppressing infectious and
contagious diseases. Dr. Basinger will promptly inform the State Board
of Health as to what action is taken. The letter of the State Board sets
forth plainly what must be done, and gives warning that legal action will
be taken, and possibly a county quarantine enforced if the law and the
rules are not enforced.

I'etersburg- Dr. J. T. Kime, Health Officer: The town authorities are
active and have ordered the Health Officer to go ahead, enforce the health
law and rules. All bills have been promptly paid which were incurred
under the order. No cases in I'etersburg at this date.

Winslow--l)r. (ieorge L. Ireland, Health Officer: The Town Board
has ordered energetic enforcement of the health law and the rules. No
cases in Winslow at this date.

I believe there will be prompt and energetic action taken by the Pike
('ounty authorities. Will go to Washington tonight, June 18.
(Signed) J.^N. HURTY.

Secretary.

Digitized by VjOOQIC

480

VISIT TO SPENCER COUNTY.

To the Indiana State Board of Health:

I left Indianapolis June KJ, 4 p. m., via Louisville, for Rockport, ar-
riving at RoclLport 9:5(.) a. m., June 17, having stayed all night at Hunt-
Ingburg. Upon arrival at Rockport I went Immediately to the court
house, and the Cx)unty Board of Health was very soon called to order
by President George Clements. My reception was most courteous, and
I was asked to instruct the Board in its duties and to make plain what
the State Board of Health wanted done. The health law was first
re^^iewed, and next the rules of the State Board. The discussion and
answering of questions lasted for two hours. The Board was not in-
formed as to whether or not there was any money appropriated for dis-
ease prevention work. Inquiry of the Auditor discovered there was an
appropriation of $105 available. Inasmuch as Dr. J. H. Johnson, tht?
County Health Officer, had abandoned his post since February 1, I rec-
ommended the position be declared vacant, and a successor be appointed.
This the Board promised to do. I also wrote out in detail my sugges-
tions as to what special action the Board should take.

In abstract these recommendations w^ere:

First. Order the County Attorney to promptly prosecute all physi-
cians who failed to report the cmses of contagious and infectious diseases
coming under their care, also to prosecute all householders who failed
to report cases in their households when a physician was not called.

Second. Order the County Health Officer to make a survey of the
county and determine the exact conditions which exist, the Board to
appoint one or more deputies to more quickly accomplish the work.

Third. Pass a formal order, making it of record and promulgating
the same, that the health law and rules would from this time on be vig-
orously enforced.

Fourth. The Board to purchase at least two formaldehyde generators
and a liberal amount of formaldehj^de, and employ men under the direc-
tion of the Health Officer to disinfect all houses outside of towns, known
to be Infected with smallpox, diphtheria or scarlet fever.

Fifth. Buy somt* pure vaccine and offer free vaccination to every
one outside of towns, the Health Officer of the county and his deputies
to do the work, and to require the Health Boards of all towns to do the
same for their respective towns and also require them to disinfect all In-
fected houses within their respective jurisdictions.

Sixth. Require the County Health Officer to report in writing every
Monday what he had done during the preceding' seven days, this report
to be re<'orded in a record book kept in the Auditor's office.

Seventh. PTmpower the County Health Officer to employ guards when
quarantine could not be otherwise maintained, and for him to immedi-
ately inform the President of the Board when and where guards were em-
ployed; also empower the Health Officer to purchase supplies when the
l)eople were poor and it was necessary.

The tliree members promised to have all these points put in a general
order liy their attorney, and pass, promulgate and enforce the same. This

Digitized by VjOOQIC

481

was certainly all that could be asked, and I left Rockport, via Bvaus*
vUle, for Petersburg.

J. N. HURTY,

Secretary.
On boat Tell City, June 16, 1902.

VISIT TO DAVIESS COUNTY.

Washington, June 20, 1002.
To the State Board of Health:

I arrived at Washington, capital of Daviess County, June 18^ late
at night. The next morning I called on Dr. W. C. Wllleford, Health Offi-
cer of Washington, and asked him to give me a report of the smallpox
situation within his jurisdiction. He reported that smallpox broke out
February, 1901. The first case came from rx)uisville, one case he also
traced to Evansvllle, one to New Albany 'and several cases from Knox
County, and a half dozen or more from Illinois. Since February there
have been 181 cases in all, with no deaths. The disease has been almost
continuously present in the city since its first appearance. The City
Council had not given free support to the Health Officer's efforts to sup-
press the disease. He had repeatedly asked that a i>esthouse be provided,
and that one or more deputies be given him. To date, dependence had
been placed entirely upon house quarantine, and it was very evident that
this method was ineffective. I found by examining the book of ordi-
nances of the city that a very excellent health ordinance had been passed
and approved April 8, 1873. This ordinance created a Board of Health,
composed of three members, chosen by the City Council. It consists ot
five sections, and gives absolute and complete authority to the Board of
Health at any time to do what it deems necessary to prevent the spread
of infectious and contagious diseases. The ordinance also gave power
to establish temporary hospitals In the following words: **The City Board
shall have power to select and establish such temiwrary hospitals as
emergency may require, and report such proceedings to next regular
meeting of City Council for Its concurrence."

Section 5 says: "The City Board of Health shall report to City Coun-
cil all expenses necessarily Incurred in discharging the duties required
by this ordinance, and such expenses shall be allowed by City Council
and paid out of the treasury of said city."

When I found that this ordinance existed, 1 asked Dr. Wllleford to
call a meeting of his Board, which was done, all members being present.
The ordinance was read to them, and the fact made plain that it simply
required action on the part of the Board, and it was not necessary to
appeal to the Council. After discussion, the members concluded they
would not act until the City Council was consulted, and permission ob-
tained to go ahead and do what was necessary to suppress smallpox.
Mayor Downey was present at the meeting of the Board, and thought
the procedure adopted would be best. The Mayor accordingly called a
special meeting of the Council to meet that night. I was called upon
to address the Council, and I tried to make plain the best procedures
for suppressing smallpox. My suggestions were well received, and a

31-Bd. of Health. Diqi.ized byGoOSlC

Digitized by VnOOQ I

482

Vote of thanks was offered. The Council then passed a resolution, direct-
ing the Board of Health to proceed along the lines outlined by myself.
The Health Board accordingly convened, and the minutes of the meet-
ing are appended hereto:

Special Meeting of the City Board of Health.

"Washington, Ind., June 19, 1902.

"This special meeting was called at the Instance of Dr. Hurty, State
Health Officer.

"Present: W. T. Ellis, President; C. S. Hicks, W. C. Willeford, M.
!>., Secretary.

"The smallpox situation was discussed, and the means for handling
it were considered. Dr. Willeford moved the adoption of the following
order:

"Whereas, Smallpox, a dangerous transmissible disease, exists and
has existed in Washington for some time; and,

"Whereas, It is to the l)est interests of the city that said disease
should be put out, and an urgent necessity exists that It should be sup-
pressed; and,

"W^hereas, The law makes it the duty of the City Board of Health to
take prompt action to suppress infectious and contagious diseases; there-
fore, it is

"Ordered: 1. That all physicians shall immediately report to the
City Health Officer all cases of eruptive disease coming under their pro-
fessional charge, which even remotely resembles smallpox, and when no
physician is in attendance, the householder shall make the report.

"2. The City Health Officer shall immediately quarantine all cases
of eruptive disease or transport the same to the Eruptive Hospital far
care and treatment; he shall immediately vaccinate all who have been
exposed to the infection, and cause them to l)e disinfected; he shall also
disinfect all houses and all places known or supposed to l>e infected.

"3. When necessary, the City Health Officer shall employ guards to
maintain quarantines. He may also employ such medical aid and such
nurses and help in the Eruptive Hospital as may be needed: Provided,
The Board of Health approves each employ ant, and he may purchase
such medical and food supplies as are necessary, rendering an itemized
bill for all purchases.

"4. The Board of Health will reiwrt to the Council all expenses in-
curred in the suppression of smallpox, and the bills will be carefully
Itemized and sworn to.

•T). Any one disobeying these regularly enacte<l orders shall be
promptly prosecutcni as the law provides."

It is apparent, If this order Is carried out with energy and intelligence,
that smallpox will soon be suppressed in Washington.

County. On June ID I also called on Dr. D. B. Smoot, County Health
Officer, who was not in town in the forenoon of that day. Dr. Smoot was
made Secretary of the (bounty Board of Health March 10, 1902, to All the
unexpired term of Dr. C. C. McCown, resigned. Dr. Smoot reported:

Digitized by VjOOQIC

483

"There hi^ve been 34 cases of smallpox, in Daviess County, outside of
cities and towns, since I was appointed. No donbt many cases have ex-
isted which were not reported; indeed, I know this to be the truth."

Not to the knowledge of Dr. Smoot had the County Commissioners
ever sat as a Board of Health, or had they ever issued any health orders.
Dr. Smoot stated he had gone forward on his own account and enforced
the law and the rules, and could not tell whether the bills incurred would
be paid or not. The County Council appropriated, September 4, 1901,
for the year 1902^ the sum of |480 for health purposes; $450 of this w^as for
the salary of the Health Officer. With Dr. Smoot I visited the Auditor's
office and from Mr. W. W. Aikman, Deputy Auditor, I learned the County
Commissioners have never sat as a Board of Health, and he also corrob-
orated Dr. Smooths statement in regard to the appropriations made by the
County Council.

Of the incorporated towns in Daviess County, Dr. Smoot says: "There
have been no cases of smallpox at EInora. The Health Officer, Dr. W. J.
ToUiver, says the Town Board is behind him and the town is ready to
fight smallpox if it appears."

Odon. The Health Officer, Dr. DeMotte, has reported one case at that
town. . He says the Town Board is ready to support him and orders that he
shall take prompt action to suppress smallpox.

Montgomery. The Health Officer, Dr. C. E. Trainer, reports there has
been no cases of smallpox in his town, and that his Board has Ordered
him to take prompt action to suppress smallpox if it appears and to do all
that is right and necessary to guard the town against introduction of the
disease. i

After talking the matter over with Dr. Smoot, I asked him to call his
County Board of Health together and Instruct its members to sit as a
Board of Health, and to take such action and issue such orders as might
seem necessary in the premises. In order to make sure that this action,
if taken, would be of a practical nature, I suggested that appropriate
orders should be formally passed, spread of record upon the Board of
Health minute book, duly promulgated, and energetically enforced.

I left Washington and Daviess County feeling certain that from that
time on energetic, practical work would be done in the line of preventing
the spread of infectious and contagious diseases.

VISIT TO GREENE COUNTY.

June 20, 1002.
To the State Board of Health:

I left Washington on the morning of June 20, arriving at Bloomfleld,
the capital of Greene County, about 9:30 a. m. The Health Officer of
Greene County, Dr. W. H. Cole, does not live at Bloomfleld, but holds his
residence at Switz City. The books are kept at Bloomfleld, as the law
commands.

Upon arrival, I immediately called upon Dr. H. V. Norvell, Health
Officer of Bloomfleld. From him I learned the city had no health ordi-
nance, and the Town Board had never sat as a Board of Health and had

/Google

Digitized by VnOOQ I

484

never issued any special orders in regard to infectious diseases. I called
in Mr. Ia H. Stalcup, President of the Town Board, and the smallpox
situation was discussed with these two gentlemen. Not a case of smallpox
has so far been reported in Bloomfield, but President Stalcup and Secre-
tary Norvell both said that the Town Board would issue a special order
to meet the conditions, and would, therefore, hereafter be prepared to
fight smallpox should it appear. I called upon Auditor H. L. Downey.
Not to his knowledge had the County Commissioners ever sat as a Board
of Health, and no health orders had ever been issued by the Board of
Health. The Commissioners, however, had ordered that quarantine be
established wherever smallpox appeared. The County Council had made
a total appropriation of $820 for health purposes, the salary of the Secre-
tary being $420. There was, therefore, available for fighting contagion
the sum of $400.

From Bloomfield I went to Switz City and called upon Dr. Cole, the
County Health Oflicer. IJe reported the Commissioners had never sat as
a Board of Health. One health order had been issued by the Commission-
ers. Afl they have no legal power to issue health orders, of course said
order was null and void. Dr. Cole reported that smallpox first appeared
January, 1800. Since that date there had been IGO cases, with one death.
At the present date, June 20, there were ten cases. He said he thought
the County Board of Health would act promptly when the members under-
stood the situation. I rode with Dr. Cole to the town of Lyons. There I
met Dr. E. Shirts, Health Oflicer. He reported two cases of smallpox at
present in the town. These we visited, and found one of them had been
quite severe and the other very mild. Dr. Shirts reported that his Town
Board of Health was very active and had ordered him to enforce the rules
of the State Board of Health and to report all bills Incurred for payment
The subject of smallpox suppression was thoroughly canvassed with Dr.
Cole, and he was directed to call a special meeting of the County Board
of Health, and present the resolutions and order which are herewith ap-
pended, and urge their passage, the same to be recorded in the Secretary's
book, duly promulgated and energetically enforced.

VISIT TO HARTFORD CITY.
To the State Board of Health:

An urgent telephone message from Dr. W. N. Cronln, Health Officer
of Blackford County, led me to \isit that city on June 24. Arriving at the
town, together with Dr. Cole and Dr. Truitt, City Health Officer. I visited
the family of Mr. Clapper, a dairyman, and the family of Mr. Hays, a
farmer. At both places smallpox prevailed. At the first house every
member of the family had been attacked, and all were convalescent. - One
of the cases, that of the youngest daughter, has been very severe Indeed.
At one time her life was despaired of, as the disease had taken the semi-
confluent form. At Mr. Hays' one case existed In his son, who was about
twenty years old. Two younger children, both girls, at the time of my
visit had fever and other symptoms of smallpox. I have no doubt they
were acquiring the disease. These cases had been disputed by some
neighborhood physicians, and the families were, of course, pleased to side

Digitized by VjOOQIC

485

with the doctors who decided th6 disease was not smallpox. It was on
this account with the attending troubles that impelled Dr. Cronin to aslt
the State Board of Health for a visit Mr. B. S. Wampler, Auditor, In-
formed me the County Commissioners had never sat as a Board of Health.
They had never issued any health orders. The County Council had appro-
priated $275 for health purposes, and, as $225 of this was for the salary
of the Secretary, but $50 remained to fight infectious and contagious
diseases. Two of the Commissioners happening to be In town, they were
invited to meet me at Dr. Cronln's ofl3ce. There we talked over .the situ-
ation and both of the gentlemen said they would be glad and would most
certainly, without delay, do everything they possibly could to suppress
smallpox in Blackford County, and to prevent its re-introductlon. The
following resolutions and orders were gone over, section by section, and
both of the gentlemen said they would support the said order at a meeting
which would be held Monday, June 30. In the meantime, they directed
their Secretary to go ahead and do everything that was necessary to sup-
press smallpox. Dr. Truitt, City Health Officer, said: "My Board gives
me most satisfactory support. I am confident, if the conditions demand,
that a pest house will be established; also, that a general vaccination order
will be issued." : . ,

KNIGHTSTOWN.

June 30. Dr. Barrett, Health Officer of Knightstown, tele-
phoned this office, asking for help and advice. Upon arrival at
Knightstown, I visited with Dr. Barrett eight houses and saw, in
all, 12 cases of semi-confluent smallpox and one ease of discrete
smallpox. There had been one death the week previous from
smallpox in Knightstown. There were 36 houses in all under
quarantine, but all were not visited. After informing myself
thoroughly as to the situation, I met with the Council which was in
special session. I presented an ordinance which has heretofore
been recommended by the State Board of Health and also gave
specific recommendations as to what should be done. The special
ordinance was passed without a dissenting voice and orders were
issued that the Health Officer should enforce the said ordinance
to tlie fullest degree. Further order was issued that fresh vaccine
should be purchased and free vaccination offered to the people,
and further that an abundance of disinfecting material and a
formaldehyde generator should be purchased and that henceforth
all infected houses should be thoroughly disinfected.

The following correspondence from Dr. Wishard was deposited
with the Secretary and was ordered made of record :

Digitized by VjOOQIC

486

June 7, 1902.

Dr. J. N. Hurty, Secretary State Board of Health, Indianapolis, Ind,:

My Dear Dr. Hurty— I enclose herein a copy of a letter just written
to Dr. J. N. McCormack, Secretary of the Kentucky State Board of Health,
Bowling Green, Ky., and one written to Hon. W. T. Durbin, Governor of
Indiana. The letters are self-explanatory.

Very truly yours,

WM. N. WI SHARD,
I Vice-rresiclent mdiaua State Board of Health.

June 7, 1902.

Hon. W. T. Durbin, Governor of Indiana, Indianapolis, Ind.:

My Dear Governor— I went from your office this morning to Dr.
Hurty's office, and requested him to immediately call up the County Audi-
tors in Franklin and Spencer counties, and notify them that we expected
to have a Board meeting, and that, unless they gave positive assurance
that proper steps would be taken to control smallpox in their locality,
we would issue a quarantine order against them. Dr. Hurty has reported
to me in the past two hours that he received absolute assurance from each
of the County Auditors referred to that they would call their Boards to-
gether and carry out most fully the steps necessary to stamp out the
disease.

I have, therefore, in pursuance with your suggestion made to me per-
sonally this morning, prepared and mailed a letter addressed to Dr. J. N.
McCormack, Secretary of the Kentucky Board of Health, covering the
status in Indiana. I enclose you herein a copy of my letter to Dr. McCor-
mack, and I will take a copy of the same with me to Saratoga, and per-
sonally present it to Dr. McCormack next Tuesday.

As I am about leaving the city, I venture to suggest that, in my judg-
ment, it will be desirable to keep one or two men on the road for the next
two or three weeks. After careful investigation of affairs at the Health
Board office today, after leaving your office, and after conference with
Dr. Hurty, I am satisfied that the necessary daily work of the office will
suffer if Or. Hurty is kept out of the office. I would therefore recommend
that Dr. Ferguson or Dr. Bray ton (senior or junior, as both are thoroughly
competent) be engaged looking after the counties in the farthest part of
the State and that Dr. Hurty be assigned to work In counties very cen-
trally located, such as Shelby, Brown, Madison and other nearby locali-
ties. I have a great deal of confidence in Dr. Ferguson's capacity for this
outside work, and if he is available, I would recommend that he be asked
to continue it. As I believe I notified you the other day, we contracted
with him to devote his time to this work during the present week at a
salary of JplO a day and his expenses. I think on his return it would be
well for you to have a personal conference with him and Dr. Hurty as to
the work still necessary to be done. In my judgment, one man looking
after the outside counties and Dr. Hurty looking after the centrally lo-
cated counties, will be kept busy for at least two weeks longer if we are

Digitized by VjOOQIC

487

to impress the local authorities with the fact that we are in earnest in our
endeavors to suppress smallpox. The local authorities are willing to do
what they can, but need the influence of higher authority to stimulate
them to immediate and necessary action.

"Very respectfully yours,

\VM. N. WI SHARD,
Vice-President Indiana State Board of Health.

June 7, 1902.
Dr. J. N. McCormack, Secretai-y State Hoard of Health, Bowling Green,
Kentuclcy:

My Dear Dr. McCormack— I am requested by Governor Durbin to pre-
sent to the Kentucky State Board of Health, through you, an official re-
port as to tlie status of smallpox in Indiana at the present time. For the
past week Dr. J. N. Ilurty and Dr. Charles K. Ferguson have been making
a sanitary insiwction of the counties in the southern part of Indiana.
They find conditions improving, and in but two counties have the offi-
cials shown undue laxity in enforcing the proper regulations for the con-
trol of the disease. These counties are Spencer and Franklin. Dr. Hurty
has spent a part of two days in Spencer County, and has received posi-
tive assurance from the local officers ihat they will enforce the most
thorough regulation of smallpox in Spencer County. Dr. Hurty has, by
direction of tne Governor and the Indiana State Board of Health, informed
the officials in Spencer County that if conditions are not entirely satis-
factory within forty-eight hours, the county will be quarantined. The
assurance given him by the local authorities lead us to believe there will
be little difficulty in controlling the disease in that locality. Dr. Ferguson
is in Franklin County, and yesterday attended a conference with the
County Commissioners and County Health Officer, and informed them that
there would be a quarantine order against their county unless they en-
forced the regulations to control smallpox at once. We have long dis-
tance telephone assurance from the County Auditors of Spencer and
Franklin counties today that the County Health Boards in these two
counties are taking all steps within their power to control the disease.
From official information received trom thirty-four counties during the
past few days, we find that, whereas in these thirty-four counties in April
there were five hundred and eighty-seven cases of smallpox, there were
during May but two hundred and seventy cases in the counties referred
to, making a reduction in the number in counties referred to of al>out
fifty-five per cent

It Is the purpose of the Governor and the Indiana State Board of
Health to continue all efTorts now being made until smallpox is driven out
of the State. We trust the foregoing report is sufficiently satisfactory to
warrant you in annulling the quarantine order against Indiana, which
is now temporarily suspended pending an official report from our Board.

Very respectfully yours,

WM. N. WISHARD,
Vice-Prasident Indiana State Board of Health.

Digitized by VjOOQIC

488

Marion, Ind., June 4, 1902.

My Dear Dr. Wishard— Yours of June 3 received, and is the first de-
tailed information I have received of affairs since our meeting. I most
heartily approve of your action in each instance and appreciate your con-
sideration In writing me so fully about it.

Captain Anderson tried to read me a circular to be sent to Health
Oflacers, but 1 could not understand it over the v^lre, and told him to sub-
mit It to you, and if you approved It, to attach my name to it as President.
I presume he has done this.

Hoping that the much-vexed question has been satisfactorily solved
and that we may soon be able to have smallpox under control, and with
kindest regards, I am, very truly yours,

J. H. FORREST.

Indianapolis, Ind., June 4, 1902".
Dr. W. N. Wishard, Indianapolis, Ind.:

Dear Doctor— I am just in receipt of your favor of 3d instant, trans-
mitting to me the prepared report of the committee of your Board which
visited the Kentucky Health Board; also the copy of the letter which you
have forwarded to Dr. J. H. Forrest, President of the Board. As you re-
quest, the report will be sent to President Forrest for his signature, and
your directions will be carried out in passing it on to the other members
of the Board. I received this morning reports from Dr. Ferguson and
Secretary Hurty. I will be pleased to have you drop in at any time and
read these daily reports, should you care to do so. Dr. Hurty reports
conditions in Posey and Vanderburgh counties **mo8t favorable." In War-
rick County two officers "are constantly on duty. Tliey report nineteen
eases in May and six eases for the first two days of June. The Healtli
Board was in session and gave assurances of past and future activity in
suppressing smallpox." Dr. Ferguson rei)orts twenty-four cases during
the month of May in Dearborn County, but at the present time only one
case, which was reported on the 20th day oi May. All cases rigidly quar-
antined. He reports quite a number of cases existing across the river in
Boone County, Kentucky, this statement being corroborated by the Health
Officer in Switzerland County. No cases in Ohio County. None In Swltas-
erland County since last November. Much activity and good spirit pre-
vailing in all the counties he has visited. I have called for a list of the
Health Officers of the State, and will today wire each county where small-
pox is reported to exist, asking for conditions. This will give notice of a
determination at this end of the line to look after the matter.

Very truly,

W. T. DURBIN.

^ June 7, 1902.

Dr. J. H. Forrest, President Indiana State Board of Health, Marion. Ind.:

My Dear Dr. Forrest— Dr. Cook and myself attended the conference

yesterday with the Governor, Secretary of State and Auditor of State, In

reference to steps to be taken to suppress the smallpox epidemic In the

Digitized by VjOOQIC

489

State. We are very sorry you could not be with us. The matter was dis-
cussed pretty thoroughly, and the Governor called our attention to the
language of the statute appropriating $6,000 for the Board of Health, and
specifying the purposes for which the money is appropriated, among
which is the suppression of smallpox. Dr. Cook and I stated to him that it
was impossible to meet the expense of controlling smallpox out of the regu-
lar appropriation of $6,000, and that it was the view of the Board that
the epidemic fund was appropriated for conditions such as the present.
The Governor stated that the emergency fund of $50,000 was at our com-
mand, but he thought we ought to use our own appropriation for this pur-
pose, and he therefore proposed that if we spent 5 per cent, of our $6,000
appropriation, which would make'a total of $300, in fighting epidemic
diseases such as smallpox, that he would meet all necessary additional
expense out of the emergency fund. Dr. Cook and I agreed to this propo-
sition, and I am sure it will meet your approval and that of the other
members of the Board, i think it is a happy solution of the difficulty. On
Saturday last I gave the Governor a verbal report of our trip to Louisville
the day before. Dr. Hurty had prepared a written report of our confer-
ence with the Kentucky State Board of Health on the train coming from
Louisville. I did not present this report to the Governor because I de^
sired to revise it a little, but I will present it to him today. We were
courteously received by the Kentucky Board, and, after we had gone over
the subject pretty thoroughly in a friendly discussion, the Kentucky
Board then decided to suspend their quarantine order for ten days, with
the agreement that it would be annulled at the end of that period if our
Board gave them positive assurance that everything was being done that
could be done.

I will send the report of our conference to the Governor this morning
and win request that he forward it to you for your signature, to be for-
warded by you to Drs. Davis and Cook for their signatures, and then re-
turn to the Governor. Dr. Hurty will sign it on his return from Southern
Indiana.

In the conference which I had with the Governor on Saturday, when
I presented a verbal report of our Louisville trip, we decided that the con-
ditions were such as to require immediate and decided action, and at the
Governor's suggestion, I requested Dr. Hurty to deputise a competent man
to aid him, and that they at once begin a thorough tour of inspection of
the Infected counties. After conference with Dr. Hurty, it was decided
that Dr. Charles E. Ferguson should be deputized, and should go at once
to Lawrenceburg and work the river counties, and that Dr. Hurty would
go to Evansville and do the same thing. Dr. Ferguson working from east
to west, and Dr. Hurty working from west to east until they should
meet in the south central part of the State. This tour will probably take
the better part of this week. The May reports of smallpox are just be-
ginning to come In, and, as you know, it will be some days before {i com-
plete report can be obtained from the different counties. It is evident,
however, from Information obtainable from all sources, that we have got
a good deal more smallpox to deal with than the official reports indicate.
As soon as we can meet the demands oi' the Kentucky Board of Health
I believe tV.e Secretary should be required to visit every county in the

Digitized by VjOOQIC

490

State where smallpox exists, and use his best effort to stimulate the local
officers to proper action. The Clerk of the Board is preparing a circular
letter to be sent to every Health Officer in the State where smallpox
exists, in accordance with the recommendation contained in the report
to the Governor of our Louisville meeting, which report you will receive
from the Governor for your signature.

With kindest regards, I am, sincerely yours,

WM. N. WISHARD,
Vice-President Indiana State Board of Health.

June 7, 1902.
Hon. W. T. Durbin, Governor of Indiana, City:

Dear Governor— I hand you herewith the written report of the confer-
ence between the Indiana and Kentucky State Boards of Health, held
last Friday, May 30, at the Gait House, T^uisviUe. I gave you a verbal
report or the same on Saturday last, but did not file the written report
l)ec'au8e I desired to revise it a little. Will you kindly mail this report
to Dr. .T. H. Forrest, of Marion, Ind., President of the Board, for his signa-
ture, with the request that he mail it to Drs. T. Henry Davis and Clark
Cook for their signatures. Dr. Hurty will sign it on his return from
Southern Indiana, where he is now making a sanitary insi>ection of the
border counties.

Referring to the personal conference which I had with you on last
Saturday afternoon, I would say that i)ursuant to the suggestions then
made by you, I at once went to the office of the Secretary of the State
Board of Health, and requested the Secretary, Dr. Hurty, to start that
night on a tour of inspection of the Ohio River counties. After confer-
ence with him, we also, m pursuance with your further suggestion, de-
cided to send Dr. Charles E. Ferguson to tlie southeastern part of the
State, to aid in making immediate sanitary inspection of the infected
part of the State bordering on Kentucky. I requested Drs. Hurty and
Ferguson to urge the County Health Officers to Institute local quarantine
and to require vaccination in all infected localities, and to say to the local
authorities that it was your intention, with the State Board of Health,
to immediately bring the smallpox epidemic under control.

In my personal judgment the expense necessaiy on the part of the
State Board of Health will not be very large, and under the present condi-
tions I think Drs. Hurty and Ferguson should be kept in the southern part
of the State during the present week, and that immediately thereafter Dr.
Hurty should be sent to every coimty and infected locality in the State as
rapidly as iwsslble, and that he should be given such additional aid as the
conditions existing may require. I am rather Inclined to think that Dr.
Hurty can do most of this work himself after a week or ten days* assist-
ance. Conditions may develop necessitating more help than appears nec-
essary at present, but I am inclined to think the assistance above indi-
cated will meet the requirements.

I also enclose herein a copy of a letter I have written this morning to
Dr. J. H. Forrest, in reference to our conversation yesterday afternoon,
at which time you proposed that if we would spend 5 per cent, of our

Digitized by VjOOQIC

491

appropriation (viz. $300) that you would meet such additional necessary
expense in fighting epidemics out of the emergency fund as may be neces-
sary. With kind regards, I am, very truly yours,

WM. N. WISHARD.

The following circular was ordered sent to all County Health
Officers:
To the Health Officers of Indiana:

Dear Doctor— On Tuesday, May 27th, the State Board of Health of
Kentucky declared a quarantine against the State of Indiana, on account
of the smallpox epidemic in this State, to take effect June 1st. At a con-
ference of the Indiana and Kentucky State Boards of Health held in
Louisville, Ky., May 30th last, the quarantine was suspended ten days
upon the representation of the Indiana State Board of Health that every
effort in its power would be used to control and suppress this disease.

It now rests with the Health Officers and the civil authorities of this
State to say by their work whether this quarantine shall be entirely
done away with, or put in force against the people of our State and
thereby entail the loss of thousands of dollars, and much suffering from
hundreds of our citizens being deprived of employment; many of them
becoming pubUc charges thereby.

The time is very short and this work requires sharp, decisive, efficient
action at once on the part of our Health Officers and local authorities.
(Complaints have been received at this office that some of the local au-
thorities refuse to furnish the necessary funds to carry out the work
of quarantining, disinfecting, etc. For the benefit of those Health Officers
who are handicapped in that manner the following opinion by the At-
torney-General of the State was given to the Governor yesterday. It
is that "The State Board of Health has the power to mandate the local
authorities when they refuse to furnish the necessary means to sup-
press this disease."

You will inform your local authorities of this opinion, and that, while
this Board has no desire to take this step, it will not hesitate to do so
if they do not act vigorously and at once. We ask you to redouble your
efforts in this good work of warding off disease and death, and assure
you of our earnest support. Report progress to this office, and, if neces-
sary, expert physicians will be sent to your assistance. Our time is short,
but by united, vigorous work we will succeed.

By order of the State Board of Health.

(Signed) J. H. FORREST.

(Signed) J. N. IIURTY, President.

Secretary.

Digitized by VjOOQIC

4dS

DR. FERGUSON'S REPORTS.

Dr. 0. E. Ferguson was appointed Deputy State Health Officer
June 1, and directed to visit and investigate smallpox in the counties
bordering on the Ohio River, commencing at Dearborn County and
stopping with Clark County. Dr. Ferguson also visited Franklin
and Adams Counties and his reports follow:

June 3. 1902.
Indiana State Board of Health:

Gentlemen— I have the honor to submit the following report of work
done June 2d.

DEARBORN COUNTY.
Lawrenceburg—

Dr. A. T. Fagaly, County Health Officer, reports that during the month
of May there were reported to him 24 cases of smallpox in his county.
There is at present only one case In the county reported May 20. AU cases
are rigidly quarantined in the county when they occur in the towns.
In the country, when Isolation is by reason of remoteness of neighbors un-
necessary, domiciliary quarantine is not practiced. A majority of the
cases in this county can be traced to West Harrison, Ind., where the
disease was mistaken for chickenpox.

Quite a number of cases have existed across the river in Boone County,
Ky., where quarantine is not practiced or enforced, though vaccination
has been quite general. The funds for fighting the disease have been
freely given by the County Council.

The Health Officer at Aurora states that he knows of no cases in his
neighborhood. Health Officer W. C. Henry attended a number of cases
last month.

OHIO COUNTY.
Rising Sun—

Dr. G. A. Stevenson, County Health Officer, reports that at present
there is not a case In Ohio County. The last one occurred in September,
1001, Dr. Stevenson, who is Health Officer for county and city, states
that the County Council has placed at his disposal all the money necessary
for his use in fighting the disease. They allowed him, however, only
$10.00 for treating the various cases he attended last year.

SWITZERLAND COUNTY.
Vevay—

Dr. J. W. Smith, County Health Officer, states that there have been
no cases in the county since last November. The city pays the expenses
of the quarantine and the Township Trustee pays for the food and fuel.
Vaccination has been general.

Patriot, Ind.—

Dr. R. A. Jameson, Town Health Officer, states that there has been
no cases In his vicinity since last year. Has had no trouble about money

Digitized by VjOOQIC

493

to quarantine. The town has been well vaccinated. He confirms the
report that many cases have developed in Boone County, Ky.

I have interviewed a number of citizens of the towns visited and they
appear ready to second the efforts of the Health Officers In their efforts
to suppress the disease.

Last year there was much doubt as to the identity of the disease, but
at present there appears to be a general acquiescence in the diagnosis.

I find the Health Officers exceptionally active and intelligent and
enjoying to an unusual degree the confidence of their respective com-
munities. ' i

I have just arrived in Madison and shall see the County Health
Officer as soon as he returns to his office.

I have the honor to be, very truly yours,

C. B. FERGUSON. M. D..

Deputy Health Officer.

June 4, 1002.
Hon. W. T. Durbin, Governor of Indiana:

Dear Sir— I have the honor to make report of work done June 4.

CLARK COUNTY.
JeffersonviUe— ^ i i

There were four cases of smallpox reported from this county in May,
not counting those that occurred in the Reformatory. Three of these were
in the county and one in the city. There is at present none in the county.
Three convalescent cases ready to be discharged are in the pesthouse.
The city controls the pesthouse and admits patients from the county, the
Township Trustees paying the city for their care. Dr. W. H. Sheets,
County and City Health Officer, has been thanked by the town authorities
for his efficiency in controlling the disease. He assures me that he has
had no difficulty in securing the money necessary to maintain strict quar-
antine.

FLOYD COUNTY.
New Albany—

Dr. R. W. Harris, County Health Officer, and Dr. Mclntire, Health
Officer for New Albany, state that at present there is not a case in Floyd
County. One case was reported in May and he is now in the pesthouse in
JeffersonviUe. There is no pesthouse in ITloyd County, but the officers
state there has been no difficulty in securing ample funds for the work
incident to effectual quarantine.

Yours very respectfully,

C. E. FERGUSON, M. D.,

Deputy Health Officer.

Digitized by VjOOQIC

494

June 4, 1902.

I have the honor to make the following report of my investigations in
the smallpox conditions as far as I have made them today:

JEFFERSON COUNTY.
Madison-
There were five cases reported in Jefferson Ck)unty in the month of
May. There are now three convalescent cases in the county, no new
cases. They are in Graham Township, eighteen miles from Madison. Dr.
Hatch, the CJounty Health Officer, states that the last cases were in the
family of a young man who contracted the disease in Louisville, where
he was attending school. Dr. Lewis, Health Ofllcer for Madison, secured
a pesthouse two years ago and all cases are promptly sent there. The
city maintains the institution and pays all expenses incident to taking
care of cases developing within her borders. He has no trouble in se-
curing money. Respectfully submitted,

C. B. FERGUSON, M. D.
[ •••,■-.

I June 5, 1902.

I report tonight result of my investigation of part of Franklin County.
The situation here is deplorable. I visited the southeastern section of
the county today and found a number of cases of smallpox, with but one
house carded. Members of the families afflicted were scattered over the
township. I found cases in two families where no precautions of any
kind had been taken. One case is in the family of a barkeeper and his
saloon is the loafing place of the community. The County Health Ofiicer
here is efficient and intelligent in matters of hygiene, but the fault
is due to two factors. First a difference of opinion among the physicians
and the total failure of the County Commissioners to grant the money
needed for guards, etc. Physicians who recognize the disease are afraid
to report it as such, as the citizens have threatened them with loss of
patronage. The County Commissioners meet tomorrow and I shall meet
them and persuade them to give financial aid to the Health Officer, or
that the county will be quarantined by the State authorities. I have
received reports of cases from the timid physicians and a promise to
promptly report all new cases. The work here is slow because of the
long drives necessary to reach the infected sections.

Yours faithfully,

C. E. FERGUSON, M. D.,

c Deputy Health Officer.

Batesville, Ind., June 6, 1902.

I have the honor of reporting to you the work of today: I met the
County Commissioners of Franklin County and laid the facts before them.
They admitted to me that they had not asked for an appropriation from
the County Council, because they did not believe the disease existed in
the county.

Digitized by VjOOQIC

495

The County Council does not meet again until September and I asked
the Board to have the Auditor call a meeting of- the Council. They lis-
tened to me but gave no satisfaction or promise. The physicians do not
report tne cases of smallpox and the County Health Officer is powerless,
as he tells me that he had physicians indicted for failure to report con-
tagious diseases and the prosecutor will not press the cases to trial.

There are undoubtedly a large number of cases in the county, but it
will talse a house-to-house investigation to find them. Doctors tell me that
they have met persons in the road going to towns in the eruptive stage
of the disease.

If the Auditor does not act promptly in calling the County Council,
I suggest you threaten the county with quarantine and in the meantime
take steps to mandate the officers to do their duty.

Yours faithfully,

C. E. FKRGUSON, M. D.,

Deputy Health Officer.

Decatur, Ind., June 7, 1902.

The condition of affairs in Adams County is similar to that in Franklin
County. The number of cases of smallpox reported in May was 54. Num-
ber reported In June, 38. There are twelve (12) cases in the city of
Decatur.

The County Health Officer, Dr. Costello, is powerless to enforce quar-
antine because of lack of funds and support of the County C/omniissioners.
They will not furnish guards for the liouses infected nor pay for the
disinfectants necessary.

In one instance he closed the church, but the people promptly went
to another one in the neighborhood.

Physicians refuse to report cases developing in their practice, but the
Health Officer is powerless to enforce the law. Last November he filed
affidavits against those Who violated the law, but has been unable to get
the cases to trial.

The attorney for the Board of Commissioners said that he would fight
any attempt to mandate the Board to spend any money in the work of
quarantine.

There is a two-room i)esthouse in the county. One patient who was
sent there ran off l>ecause no one was there to guard and because nothing
was provided In the way of food or medicine.

The papers refuse to publish the warnings of the Health Officer as
they fear the merchants who advertise.

From my observation in this county the only thing that will compel
tl'fe authorities to do their duty is to threaten them with quarantine.

Yours very truly,

C. B. FERGUSON, M. D.,

Peput^ Health Officer.

Digitized by VjOOQIC

496

Indianapolis, Ind., June 16, 1902^
Indiana State Board of Health:

Gentlemen— I have the honor to report that I visited Dunkiric, Jay
County, on Sunday and Monday, 15th and 16th inst

I called upon Dr. Murray, the City Health Officer, and learned that
there had been a number of cases of smallpox in his town that' had not
been reported to him. I find on investigation that there have been seven
cases in the town and but two have been reported. The case In
question at present is that of a barber, Lon Ney. His attending phy-
sician protests that he does not have the disease, though the house is
carded by the Health Officer. Dr. Fertich, the attending physician, took
a cat) and with two friends and the patient, then in the eruptive stage,
drove to Muncie. Dr. Spickerraan of the Town Health Board pronounced
it smallpox and they drove back to Dunkirk unconvinced.

Dr. Fertich does not name the disease,^ but denies that it is variola.
He promised me that he would, however, report all eruptive diseases to
the health authorities. Respectfully,

C. B. FERGUSON, M. D.

REPORTS OF DR. I^ELSOJN^ BRAYTOK

Dr. Nelson Brayton was appointed a Deputy State Health Officer
June 1 and sent to investigate smallpox in the following counties:
St. Jot^^ph, Clay, Sullivan, Greene, Whitley and Wabash. His re-
ports follow:

Indianapolis, Ind., June 3, 1002.
Indiana State Board of Health:

Gentlemen— As regards the smallpox condition in South Bend as I
found it on my visit to that city last Friday and Saturday, I may make
report of the following condition of affairs:

In company with Dr. A. M. Buttei'worth, Local Health Officer, I visits
all the cases of smallpox in the city, about ten in all.

Webster 2

Dawson 3

Wunderlich 3

Patterson 2

The case about which some dispute and diagnosis occuiTed developed
into a case of variola, the youngest child in the Wunderlich family, aged
2 years.

In one section of the city, that in which the Wunderlich, Webster and
Patterson cases occurred, there has evidently been an extensive epidemic
of the disease, which had been reported to the Ix)cal Health Board ns
"chickenpox.** In company with Dr. Butterworth I visited several of
these cases, which are now recovered. There is no doubt but that these

Digitized by VjOOQIC

497

were c&ses of genuine variola. One of the cases occurred in the wife of
a grocery keeper named Reustheimer. She reported that she had not
been incap&citated by the disease, that she had had the grip a few days
before she broke out and had been at her regular work all the time in the
grocery while the eruption was on her person. The epidemic has been
exceedingly mild, no deaths have occurred, no severe symptoms, compli-
cations or marked pocking was noticeable.

The local officers seemed to be doing a satisfactory work in quarantine
and vaccination. Domiciliary quarantine, however, has In the main been
relied upon. Proper information and instructton about the disease, the
method of its prevention, vaccination, were given the physicians whom
I met and the local papers.

I have the pleasure to be, very respectfully yours,

NELSON D. BRAYTON, M. D.,

Deputy Health Officer.

Brazil, Ind., June 12, 1902.
To the State Bbard of Health:

As regards the smallpox situation in Brazil, Clay County, I beg leave
to report the following conditions as I have found them:

The County Health Officer, Dr. Carson, reports me that he has had no
difficulty with the County Board of Health (County Commissioners) in
regard to payment of his vouchers. They admit the Justice of his demands
and have responded promptly with funds when asked to do so.

Dr. Carson reports about 11 cases in April, 22 in May and no deaths.
At present he states there are no cases quarantined throughout the county.
There are, however, 5 cases in one family in the city of Brazil. These
are traced from a family which had measles reported as smallpox, or at
least so reported that it mixed the diagnosis. None of these cases are at
all serious. These cases were seen with Dr. Williams, the local municipal
officer.

I also saw today Dr. Pyle of Carbon. Dr. Pyle reports 7 cases— one
of these he thought to have been of hemori'hagic tyi)e with recovery. He
reported that one of these cases when first seen by Dr. Van Sandt (also
of Carbon) was pronounced chickenpox, although in adult male. Dr. Pyle
said he Immediately instituted quarantine, which was rigidly observed.

Vaccination seems to be quite generally refused by the citizens of the
country and city. Dr. Carson reports it almost useless to try to enforce
it upon them. Disinfection is practiced by formaldehyde. General ob-
servance of quarantine regulations is reported with but one exception—
a boy who broke his quarantine.

With the exception of the possible infection by a sporadic case which
walked the streets here in a pustular stage two weeks ago, no further
serious trouble seems to be in store at the immediate present.

I shall tomorrow visit the cities and towns in the east and south of
the county, perhaps winding up at Clay City in the evening.

Very respectfully,

NELSON D. BRAYTON,

Deputy Health Officer.

82-Bd. of Health. ^-^ ,

/Google

Digitized by VnOOQ I

498

Brazil, Ind., June 13, 1902.
To the State Board of Health:

With the exception of Clay City and Bowling Green I have now seen
personally and conferred with all the Health Officers of the county.

Dr. Geo. F. Lewis has replaced Dr. Thornton as Health Officer at
Knightsville. There appeared at Donaldsville, a suburb of Brazil, and
near Knightsville, a number of cases of variola in the months of May and
April. These started from a boy who ran around the streets in the pus-
tular until at>out five families were afiPected. There were seven (7) eases
in the Hoosier family; four (4) in the Banford family^ and three others
were reported to have had the disease. Most of these cases I saw.

Dr. Young, at Harmony, reports 22 cases as having occurred in his
care this spring. One of the families broke quarantine — Steele was the
name. Domiciliary quarantine was practiced. Vaccination was quite
generally refusetl, even after its efficacy liad been shown in i>re venting
the disease.

Poland, Ind.— .

Poland, Ind., had an epidemic one year ago— no cases this year— about
75 cases occurred. No deaths, but two cases very dangerously sick.
Vaccination w^as quite generally refused. Dr. Klliott tried his l)est to en-
courage vaccination, but failed. There are two other doctors in townr-
one a Dr. Chamberlain, who said he had not vaccinated a single i>erson.
Tlie other was Dr. Bartholow, who preached against vaccination. Both
of these last two men are old fogies, who should be retired.

This epidemic at Poland was interesting as it shows the harm that
could be done by the anti-vaccinationist, especially a physician.

Dr. Elliott seems a very good man. He said he was utterly iinable to
get over 40 people to be vaccinated. Tlie people in the town were very
obstinate and bullheaded.

Center Point, G. R.—

At Center Point Dr. Finch reported things well under (^ntrol. He has
kept a systematic record of all cases and vaccinations; has- even recorded
the age, sex and number of times successfully vaccinated on charts.

He has vaccinated over 900 people in ^ugar Loaf Township. Tliere
have been about 78 cases in his jurisdiction to date. None this year. Two
deaths. He reported that the Blue trial Incensed some people against
^'accination In his district. He seemed a very efficient, earnest and capa-
ble officer.

Staunton—

Dr. x*. H. Veach- reports no cases In this epidemic with but one ex-
ception. The community became frightened when Clay City was Infected
by the disease and was well vaccinated. He had vaccinated over 350.

I had forgotten to state that at Poland Dr. Klllott stated that no at-
tention was paid to the rule that no child should be permitted to enter
the school unless properly vaccinated. He said this ruling was a dead
letter. I remain, respectfully,

NELSON D. BRAYTON.

Deputy Health Officer.

Digitized by VjOOQIC

499

Switz City, Ind,, June 14, 1902.
To the State Board of Health:

I have today visited in Clay City where I find Dr. Wolfe still preaching
against vaccination and smallpox. People in the town say that he now
believes the epidemic was smallpox, but he argues that it was not simply
to show his ''obstinacy and buUheadedness.*'

Dr. Modesitt stated that no cases had occurred this month or since the
last epidemic. About twenty per cent, of the people were opposed to vac-
cination, but he said no prominent or educated people were among them.
Generally they were illiterate. He now says he believes there should be
compulsory vaccination laws to prevent the disease; as did also others
with whom I talked in the town.

In ihe epidemic of 1900 $1,000 was spent by the town to fight the
disease. Aside from this, allowance of over $600 were made in the town-
ship for physicians' bills.

He thought there were over 600 cases at that time. Others said
1,200. About 1,000 vaccinations were practiced in the epidemic. Two
deaths occurred in the epidemic— one a girl of 3 years and another a
woman of 46.

No attention is paid in the schools as regards the vaccination require-
ments on admission.

GREENE COUNTY.
Worthington—

Dr. W. H. Beaty reports no cases in his jurisdiction. Vaccination was
partially practiced some time ago.

Switz City—

Dr. W. H. Cole, the Health Oflacer of the county, reports that there have
been 32 cases in the county this winter: 3 oases at Scotland, 18 cases at
Newberry, 9 cases at Marco, 1 cas^ at Linton; 1 death at Newberry.
Quarantine had been brolien once. He had been compelled to place
a guard over houses in three instances.

Dr. Cole reported that the County Council had formally appropriated
$350 to fight the epidemic and designated it as a "quarantine fund." As
a result some of the County Commissioners had refused to sign vouchers
made necessary for the proper disinfection of premises, etc. Dr. Cole
state<l that as a result of their parsimony he had been compelled In all
instances to fumigate and disinfect at his own expense in all instances—
a decided injustice, he thought, as the liberal Interpretation of the word
and purpose of the allowance of the County Council should have included
fumigation or disinfection also.

The names of the County Commissioners who composed the Board
are: Andrew Bucher, Worthington; George Marshall, Newark; J. D.
Hasman, Linton.

I called on Mr. Hasman at Linton and he was favorably disposed
toward the granting of appropriations for payment of claims, but the other
two men are not so disposed.

Mr. Frank Ramsay of Bloomfield is the main man on the County
Council.

Digitized by VjOOQIC

506

Linton—

At Linton, Ind., I found one case, but it had been Just released from
quarantine. Its origin was traced to Illinois. It was kept in quarantine
in a tent at the outskirts of town. No more cases have so far developed.
At Marco, Ind., there are reported 5 cases. I shall go there tomorrow.
The history of these cases is quite interesting as it shows extraordinary
culpability in the attending pnysician. Dr. LukenbiU, who also had the
disease in his own family— and who is reported to have been fined by tjie
grand jury in Knox CJounty for failure to report cases. I shall then
next proceed into Sullivan County.

Respectfully,

NELSON D. BRAYTON,

Deputy Health Officer.

Sullivan, Ind., June 16, 1902.
To the State Board of Health:

During the last two days I have more fully investigated the condition
of affairs in the southwestern part of Greene County, and I find them not
nearly so reassuring as I had hoped to do. At Lyons, Ind., (no Health
Officer) I found two well developed* cases of smallpox— these were dis-
covered entirely independently of any previous reports of physicians. Both
of these cases were in children. The first case was one of a child in
pustular stage who had had no doctor in attendance. The other was
found from questions asked of an inhabitant about breaking-out diseases.
I found a well developed case of smallpox being treated by Dr. Aydelotte
for chickenpox.

I also discovered two other cases at Inland City, about 5 miles from
Marco, on the S. I. R. R.

At Marco I found three new cases— one in the McCombs family and
two in the Byrum family. I also investigated 5 other families and found
that three of them had already had the disease.

In the family of Dr. LukenbiU, one of the children nearly died of the
disease and is very badly pocked. I slioula judge that over twenty cases
Jiad occurred in the town unrecognized and unreported.

I also saw and diagnosed scabies in three different families. For want
of time in fulfilling my engagement for Sullivan County I was unable to
trace a rumor of more of the disease in a family on the western border
of the county and who were supposed to have had the disease three
weeks ago.

As regards the case of Dr. LukenbiU, he attended five weeks ago in
Knox County a case of smallpox and pronounced it "black itch.** He
also after the case was quarantined (so I am informed), told the pa-
tient he did not have smallpox and advised him to get up and go around
at his business. This the man did.

About three weeks ago a Justice of the Peace fined him $10 and costs
$10.05 for so doing. This in addition to his attorney's fee made the offense
cost $30.05. He also, I am informed, went about his practice in Marco
when three of his family had the disease. If I am correctly informed
this occurred while they were yet in quarantine. The exact ethics of

Digitized by VjOOQI^

501 .

fiUcb procedures, 1 must confess that J do not understand. There is in
his locality a very bitter feeling against him and it looks as though the
law was flagrantly violated.

It may, however, in justice to him be said that at the present time he
is using all due precaution in the way of disinfection while treating his
present cases.

SULLIVAN COUNTY.
Pleasantville—

Mr. Bough, of the County Council, reports that $500 was appropriated
to fight smallpox in the county. Dr. Jackson, of Pleasantville, reported
3 cases in the Brewar family. These are now well and out of quaran-
tine. He seems to have taken prdmpt and efficient action. Vaccination
was practiced to a large degree in the community.

Carlisle-
No cases reported. Vaccination has been practiced to quite a large
extent, however. One or two sporadic cases of chickenpox were reported
earlier in the season— about December and March, I believe. Just what
these really were I could not trace.

Respectfully,

NELSON D. BRAYTON,

Deputy Health Officer.
June 12, 1902.

CASES OF SMALLPOX.
Marco, Ind.—

McCombs, 7; one reported by writer.
Byrum, 2; both reported by writer.

Lyons, Ind.—

Grace Cole, 1; reported by writer.
Harmon Brown, 1; reported by writer.

Inland City—

Booker, 1; reported by writer.

Yowal, 2; reported by writer.

Approximately 20 cases in Marco and vicinity unreported— mostly re-
covered. NELSON D. BRAYTON,

Deputy Health Officer.

Indianapolis, Ind., June 17, 1902.
To the State Board of Health:

In company with Dr. Thixtun I today visited every case of smallpox
with one exception in Sullivan County. I may state that I believe the
situation is now being well handled by the local officers. Dr. Thixton
states that people are now maintaining their quarantine.

Digitized by VjOOQIC

502

I found indisputable evidence that some one in Star City had brol^en
quarantine about two weeks ago and gone over to Shelburn. A clipping
of tl^is from some local paper was sent you a few days ago. I believe
the quarantine is now being rigidly enforced and the people of Shelburn
show no disposition to break it.

Dr. A. J. Neilans, a local physician at Shelburn, had positively re-
fused to consider the epidemic as smallpox after the first part of May.
He said the disease was chickenpox. He Is now vaccinating people, how-
ever. (It Is currently rumored that he w^ill be prosecuted by the Town
Board after this epidemic for the stand he took in the matter at the
start.)

Oases in Sullivan County number about 45 as follows: Shelburn—
Eldridge, 5; Miller, 3; Anders, 5; Addie Miller, 1; Bolinger, 1; Kochor, 2;
Beasley, 5; McClosky, 7; Stanley, 5.

At Star City there are about 9 cases, one or two of which are now
ready for disinfection. Hymera is now said to be free of the disease.

Respectfully,

NELSON D. BRAYTON.

Deputy Health Officer.

Columbia City, Ind., June 25, 1902.

State Board of Health, Indianapolis, Ind.:

Gentlemen— As regards the smallpox situation at Garrett, Ind., I beg
leave to report the following condition of affairs:

There are in all five families reported and carded as smallpox. One
case in each family with the exception of one family, which has two cases
(6 in all). All these cases were seen by me personally. In two instances
there is a tendency to break quarantine. I suggested a guard for these
placed, which suggestion will be followed out.

I should like to report a man named Dr. Carey living at Huntertown,
who has persistently refused to recognize the disease or its contagious-
ness, need of disinfection, etc. He has been informed that if he con-
tinues further visits to one of these families he will be placed In quaran-
■ tine himself.

I believe proper precautions against further spread of the disease
will be rigidly instituted and enforced by the local authorities. Vac-
cination was quite generally practiced one year ago.

DEKALB COUNTY.

Dr. Sebring reports that there has been no formal action on part of
County Board of Health towards making appropriation In case of epi-
demics. Just at present there are no cases In the county except those
at Garrett. At Auburn vaccination was very generally practiced one year
ago and no cases have appeared. The epidemfc there was rigidly treated
and the Mayor and City Health Ofl3cers were thoroughly on their guard

Digitized by VjOOQIC

503

against any spread of the disease. The county has a pesthouse near
Auburn.
I shall continue my investigation tomorrow In Whitley County.

Respectfully,

NEI^ON D. BRAYTON, M. D.,

Deputy Health Officer.

Warsaw, Ind., June 26, 1902.
State Board of Health, Indianapolis, Ind.:

Gentlemen— I have today visited the Secretary of the County Board of
Health at Columbia City, Dr. O. V. Schuman. He reports that there are
no cases of smallpox In the county, that the county is fairly well vac-
cinated and that the people are alive and awake to the danger of the
disease and ready and willing to assist the physlciaiis in its suppression
should an epidemic occur. He states that no formal action has been
taken by the County Council to appropriate funds in case of an emergency,
but that they are willing to do so at once should conditions arise that any-
thing should be necessary in a financial way.

Dr. Williams reports no cases in Columbia City proper.

I have also visited the towns of Plereeton, Larville, Winona and
Warsaw (Kosciusko County). Dr. Bash, the County Health Officer, was
out of the city today, but he has no record of cases In the county at
present. Dr. Weber rei)orts none in the oity. He states that vaccination
is not opposed and that the Council would take proper precautions to see
that everything necessary would be supplied In case an epidemic did
occur.

*Pierceton, Ind.—

At Plereeton, Ind., Dr. Ix)ng reported having had one case in a fam-
ily north of the town in April. He vaccinated all of the other members
of the family and none of those exposed took the disease, although
there were five meml)ers In the family who had never been vaccinated.
Complaint was made by the local officer. Dr. Leedy, that Dr. Coffman
had refused to recognize the contagious character of the disease or its
identity in an epidemic which the town had had a year ago, but on the
threat of quarantine for himself he manifested a different spirit and
obeyed the law in the case.

I shall tomorrow visit in Sidney where an epidemic is reported to have
recently occurred and some of the towns of northern Wabash County.
Wabash City itself is rt»ported to have no cases.

Respectfully,

NELSON I). BRAYTON, M. D.,

Deputy Health Officer.

Claypool, Ind., June 27, 1902.
The State Board of Health:

Gentlemen— I beg leave to report the following status of affairs a^ I
have found them In Wabash County and the southern part of Kosciusko
County.

Digitized by VjOOQIC

504

There seems to be at present no cases reported in either of these
counties. At Servia it is estimated that over 45 cases occurred, during the
winter. Dr. J. B. Williams, Health Officer of the county, reports that
vaccination was bitterly opposed by some of the town foils and hence
the wide dissemination of the disease.

At North Manchester Dr. Lower reports no cases at present About
12 cases occurred during the spring. Vaccination was cofiimonly and
frequently practiced and hence the disease spread but little.

Dr. Mooney reports but 4 cases having occurred during the spring
and winter at Laketon. No cases have occurred at Silver Lake and noth-
ing at Liberty Mills.

At Sidney, in Kosciusko County, about 66 cases occurred in the winter.
Vaccination was not extensively practiced and was opposed by some of
the town people. A few cases were carried to Pierceton and a few more
to some other places. The original infecting case came from South Da-
kota.

I have seen no cases of smallpox today, although my attention was
called to two cases that were of dermatological interest and one of them
was of suspicious nature. It was not smallpox however.

Respectfully,

NELSON D. BRAYTON, M. D.,

Deputy Health Officer.

The letters here given were sent to the Health Officers of every
county. The object of the letters plainly appears and the reports
to date show that a deeper interest in health work has been aroused
in many counties.

June 28, 1902.

Dear Doctor— You are aware that your County CommisHioners under
the law, constitute a County Board of HeaUh, ex-officlo. The Com-
misflioners have powers and duties not belonging to the Board of Health,
and the Board of Health has powers and duties not belonging to the
Commissioners. It is therefore necessary for the Board of Health to
formally act as such, when health matters are attended to, and for the Sec-
retary to carefully record in a minute book all transactions of his Health
Board. These minutes fnust afterward be approved and signed by the
President and Secretary. As there has been a good deal of irregular ac-
tion by Health Boards, you are directed to bring this matter before your
Board. As smallpox has existed in the State more or less for four years
and as ^he infection is now freely distributed in cars, depots, courts and
other public places, it is only reasonable to expect that the disease wUl
continue to prevail unless it is strongly opposed. If therefore smallpox
has not yet appeared in your county, be assured it most likely will come
in time. Indeed, it will be passing strange it if does not come. The
State Board therefore directs, in order to be prepared for the fight, that
you present to your Board of Health the enclosed resolutions and urge
that they be formally passed. When this is done you will know your

Digitized by VjOOQIC

505

powers and duties and be able. If occasion requires, to proceed intelli-
gently against the enemy. Do not fail to acknowledge receipt of this
letter and in reply answer the following questions:

1. Have your Commissioners ever formally sat as a Board of Health,
and if so, when?

2. Have you a minute book in which you record all transactions of
your Board and also your reiwrts to the Board?

3. How much money, including your salary, was appropriated by your
County Council for health purposes for the year 1902?

4. What salary is allowed you?

When your Board of Health meets be sure to inform the State Board
as to what action is taken in regard to the enclosed order.

Very truly yours,

J. N. HURTY.

Secretary.
By order State Board of Health.

Resolutions refen-ed to in preceding letter and sent to all county
officers :

Whereas, It is possible to suppress all infectious, and contagious dis-
eases, and as such diseases cost the people large sums of money and are
the cause of much unhappiness and sorrow to the people, and

Whereas, This body is constituted by the law a Board of Health and is
commanded by the law to take prompt action to arrest the spread of in-
fection and contagion, it is ordered:

1. The Secretary of this Board, who is County Health Officer, shall
energetically enforce the health statutes of the State, the rules of the State
Board of Health and the rules and health orders of the County Board of
Health.

2. He shall promptly put in quarantine all known cases of infectious
diseases as are listed in rule 1 of the State Board of Health when said
cases are outside of the corporation of cities and towns. Within the
corporations of cities and towns the authorities thereof shall promptly
take like action.

3. With the consent of the Auditor, the County Health Officer may
engage medical attendance, employ guards to maintain quarantine, and
he may purchase medicines and food supplies when the conditions de-
mand. Not more than $2.00 per visit may be paid foi* the necessary
medical attendance and completely itemized bills checked and sworn to,
shall be presented before payment will be made.

4. If at any time the work in the prevention of the spread of in-
fectious and contagious diseases is more than can be expected of the
County Health Officer, he may, with the consent of the Auditor, employ
one or more intelligent men to act as deputies to establish quarantines
and to conduct disinfections. Said deputies, and also quarantine guards
shall not be paid more than the statutory amount of 20 cents per hour
actually served; and their expenses, such as livery hire, car fare, beds
and meals, will be paid upon pi'esentation of fully itemized bills which are
sworn to.

Digitized by VjOOQIC

506

5. Whenever any case or cases of smallpox are placed under quaran-
tine, all persons known or reasonably supposed to be exiwsed shall be vac-
cinated, and after thorough disinfection in body and in apparel will be
permitted their liberty. If any person or persons known or reasonably
supposed to be exposed to smallpox, will not submit to vaccination and
disinfection in body and apparel, then they shall be placed in quaran-
tine until such time, in the opinion of the County Health Officer, as may
be safely allowed their liberty. The vaccine shall be supplied by the
CJounty Health Officer, it shall be pure and fresh and for each person
vaccinated the sum of 40 cents will be allowed, provided a complete
record of each vaccination be supplied, giving date, name, postoffice
address, age, sex and previous history, if any, of vaccination.

6. When visiting persons known to be affected with smallpox,
diphtheria and scarlet fever, all physicians and Health Officers shall pro-
tect their clothing and hair against infection, and shall thoroughly dis-
infect their hands before coming in contact with the public. To accom-
plish this a linen or rubber coat with skuli cap shall be worn by physicians
and Health Officers when visiting patients afflicted with the diseases
named, and said linen or rubber coat and skull cap shall be carried
in a hand bag or other approved receptacle and kept well disinfected with
formaldehyde. The hands shall be disinfected by washing with anti-
septic soap and applying an effective liquid antiseptic.

7. The County Health Officer shall purchase formaldehyde candles
in amount not to exceed $20.00, and, as necessity requires, such purchase
may be repeated with the consent of the Auditor. Said formaldehyde can-
dles are to be used for disinfecting houses known or supposed to be in-
fected. A complete record of all disinfections shall be kept, and made a
part of the Health Officer's account of his health work, as required in 8.

8. The County Health Officer shall each Monday, and oftener if he
wishes, record in the minute book of the Board of Health a complete
account of health work done by him during the several days preceding,
and said minute book shall be kept in the office of the County Auditor.

0. This order shall be promulgated as the law requires by being pub-
lished in two consecutive issues of two papers of different political de-
nominations, and the Secretary is ordered to so promulgate.

10. Any one violating the State Board of Health statutes, the rules
of the State Board of Health or the rules or orders of the County Board of
Health shall be promptly prosecuted by the County Attorney and the
County Health Officer shall actively aid in all such prosecutions.

Passed by the County Board of Health, , 1902.

, President.

, Secretary.

July 2, 1902.

Dear Doctor— Referring to our letter of June 28th, with enclosed order
to be presented to your County Board of Health, the order may be amended
as you and your Board see fit. The action is recommended, not ordered,
by the State Board. It is an effort on our part to try to have all County

Digitized by VjOOQIC

607

Boards of Health ready for action when the time comes, or to do things
right if the time for action is now at hand.

Very truly yours,

J. N. HURTY,
' Secretary.

The following correspondence is self explanatory:

June 30, 1902.
Hon. Wlnfield T. Durbin, Governor of Indiana:

Dear Sir— I have the honor to inform you that on Sunday, June 29th,
at 4 p. m., I received a letter from Dr. J. N. McCormack, Secretary of the
Kentucky State Board of Health, and this letter read as follows:

"Am Just in from Michigan and have been trying to get you by *phone.
Will you wire me on receipt of this as to smallpox conditions in Indiana?
Our terms of suspension expire Tuesday, as you know, and I would like to
be advised by you today, or tomorrow at the latest. Address me at Bowl-
ing Green."

After trying to secure you by telephone and falling, I finally sent the
following telegram:

"Dr. J. N. McCormack, Bowling Green, Ky.— Smallpox diminishing
rapidly. Only a few cases now in Southern Indiana. State Board is
active; also local Boards. Governor and State officers heartily support
all right efforts to prevent disease."

I have this day, June 30th, 2:45 p. m., received the following:

"Secretary Indiana State Board of Health— Quarantine raised upon
your assurance that good work will be continued.

"J. N. McCORMACK,

"Secretary."

I presume this ends the Kentucky nonsense.

Knight stown. I went to Knlghtstown this morning t>ecause of request
from the Town Board of Health. I tried to get over last Friday, and also
last Saturday, but was prevented by subpoena to the Marion County
court At Knlghtstown serious conditions exist. There are thirty-two
houses under quarantine on account of smallpox, and there are in all
thirty-six cases. Twelve cases are of the confluent form and very serious.
I fear four of them will die. There has already been one smallpox death
in Knlghtstown. I visited Ex- Senator New by, who has the disease. The
attack was a very mild one, but he has been quite sick for about two
weeks. There are only a very few eruptions upon his face, but his back
and breast are well peppered. He has at no time been seriously ill, and
I think will be ready to be discharged from quarantine so far as he is con-
cerned in another three days. His children were immediately removed
from his house, and it remains yet to be seen whether or not his wife comes
down with the disease.

I met the Town Council, and. without hesitation, they passed the
proper orders which are necessary for the suppression of smallpox. A pest-
house and a contagious disease service is established. Disinfectants have
been purchased, and also vaccine. The Health Officor, Dr. O. II. Barrett,

Digitized by VjOOQIC

508

Is an intelligent and energetic man. He knows exactly what must be
done, and one section of the special ordinance empowers him to employ
necessary help, purchase supplies, and, in a word, do everything which
is rational and scientific for the prevention of smallpox.

I had a telephone message from President Forrest directing that 1
visit Rush, Franklin and Ripley counties. I had already arranged to go to
Franklin County tomorrow, Tuesday. It is almost impossible to secure
the co-operation of the people until the disease appears in virulent form,
and possibly causes a death or two, as was the case at Knightstown.

Very respectfully,

Secretary.

Indianapolis, Ind., July 3, 1902.
Dr. J. N. Hurty, Secretary State Board of Health, Indianapolis:

Dear Sir— In the absence of the Governor, I beg to acknowledge re-
ceipt of your courteous communication of 30th ult., with reference to the
smallpox quarantine by the Kentucky authorities, and to inform you that
I have placed It on his desk for his personal consideration when he re-
turns to the city. He is now in the Northwest with his family, and is not
expected to return until about the 12th instant.

Respectfully,

CHAS. B. WILSON,
Secretary to the Governor.

AN OPINION BY THE ATTORNEY-GENERAL.

April 29. 1902.
Secretary State Board of Health:

Dear Sir— I have to answer the questions contained in your letter of
March z7th, as follows:

"1. The health law passed in 1809 makes it obligatory upon County
Commissioners to promulgate the rules of the State Board of Health by
publishing them in local papers. . In Grant County the Commissioners are
anxious to conform to the law, but the County Council will not appropri-
ate the money necessary to fulfill the law. What steps should be taken
under such conditions?"

The act of 1809, amendatory of the Board of Health law, provides
that the State Board of Health shall promulgate its rules by sending copy
of the same to the Secretary of the County Board of Health, "and the
Commissioners of said county shall cause such rules to be published for
two consecutive issues of two weekly newspapers, representing the two
dominant political parties of said county, if such papers be published.**
(R. S. 1901, §6715.)

It thus appears that there is a plain statutory duty imposed upon the
County Commissioners by the act of 1899, to publish the rules of the State
Board of Health. It appears that the County Council has not appropri-
ated the money necessary to fulfill the law. Unless such appropriation be
made, the County Commissioners of course have no power to make the
publication required by law.

Digitized by VjOOQIC

509

Section 25 of the county reform law provides that no Board of County
Commissioners shall have power to bind the county by any contract or
agreement, or in any other way to any extent, beyond the amount of
money at the time already appropriated by ordinance for the purpose of
the obligation attempted to be incurred, and all contracts and agreements,
express or implied, and all obligations of any and every sort, beyond such
existing appropriations, are declared to be absolutely void. (R. S. 1901,
§5594-e-l.)

The county reform law also provides that estimates shall be filed with
the County Council at its annual meeting of all county expenses for
which appropriations must be made, but that by a three-fourths vote of
the Council, and not otherwise, an appropriation may be made for an item
not contained in any estimate. (R. S. 1901, §5594-z.)

It is quite probable that in the case of which you speak no estimate
was filed for the expense, of promulgating the rules of the State Board
of Health, with the Grant County Council, and it is certain that no appro-
priation was made. Where no appropriation has been made, the law pro-
vides that—

**If at any time after the adjournment of the regular annual meeting
in September an emergency should arise for further appropriations for
any purpose for which the Council is authorized to appropriate by this act,
such further appropriations may be made at a special meeting of the
Council, on estimates prepared and presented as hereinabove provided
by an ordinance passed by at least a two-thirds vote of all the members
of the Council, and not otherwise." (R. S. 1901, §5594-a-l.)

An appropriation can therefore be made at this time only as provided
in the section last quoted, and it would probably be expedient to have esti-
mates prepared and submitted at a special meeting, although it would be
possible, by a three-fourths vote, to make an appropriation without esti-
mates.

Whether the County Council could be compelled to appropriate is a
question which the Supreme Court has not yet decided. In four diflTerent
cases which have been before the Supreme Court, attempts have been made
to mandate County Councils to make appropriations, and in every in-
stance these attempts have been unsuccessful, although the court has not
gone so far as to say that an appropriation, in the discharge of a plain
statutory duty, could not be compelled by mandamus.

The question is one which is very doubtful, and. without the authority
of the Supreme Court, I could not say that mandamus would lie. How-
ever, I can think of no other possible remedy, and am inclined to think
that, rather than see the law fail, the courts would grant this very ex-
traordinary remedy.

I do not believe, however, that where a plain case of duty is presented
to a Board of responsible citizens, such as make up the County Councils
of the State, they would be so blind to their oaths as to make it necessary
to proceed against them in the courts.

"2. Smallpox is now epidemic in Grant County, and the Health Officer
announces himself as helpless to stop the spread of infection because the
County Council refuses to appropriate the money which is necessary to
accomplish the work. The County Board of Health, composed, as you

Digitized by VjOOQIC

510

know, ex-oflaclo of the Ck)unty Commissioners, is willing, on its part, to
fulfill the demands of the law. What steps are to be taken to enable the
health authorities to enforce the statute, which seems in this instance
to be entirely nullified by the County Council?"

In this case I would suggest that a special meeting of the County
Council be called, and that, in view of the emergency, estimates be pre-
pared and submitted to them, and tliat if no appropriation is made, pro-
ceedings be instituted against them by the County Commissioners, through
the County Attorney, to compel an appropriation, by mandamus.

"3. Will it be illegal for the County Board of Health to proceed to
enforce the law which says: 'It shall be their duty to take prompt action
to arrest the spread of infectious and contagious diseases?' Or will it
be necessary for the Board to first procure an appropriation from the
County Council before the commands of the law can be fulfilled?"

In this case the same procedure should be followed as in the previous
one.

I have the honor to be, very truly yours,

W. L. TAYLOR,

Attorney-General.

After full discussion of the smallpox condition in Franklin
County the Deputy Attorney-General was called and consulted,
and it being finally determined to impose quarantine upon Frank-
lin County, Mr. Moores drew up the following proclamation which
was passed : ■

PROCLAMATION BY THE INDIANA STATE BOARD OF HEALTH,

Whereas, Smallpox, a loathsome and dangerous and easily communi-
cable disease, Is epidemic within and throughout Franklin County, Indi-
ana, and—

Whereas, The health law of the State requires Health Boards to take
prompt action to arrest the spread of contagious and infectious diseases,
and as—

The Franklin County Board of Health has not fully performed the
commands of the law in this respect, and as the law provides that ail
Boards of Health "shall perform such duties as may from time to time be
required of them by the State Board of Health pertaining to the health
of the people, it is therefore-
Ordered by the Indiana State Board of Health as follows:

1. The County Board of Health and all City and Town Boards of
Health of Franklin County, Indiana, are directed to immediately enforce
the health statutes and also to enforce rules 6. 7, 8, 0, 10. 11, 12. 13, 14,
15 and 10, as appear in the certified coi)y of the Rules of the Indiana State
Board of Health hereto attached.

2. The County Board of Health and all City and Town Boards of
Health of Franklin County, Indiana, are directed to proviae the money
necessary to enable their Secretaries to enforce the health statutes and

Digitized by VjOOQIC

511

the nil^s of the State Board of Health, and said Boards are further ordered
and directed to cause all known cases of smallpox within their respective
Jurisdictions to be placed in quarantine, and there held, and the quaran-
tined persons provided for until such time as the Health Officer in charge
may decide that all danger has passed.

3. With the consent of the Auditor, the County Health Officer may
engage medical attendance, employ guards to maintain quarantines and he
may purchase medicines and food supplies when the conditions demand.
Not more than $3.00 per visit may be paid for necessary medical attend-
ance, and completely itemized bills checked and sworn to for all expenses
incurred shall be presented before payment will be made.

4. If at any time the work in the prevention of the spread of infec-
tious and contagious diseases is more than can be expected of the Ck)unty
Health Officer, he may, with the consent of the Auditor, employ one or
more intelligent men to act as deputies to establish quarantines and to
conduct disinfections. Paid deputies and also quarantine guards shall
not be paid more than the statutory amount of twenty cents per hour
actually served, and their expenses, such as necessary livery hire, car fare,
beds and meals, will be paid upon presentation of fully itemized bills,
which are sworn to.

5. Whenever any case or cases of smallpgx are placed under quar-
antine, all persons known or reasonably supposed to be exposed snail be
vaccinated, and, after thorough disinfection in body and in apparel, will
be permitted their liberty: Provided, Said person will faithfully promise
to report to the Health Officer for medical examination ten days from
the date of exposure. If any person or persons known or reason-
ably supposed to be exposed to smallpox will not submit to vaccination
and disinfection in body and in apparel, then said person or persons shall
be placed in quarantine until such time, in the opinion of the CJounty
Health Officer, as they may be safely allowed their lil)erty. Tlie vaccine
shall be supplied by the County Health Officer; it shall be pure and fresh,
and, for each person vaccinated, the sum of fifty cents will be allowed,
provided a complete record of each vaccination be supplied, giving date,
name, postoffice address, age, sex, and previous history, if any, of vaccina-
tion.

6. When visiting persons known to be affected with smallpox, diph-
theria and scarlet fever, all physicians and Health Officers shall protect
their clothing and hair against infection, and shall thoroughly disinfect
their hands before coming in contact with the public. To accomplish this
a linen or rubber coat with skull cap shall be worn by physicians and
Health Officers when visiting patients affiicted with the diseases named,
and said linen or rubber coat and skull cap shall be carried in a handbag
or other approved receptacle and kept well disinfected with formaldehyde.
The hands shall be disinfected by washing with antiseptic soap, and ap-
plying an effective liquid antiseptic.

7. The County Health Officer shall purchase formaldehyde candles
or formaldehyde solution in amount not to exceed $20.00, and, as necessity
requires, such purchase may be repeated with the consent of the Auditor.
Said formaldehyde candles or formaldehyde solution are to be used for
disinfecting houses known or supposed to be infected, and all such houses

Digitized by VjOOQIC

612

shall be disinfected by the Health Officer or his deputies. A complete
record of all disinfections shall be kept and made a part of the Health
Officer's account of his health work, as required in 8.

8. The County Health Officer shall each Monday, and oftener if he
wishes, record in the minute book of the Board of Health a complete ac-
count of health work done by him during the several days preceding, and
said minute book shall be kept in the office of the Ck>unty Auditor.

9. Any one violating the State health statutes, the rules of the State
Board of Health or the rules or orders of the Ck>unty Board of Health, shall
be promptly prosecuted by the County Attorney, and the County Health
Officer shall actively aid all such prosecutions.

10. All Boards of Health of all counties bounding Franklin County
and all Boards of Health of all counties of the State of Indiana into
which any person from Franklin County shall come, are ordered and di-
rected to place in quarantine for fourteen^ days all persons entering them
from Franklin County.

11. The order as given in 10 shall be enforced until annulled by the
State Board of Health.

Passed in regular session of the State Board of Health, Friday, July
11, 1902.
Attest:

% , President.

, Secretary.

Digitized by VjOOQIC

FOURTH QUARTER.

Augftist, September and October^ t902*

FOURTH REGULAR MEETING FOR THE FISCAL

YEAR

Offkt-: Indiana State Board of Health,

Indianapoli&, Ind., October 10, 1902.

Present: Drs. Forrest, Cook, Davis, Wishard and Hurty.

President Forrest called the meeting to order. The minutes of
the last meeting were read and approved.

COMPLAINT OF MILL DAM AT MILLCiUOVE, OWEN COUNTY.

Petitions and evidence pro and con w^re presented concerning
the Devore Mill dam at ^lillgrove. Said documents are filed in the
office and action was postponed pending receipt of further evidence.
The attorneys for the defense. Judge Robins<m and Mr. Ilickem,
made statements before the Board.

The manuscript for the Rei)ort for 1901 was reviewed and it was

Ordered, That the same be approved and given over to the Print-
ing Board.

The Swretary's rejxjrt for the fourth quarter, Ix^ing called for,
was read and after discussion ordered si)read of record.

REPORT OF SE( RETARY FOR FOURTH QUARTER.

SmalljDox has prevaile<i throughout the State during the quarter.
July was the worst month so far since the epidemic began on ac-
count of the number of deaths. There were 502 cases and 46 coun-
ties were infected. The deaths numbered 17, 15 of these occurring
at Knight.stown. This one month, therefore, scores a higher record

33-Bd. of Health. (5U) Digitized by GoOgle

514

for deaths than did the whole State during the year 1900. There
were, in all, 183 eases at Knightsfown. The neighboring towns
all quarantined against KnightstowTi, but no quarantine of the town
itself was made. The interurban trolley line from Indianapolis
Avas voluntarily stopped by the Trolley Company at Charlottesville,
a small town about five miles west or Knightstown. The trains
of the Pennsylvania road stopped regularly, and during one month,
•not to exceed ten passengers got off at Knightstown. Soon after
the first three deaths occurred, it is estimated that one-third of the
inhabitants of the place left. The prostration of business was
complete. For six weeks tlie merchants insisted they did not take
in enough money to pay rent, and for four wrecks not a person
registered at the hotel. An energetic fight was waged against the
disease, but it w^as not until every one in the town had Ijeen vac-
cinated tliat tlie epidemic ceased.

During the quarter the Secretary has made, at his own expense,
26 water analyses; 20 of these w^ere found to bo polluted and the
sources were condemned from which tlie samples were obtained.
Twelve samples of sputum weiX3 examined and 7 of these were
found to contain tulx^rcle bacilli. Two diphtheria cultures were
received and examined and both found to be true diphtheria.

The following visits were made during the quarter :

On July 9. Anderson and Muncie.' At Anderson to confer with the
authorities of the town in regard to the water supply and also in regard
to the conditions of White River at that place. At Muncie to confer with
the authorities in regard to the pulp mill, also the strawboard mill and
in regard to a new line of sewers which were contemplated.

.July 20. Knightstown, account of smallpox.

July 23. Brook ville, account of smallpox.

August 7. Warsaw, account of smallpox.

August 21. Spencer, account of teachers' institute.

August 20. Albion, account of smallpox and teachers' institute.

September 1. Winamac, account teachers' institute.

September 4. Lynn, account of de<ilcation of new sehoolhouse.

September 30. Fowler, account of smallpox.

The expenses of the Secretary were paid at the last three named
places The reasons for these visits and the results of the same are
fully set forth in the reports which follow:

Digitized by VjOOQIC

515

ANDERSON AND MUNCIE.
July 9—

Mr. Marshall O. Leighton, Hydrographer of the TJ. S. Geological
Survey, was at Anderson and Muncie the first week in July. On
the 9th the Secretary was invited by the Health Ofiicer of Ander-
son and the Conriniittee on Public Health of the City Council to
meet Mr. T-^ighton at Anderson. An invitation of like character
was received from Muncie. At Anderson the object was to confer
with the authorities named, also with Mr. Ij^ghton in regard to
stream polhition, and the filtration of the public water supply. Ar-
riving at Anderson, I joined Mr. Leighton, the Health Officer and
the Chairman of the Health Committee of the City Council, and
together we visited the city waterworks. The supply at present is
taken directly from White River without filtration, sedimentation
or any preparation is pumped directly to the people. This water
supply is not used for drinking purposes and the city authorities
especially advise the people not to drink it. It, however, is used
for other domestic purposes, as bathing, and as it is polluted water,
it is dangerous for this purpose. A long conference was held as to
the best method for purification and the best way of supplying
Anderson with good w^ater. My advice was that filtration beds
be constructed and the supply taken directly from White Eiver.
The Anderson authorities lean strongly toward deep wells.

The American Strawboard Co., at Anderson, was visited and the
river inspected where the refuse from this factory is delivered into
the same. The works is operating under a thermit from the State
Board of Health and tliey claim they are following said permit in
every detail. This was certainly true at the time of our visit, but
there were reasons to believe that the permit had not been com-
pletely obeyed or else the signs present were those remaining from
past periods. On the same day, at Muncie, w^ith Mr. Leighton,
I met the City and County Health Officers, also two members of
the Council. With theee gentlemen we inspected an area of the
city where new sewers were contemplated. This subject was
studied and our advice given in regard to the matter. We then
visited the pulp mills, which are caring for their refuse under a
permit from the State Board of Health. Nothing offensive or
polluting was l)eing discharged into the river at that place. The

Digitized by VjOOQIC

516

Consumers Strawboard Co. was next visited and at this place it
was found that the State Board of Health permit was being ob-
served.

KNIGHTSTOWN.
July 20 —

The Chairman of tlie Town Board of Knightsto^vn telephoned
me, urging me to como to Knightstown on Sunday, July 20. There
had been a fresh outbreak of smallpox and he feared that all was
not being done that could be to prevent the spread of the disease.
A partial history of the epidemic at Knightsto\vii has already been
given. The said epidemic began June 2. A young man, Jesse
Swain, who traveled from Cincinnati, was taken sick at Knights-
town and the disease proved to be smallpox. It was first diagnosed
measles. Swain was un vaccinated and eventually developed con
fluent smallpox and died June 12. On that day a second case
appeared. It was a mild attack of a person who was never vac-
cinated and recovery took place. On the 22d of June quite a
nimiber of cases appeared all at once. The exact number is not
known. From this time on the disease rapidly appeared and deaths
ocx^urred. On July 20, at the time of my visit, I found that 12
new cases had suddenly sprung into existence two days before, and
it was this fact that was alarming the President of the Town Board.
All of these cases were among unvaccinated people, and they all
had refused vaccination. This brought matters to a head so far
as vaccination was concerned, and the Town Board issued an order
that every unvaccinated j^erson who refused to be vaccinated should
be placed under quarantine until he so consented. This proved
effective and after general vaccination was accomplished, no more
cases appeared. By August 10 the town was free from the disease,
but the country people in the surrounding region still refused to
trade at Knightstown or go near the place, and the Knightstown
authorities again called upon me to issue a statement that no danger
on account of smallpox existed in their town. This request was
gladly complied with.

REPORT OF VISIT TO RROOKVILLE ON ACCOUNT OF SMALLPOX.

In accordance with the directions of the State Board of Health
and the Governor, I went to Brookville on account of the smallpox
situation in Franklin County. I arrived at 9:16 Tuesday morn-*

Digitized by VjOOQIC

517

ing, July 23d, and immediately called upon the County Health
Officer, Dr. Geo. W. Squier. He was absent in the country seeing
a patient and I, therefore, called upon several business men in
order to talk over tlie situation and secure their influence and aid
in inducing the health authorities of the tovm and of the county
to enforce the health law and to pass special ordinances prepared
by the Attorney-General. I first met Mr. Bradt, manager of the
Thompson-Norris Paper Co. He heard me most. courteously and
promised his fullest support in my efforts with the Town Board
and the County Board of Health. With Mr. Bradt I called upon
Mr. Rochefeller, a dry goods merchant. He, also, listened cour-
teously and offered his influence. I called next upon Mr. Burk,
editor of the Brookville American. He heard me courteously and
offered all the assistance he could give. Afterwards I met Mr.
Trichler, a groceryraan, and he, too, offered his assistance. Mr.
Trichler went with me to call upon Mr. Werst, President of the
Town Board, and introduced me. At first Mr. Werst was inclined
to be a little offish, but eventually came around and said that the
Town Board would, without question, pass the ordinance which
the State Board of Health recommended.

On Wednesday night the Town Board was called in special ses-
sion and I was invited to address the members. The simple story
of the law and its requirements was told and various questions were
asked. The Board was not in regular called session, but had
come together voluntarily. President Werst promised, and so did
each of the members individually, that at their next regular meet-
ing, Monday night, July 28, the ordinance would be passed a^
read tliat night. This was verj'' satisfactory^, and in addition it was
promised that the ordinance would be enforced and every scientific
precaution known would be taken in order to prevent the spread of
smallpox. It may be noted here that a small pesthouse had already
been provided on the lot occupied by the waterworks building.
This was a very small stnicturo and would hold probably four
patients.

The next day, according to arrangements, tlie business men
named above, joined me and we met the County Board of Health
which had come together at my invitation, the meeting not being
formal and legal, but entirely voluntary. The whole situation
was presented to the members and they agreed they would pass tho

Digitized by VjOOQIC

518

order recommended by tlio State Board of Health and which was
d^a^\^l up by the Attorney-General. This would be done at a
regular meeting to be held Monday, July 28. They could not, of
course, act at the time, because the meeting had not been regularly
called, but was sl voluntary one. They also promised that the
order would be energetically enforced and that every scientific
measure known would be used in order to prevent the entrance
and spread of smallpox in Franklin County.

I left Brookville at 1 :30 on Thursday, July 24, and* rode in a
buggy through the settlements of Oak Forest and St. Marys and
the town of Oldenburg and into Batesville. The object of the
journey was to make investigations as to the existence of smallpox
in the region traversed. Shortly before we reached Oak Forest,
the young man who was driving me, and whom I had hardly looked
at, asked if I was an Indianapolis doctor, and I told him I was;
he then asked if I thought this ^'pimple disease," which so many
people were having, was smallpox. I told him I was quite certain
the majority of cases of what he called "pimple disease" were mild
smallpox. He replied, "Then I have it sure." I lifted his soft
hat and found at the edge of the hair three immature smallpox
pustules. We stopped further on in a shady place and I examined
him very thoroughly. I found from this examination and also
from the history he gave mo, that ho undoubtedly was suffer-
ing at that very moment from an attack of smallpox and wae in
one of the stages where it is most easily transmitted. This is one
example of many which could be given showing that smallpox in-
*fection is being spread in almost every direction, and shows how
futile it is to try to stop the disease unless vaccination is gen-
erally practiced. This boy was, of coui'se, finally placed in quar-
antine and I thoroughly disinfected myself before 'going among
the people.

At Oak Forest I made inquiries of ^[r. Fred Stump, who owns
the general store at that place. Ho told me there had been some
cases of eruptive disease in that neighlwrhood, but he knew of
none at the present time. He said : "In the spring, St Marys, a
postoffice settlement abflut five miles away, had been visited by
several cases of what some doctors said was smallpox and what
other doctors said was chickenpox." He also told me he had heard

Digitized by VjOOQIC

that Will Becker was sick with a fever, and that it was probably
typhoid fever. I inquired carefully how I could find Mr. Becker's
housa Eventually I arrived there and found tliat Mr. Becker
was almost certainly entering into an attack of smallpox. He had
high fever, backache, headache, gastric disturbances and all of the
l)eginning symptoms.

At St. Marys I found the people very reticent, and one man, a
saloonkeeper, was not only reseiTed, but a little threatening,
for he told me I had better move on. Entering this place I saw a
little girl who was about nine years old, who was holding a horse
while he baited on the grass of the front yard. She had on slippers
but no stockings and her \egs wore well covered with scabs. She^
cei-tainly was just getting over the desquamative stage of small-
ix)x. She announced she was from Batesville and was visiting her
grandmother at St. Marys. I was told by a man who would not
give his name, "We have lots of cases of breaking out around here,
but it don't hurt any one, we don't need any doctoring, and we
won't be quarantined." This same information was secured by
Dr. Squier in other localities in the county.

At Oldenburg I called upon the Health Officer, Dr. Mull. He
told me there had been many cases of smallix>x at Oldenburg, but
he had promptly quarantined them and cared for them the very
best he po^ibly could. He said : "I now have a blacksmith and
his family under quarantine and said blacksmith threatened to
shoot me if I tacked a card upon his house. I have not only placed
the card upon the house, but I have confined the whole family to
the premises." Dr. Mull took me to see a saloonkeeper, who had
smallpox and who was supposed to be under quarantine, but we
found him waiting upon the bar. He was in the desquamative stage
of a mediimi attack of smallpox. Dr. ilull immediately removed
him from the pixjmises and placeil him with warning under quar-
antine again.

Oak Foi-est and St. Marys are small settlements with postoffiees,
and are not incor|X)rated. They are under the sanitary direction
and care of the county. Oldenburg is incorporated and Dr. ilull
informed me the Town Board had given him full ix>wers and
positive orders to do everything that was nece^ary and known
to science for the purpose of preventing the entrance of smallpox
and its spread. ^ ^

Digitized by VjOOQIC

520

Arriving at Batesville, I called upon the Health Officer, Dr.
Chas. M. Gibson, but lie was away in the country, and then I called
upon the leading physician, Dr. Jos. Ziteke. He told me there
were several ca«?6 of smallpox in the town, but none were under his
charge. He cited the following which was printed that day in
the Batesville Tribune :

"There are a few cases of so-caHed smalli)ox in this vicinity, but tlie
patients are neither in bed nor quarantined, and they are doing well."

It seemed, therefore, that things were somewhat loose in Bates-
ville so far as smallpox conditions wei'e concerned. I left word
for Dr. Gibson that he must see to it that the law and the rules of
the State Boanl of Health were thoroughly enforced, otherwise the
State Board would have to take hold. I arrived home via Big
Fcmr from Brookville at 12 :15 on the morning of July 25.

WAKSAW.

August 7 —

On account of an urgent telephone from the ilanager of the
Winona Assembly, who told me small^wx had been discovered, and
he strongly requested that I visit Warsaw and the Assembly, and
give them such advice and aid as I could. Upon arrival at War-
saw with Dr. Webber, the Town. Health Officer, I called at a house
ill close proximity to the Asseinbl^^ grounds, and there found a man
who was sick with smallix>x. The situation was discussed and it
was concluded to remove the patient to a house which was especially
prepared for him, situated two miles distant from the Assembly
grounds. This was done without any publicity whatever, so as
not to alann the thousands of poo])le who were in attendance upou
the Assembly. Those who had \)evi\ exposed were quietly sought
out and were vaccinated and I am glad to say that no more castas
a])peared.

SPENCER.
August 21 —

The Owen County Teachers' Institute, on the three days of
August 19, 20, 21, was in session. On the afternocm of the 21st
I was invit<xl to addroi^s this Institute upon the subject of ^'School
Hygiene." A vote of thanks was received for the address and I
believed that not a little good was done for the cause of sanitation
in that hwality.

Digitized by VjOOQIC

521

ALBION.

August 26 —

On account of a letter from Dr. B. E. Miller, Health OiBcer of
Noble County, which was countersigned by the Hon. John Schiraer-
-horn. Chairman of tho County Board of Health, I went to the
county named. The letter set forth that smallpox prevailed at
Albion and in the surrounding neighborhood and it seemed im-
possible to correct the wrong diagnosis made by several physicians.
It was the desire of the County Board of Health to do all that
could possibly be done for the purpose of stopping the disease,
but its efforts were greatly paralyzed because of the difference of
opinion among the physicians, and also because there were many
merchants and others who did not want to have smallpox and,
therefore, found it agreeable and to their liking to decide that it
did not exist. Up/on ai-rival at Albion, 1 was met by Dr. Miller and
immediately taken to attend a conference of the physicians of the
town. After discussion, we agreed in regard to the standards by
which we would decide smallpox to exist, and then called upon
several ^♦asos. All of the cases found proved to be smallpox, and
the dissenting doctors, if they did not accept the diagnosis of
smallpox, did at least conclude to keep silent. It was announce<l
to the people officially that smallpox existed and that all persons
not vaccinated within tlie last five years should be vaccinated.
With Dr. ifiller'I visited several families in the neighborhood of
x\lbion and on the 27th, visited Wolf Lake, a small settlement
about ten miles from Albion. Here smallpox had prevailed in
mild form for some time, but at the time of our visit there were
several cases which were very severe, one of them dangerously
severe. Drs. -J. E. Luckey and E. W. Depow ai'e the practitioners
at Wolf Lake. Both of tliese had failed to recognize the mild
cases of smallpox and now that it had appeared in severe form,
they still refused to call it smallpox, and a dangerous state of
affairs existed. Official notice was given at Wolf Lake that small-
pox existe<l and that vaccination must be practiced, and also that
strict quarantine would l)e maintained over every person who
was afflicted with any disease even remotely resembling smallpox.
At this place we heard of an interesting story where a druggist
prescribed for smallpox. The patient appeared at the drug store

Digitized by VjOOQIC

522

broken out with the disease, and tlie energetic, live, business man
prevailed upon him to buy a bottle of Swift's Specific, a box of
cathartic pills and a box of ointment. It is hardly worth while to
remark that these remedies had no effect whatever, but the trans-
action is, nevertheless, interesting. While riding with Dr. Miller
two farmhouses were visited where typhoid fever prevailed. This
disease is quite prevalent in Noble County and Dr. Miller is mak-
ing a noble fight against it. It certainly is true that if the people
of this county would only take the advice of Dr. Miller to a greater
degree they would be richer, healthier and happier.

WINAMAC.
September 1 —

Early in ifarch I liad promised tlie County Suixirintendent of
Pulaski County that I would address the Teachers' Institute
which would l)e held in Septeml>or. On account of our appropria-
tion l>eing almost exhaiiste<l, I ad(lressed the Superintendent and
told him it would Ix^ iinjx>f«iblo for mo to attend, giving the rea-
sons why. After a delay of several days ho wrote, saying that my
expenses would be paid. iVccordingly I attended the Institute,
delivered a lecture upon ^'School Hygiene," and gave information
in regard to the State I^oard of Health and its workings. A
unanhnous vote of thanks was given me and X feel confident some
good was accomplished. At Winamac I met Judge G. W. Beman,
who occupied, the circuit Ivench for Starke and Pulaski counties.
I found him deeply interesteil in health matters and he requested
that I make an inspection of Wolf Lake, and also of the city of
Knox, and promised that my expenses would be paid. I accord-
ingly went to Wolf Lake, made a thorough inspection of this
beautiful sheet of water and offered some recommendations in
regard to drainage in the neighlvorhood, which the County Com-
missionei*s took under consideration. At Knox small|X)x was found
to exist, and what I thought to he proper advice and direction were
given in the matter. From there I went to Xorth Manchester, for
the authorities of that town hearing that I was at Knox, invited
me by telephone to come there. Smallpox had not yet appeared
at Xorth Manchester, but cases were known in tJie immediate
neighborhood. My advice to the authorities was that general vac-

Digitized by VjOOQIC

623

cination be provided for and urged upon the people. This advice
was taken and I have since learned that the majority of the people
at North Manchester have been vaccinated and, therefore, no out-
break of smallpox is likely to occur at tliat point.

LYNN.
September 4 —

Some two years ago the State Board of Health condemned the
schoolhouee at Lynn. At that time the Secretary made a visit to
the place and presented an exliaustive survey of the said school-
house, and it was upon said sanitary survey that the condemna-
tion was made. There was no opposition to the orders of the State
Board of Health and finally, this fall, a beautiful new schoolhouse,
sanitary in every particular, was ready for occupancy. I informed
the authorities at Lynn that I could not be in attendance at the
dedication because our funds were exhausted, and they promptly
offered to pay my expenses. Accordingly I attended the dedi-
catory exercises and made an address upon school sanitation and
its benefits. I think the State Board of Health is to be congratu-
lated upon having brought about this great improvement at Lynn.

FOWLER.

September 30 —

Smallpox appeared at Fowler about the middle of September.
A young man named Harrington, living at Eaub, but whose
parents resided at Fowler, came to the last named place on account
of illness. The disease proved to be smallpox and he was promptly
removed by Dr. Mavity, the Health Officer, to the pesthouse, which
the town had provided for just such an emergency. There was
considerable dispute among the people as to wliat the disease was,
very few of thorn l>eing ready to accept Dr. Mavity's diagnosis.
The fatlier of the young man telegraphed to this Board, asking us
to visit the place and decide as to whether or not his son was af-
flicted with smallpox. My reply was to the effect that we had no
money with which to pay expenses and therefore I could not come.
A return telegram was to the effect that he would pay said ex-
penses, and accordingly I visited Fowler. As alx>ve said, the case
was unquestionably smallpox and it was of rather severe type. The
family had all been vaccinated and placed under quarantine, and

Digitized by VjOOQIC

524

with Dr Mavity after visiting the son in the pesthouse, I calle<l
npon the family The father was perfectly satisfied with the ad-
Vice and help which were given him and paid expenses as he had
promised.

i wish to state for the purpose of record that during the quarter
numerous telegrams, letters and telephone m^essages have been
received requesting aid and advice from the State Board of Health.
To all of these the general reply has beea returned, namely : "We
have no money and we can not therefore perform the functions
which the statutes impose upon us." The correspondence has been
very large and of the usual character and it indicates that the peo-
ple have a deep interest in health affairs. They certainly are com-
ing to more and more imderstand that the sen^ices of the State
Board of Health are valuable to them.

Secretary Indiana State Board of Health:

Dear Sir— I desire to report the smallpox eouditious that I have found
in St. Joseph County. South Bend and Mishawaka are the only places
where smallpox is prevalent. Mishawaka has twenty-flve well-pronounced
cases, some of which are the very virulent form. South Bend had, when
I was there, two cases, both of them being very light. One death has
already occurred in the county, and 1 predict that two more will die of the
disease within a few days.

The situation has l>een admirably handled by the local Health Officers,
Dr. J. W. HiU, County Health Officer, and Dr. D. C. Dresch. City HeaJth
Officer at Mishawaka. Forty-two hundred vaccinations have been prac-
ticed in a community of sixty thousand people. All school children haye
been vaccinated, and about three thousand operatives in the various
factories. Ropes have been stretched in front of the infected houses, and
rigid quarantine has be en enforced and guards placed wherever smallpox
has occurred. There is a pesthouse about two miles from South Bend,
the St. Joseph County pesthouse. It has at present three patients in it;
one of these, I predict, wiU die. So far it is not well equipped, and I
have made suggestions to the County Board of Health, all of whom I have
met personally, that they should immediately provide necessary articles
for the care and maintenance. This pesthouse is situated near the
county poor farm, and is witliout proper sanitary arrangements. Water
must be brought from the poor farm well, which is only ninety feet deep,
from which about one hundred inmates at tlie iX)or farm use, and the
sanitary arrangements for their excreta are not at aU as would be de-
sired. 1 Lave suggested to the County Board of Health that they imme-
diately provide otlier arrangements, such as a proper cesspool and sewer-
age connections; also for the pesthouse. 1 also met the Auditor, who
realizes the situation of the county in the matter, and I believe that the
County Board of Health will furnish all of the financial aid that is neces-
sary to suppress the epidemic. In all 1 visited twenty-two of these

Digitized by VjOOQIC

625

twenty-seven cases in the county, and explained the necessity of prompt
and vigorous measures in the prevention of the spread and contagion of
the disease. NELSON D. BRAYTON,

Deputy Health Officer.

DISINTERMENT AND REMOVAL OF BURIED HUMAN REMAINS.

Mrs. Alice Dale, of Daleville, requested permission to remove
the remains of her child, dead of diphtheria, which wer^ buried
May 12, 1898, said remains to be simply removed from one ceme-
tery to another. The plea was made that her health was precari-
ous and she wanted to see her dead child buried beside her husband.
A special permit was granted by the Board to remove the remains
of the child in December.

HEALTH OFFICER AT SHELBYVILLE.

The question was raised, who shall be recognized as Health Of-
ficer at Shelbyville, pending a decision of the court. The dispute
was between Dr. T. C. Kennedy and Dr. Thoe. G. Green. After a
full consideration it was decided to recognize Dr. Kennedy.

BILLS TO BE PRESENTED TO THE NEXT LEGISLATURE.

The following bills, namely, one establishing a laboratory and
entitled "Laboratory," and one relating to quarantine, and en-
titled '^Quarantine," were studied for several hours and the follow-
ing forms adopted:

Laboratory.

A bin for an act creating a State Laboratory of Hygiene, providing an

appropriation for its establishment and maintenance, prescribing'pen-

alties, and rei)ealing all conflicting acts.

Section 1. Be it enacted by the General Assembly of the State of In-
diana, That a State Laboratory of Hygiene is hereby established as a de-
partment of the State Board of Health, the same to be under the control
and management of said Board.

Sec. 2. The State Laboratory of Hygiene shall be located in the State
House in Indianapolis, and basement room No. 10 is set aside for said
laboratory', and if In time more room is needed, upon application by the
State Board of Health, the custodian shall furnish the same.

Sec. 3. The State Laboratory of Hygiene shall be used for making
analyses of foods and drugs for the purpose of enforcing the pure food
and drug law; for making analyses, pathological examinations and studies
in hygiene and preventive medicine, and for no other puri>ose or purposes.

Digitized by VjOOQIC

526

AH work of the laboratory shall be done exclusively for the benefit of the
public.

Sec. 4. The Secretary of the State Board of Health, who is also State
Food Comniissloiier, shall be the director of the State Laboratory of Hy-
giene, and shall have power, with the consent of the State Board of
Health, to appoint and fix the salaries of all employes necessary for the
conduct of said laboratory, and for the enforcement of the pure food and
drug law, and he shall have power to discharge any of said employes for
cause, subject to the approval of the State Board of Health, and said dis-
charged employe shall have the right to appeal to the State Board of
Health.

Sec. 5. The State Board of Health shall have power to pass rules for
the enforcement of all health and all pure food and drug statutes, and
any one violating any of said rules shall be guilty of a misdemeanor, and,
upon conviction, shall be punished by a fine of not less than ten nor more
than one hundred dollars. Said rules shall be promulgated by being de-
posited in pamphlet form with the Auditor of each county, and, when so
promulgated, shall be in full force. A full account of all work done in
the laboratory and work done in enforcing the pure food and drug stat-
utes shall be published in the annual report of the State Board of Health.

Sec. 6. Whenever information is furnished by the State Board of
Health, or any other Board of Health, or any member, ofllcer or agent of
any such Board to any prosecuting attorney or to any city, town or
county attorney, showing violation of the health or pure food and drug
statutes, or any violation of any of the rules of the State Board of Health
within the jurisdiction of said attorneys, then said attorneys shall prompt-
ly bring prosecution as the law commands, but nothing herein contained
shall in any wise interfere with or prevent any prosecution for any offense
instituted in any manner which is now or hereafter may be pi-ovlded by
law.

Sec. 7. Five thousand dollars, or as much thereof as is found neces-
sai-y, are hereby appropriated for equipping the State Laboratory of Hy-
giene with all necessary apparatus, books and appliances, the same to be
paid out by certificates from the State Board of Health, and on presenta-
tion of such certificates the Auditor of State shall draw his warrant on
the State Treasurer for the amount certified; and all certificates shall have
attached itemized bills for their face amount, and any unexpended por-
tion of this appropriation shall revert to the general fund within sixteen
months from the going into force of this act. For salaries of the em-
ployes, maintenance of the laboratory, purchasing of food and drug sam-
ples, transportation and hotel exi)enses of those necessai*y to conduct in-
si)ections, and attend prosecutions, and for necessary incidental exi>enses,
ten thousand dollars per annum are appropriated.

Sec. 8. Any person or persons who shall violate any of the provisions
of this act, except as otherwise provided, shall be deemed guilty of a mis-
demeanor, and, upon conviction thereof, shall be fined in any sum not less
than ten nor more than one hundred dollars.

Sec. J. All statutes and parts of statutes in confiict with the provisions
of this statute are hereby repealed.

Digitized by VjOOQIC

527

Quarantine.

An act to provide for the restriction of dangerous communicable diseases,
prescribing penalties and repealing all conflicting acts.

Section 1. Be it enacted by the General Assembly of the State of In-
diana, That any physician called upon to attend a sick person, and who
finds the cause of such sickness to be of a contagious or Infectious char-
acter, or If the disease is ordered to be reported in the rules of the State
Board of Health, such physician shall immediately report the facts to the
Secretary of the Board of Health having jurisdiction.

Sec. 2. Whenever any person knows or has reason to believe that any
member of his family or household (boarder, roomer or visitor) has either
smallpox, diphtheria, membranous croup, scarlet fever, measles, or any
other communicable disease listed In the rules of the State Board of
Health, he shall within twenty-four hours from the time the existence of
the disease is known, if no physician Is in attendance, give notice thereof
to the local officer of the town or city in which the disease occurs, or the
Comity Health Officer if the case is without the corporation of cities or
towns, and such notice shall be given either verbally or by written com-
munication mailed or delivered within the time specified.

Sec. 3. The Health Officer having jurisdiction, upon being notified
in any way oi the existence of either of the four diseases named in Sec-
tion 2, or of other diseases which are or may be listed in the rules of the
State Board of Health, shall immediately, in person or by deputy, quar-
antine the infected house, rooms or premises, so as effectually to Isolate
the case, and the family if necessary, in such manner and for such time
as may oe necessary to prevent transmission of the disease; and, whenever
a house, tenement, or room is placeil in (piarantine, a placard shall be
posted In a consi>Icuous position, giving the name of the disease In letters
not less than two inches long, and also containing the following quaran-
tine order: **A11 persons are forbidden to enter or leave these premises
without special permit from the Health Officer having jurisdiction, and all
persons are forbidden to remove or mutilate this card without orders from
said Health Officer, and, when visiting persons afflicted with smallpox,
diphtheria, membranous croup, scarlet fever or other infectious diseases
named in the rules of the State Board of Health, all physicians and Health
Officers shall take such precautions as are directed In the rules of the
State Board of Health covering this matter. The penalty for violating
any of the provisions of this section shall be ten dollars tine or imprison-
ment for ten days, or both, as the court decides."

Sec. 4. Immediately after the recovery or death of any infected per-
son or persons, the Health Officer having jurisdiction shall cause the in-
fected premises to be thoroughly disinfected and cleansed according to the
methods prescribed in the rules of the State Board of Health, after which
the said premises shall be released from quarantine.

Sec. 5. No parent, guardian, peraon or persons having the custody
of any child shall permit such child, If infected hvith any communicable
disease, or if It has been exposed to such, to attefcd any public or private
school, or appear in public in any way, and all school teachers, public, pri-

_ Digitized by VjOOQIC

528

vate or parochial, shall exclude from their schools all such children unless
a written permit is given by the Health Officer having jurisdiction.

Sec. G. It shall he the duty of the Secretary, or a representative of
all Boards of Health, to attend a meeting of the State Board of Health,
when requested by the latter, for consultation or conference concerning
the restriction and prevention of contagious and infectious disejises, or
for the consideration of other important sanitary matters, and the expenses
of the delegate shall be paid by his Board.

Sec. 7. It shall be unlawful for any person having pulmonary tuber-
culosis to be employed as a teacher in any public, private or parochial
school, and the State Boara of Health, any (bounty Board of Health and
any local Board of Health, or a majority thereof, shall have power to re-
move, or cause to be removed, from any hotel, boarding house, boarding
school or other building of like character, tenement or apartment houses,
to a i)r(>per place designated by such Board, persons sick with any conta-
gious, infectious or pestilential disease, and such Boards shall also have
power to remove, or cause to be removed, to a proper place to be so desig-
nated, all things and articles witliin the jurisdiction of such Boards,
which, in their opinion, shall l)e infected with any matter likely to com-
municate disease to the inhabitants of any county or other nnmicipality
of tuis State, and said Boards may destroy, or cause to be destroyed, .such
articles and things, when in their opinion the safety of the public health
recpiircs it: Provided, however. That no person sliall be removed under
this act. except after examination and determination »])y two physicians
in good standing and practice that such [jcrson is sick with a contagious,
infectious or iiestilential disease. The Boards of Health above mentioned
may. by resolution, delegate the authority herein conferred to any Health
Officer in the employ of such Boards.

Sec. 6. Whenever a Health Officer shall know or su8i)ect or be in-
formed of the existence of any communicable disease dangerous to the
public health, and there be no physician in attendance, or should any
physician while in attendance fail or refuse to Immediately report such
case to the Health Officer, it shall l)e the duty of said Health Offi<'er, or
deputy, to examine such case or casps of alleged communicable disease
dangerous to the public health, and act as required by the rules governing
such cases of communlcal)le diseases.

Sec. 9. In all cases of death from cholera, bubonic plague, leprosy,
typhus fever, yellow fever, smallpox, diphtheria, membranous croup,. scar-
let fever and cerebrospinal meningitis, the funeral shall be strictly pri-
vate, and the burial shall be made within twenty-four hours after death.
Xo public or church funerals shall be held, or any person permitted to enter
the house containing the renmins, excepting the undertaker and his as-
si.stants. unless by permission of Health Officer.

Sec. 10. All trolley or steam cars or other public conveyances which
are known to contain the Infection of any disease, or any such cars which
may reasonably be supposed to contain such infection, shall, upon order
of the State Health Officer or any Health Officer in whose jurisdiction the
infected car may be found, be disinfected according to the rules of the
State Board of Health, and the cost of disinfection shall be paid by the
company owning said car.s. If at any time any city, town or region is

Digitized by VjOOQIC

^ 529

uhder quarantine, all trolley and steam railroad companies passing through
any such quarantined city, town or region shall obey the quarantine or-
ders of the State Board of Healkh which are issued for the purpose of
l>reveuting the spread of infection. Each violation of such orders fehall
be c separate offense, for which a tine of one hundred dollars shall be
assessed.

Sec. 11. Tlie expenses incident to disease prevention shall be paid by
the cities and towns in which the work may become necessary, and, when
without the corporation of cities and towns, said expenses shall be borne
by the county. If at any time the authorities of any county, city or town
fjii?, neglect or refuse to enforce the statutes and the rules of the State
Hoard of Health for the restriction of dangerous communicable diseases,
then the State Board of Health, if in its opinion it becomes necessary,
shall take charge and enforce the law and the rules, and all expenses shall
be paid by the county, city or town in which such enforcement becomes
necessary.

Sec. 12. Any person who violates any provision of this act, or any
rules or regulations of. the State Board of Health for the enforcement of
this act, except as otherwise provided, shall be punished by a fine of not
less than ten nor more than one hundred dollars.

Sec. 13. All acts and parts of acts inconsistent with this act are hereby
rep**aled.

The manuscript, of the Annual Ik^jmrt for IDOl was revieweii
and (liscMi^sed and finally approved, and it was

Ordered, That the manuscript of the Twentieth Annnal Reix)rt,
as amended and approved, he sent to the Printing Board.

REPORT FOR 11)02 ON STATE MEDICINE AND HYGIETsE.
By J. N. HuRTY, M. D. , Indianapolis.

State Medicine. Tlie Legislature has not lx>en in session since
the last report was made, and therefore there are no changes to
record in the various laws relating to State Medicine. There has
heen some litigation in the lower courts in various parts of the
State under the ^fedical Law, the Phannacy Law, Food Law and
liealth Law, but not under the Dental Law. The Supreme Court
has made final decisions in two instances under the Medical Law,
in one instance under the Food Law, and in tw'o instance:^ under
the Health Law, as follows :

Hurley vs. Eddingfield. This case came from Montgomery
County. Dr. Eddingfield was applied to to render medical service
to Mr. Hurley, who proffered the usual fee. Dr. Eddingfield
refused to respond, giving no reason for refusal. The suit was

34~Bd. of Health.

Digitized by VjOOQIC

530

by the heirs of Hurley and for $10,000 damages, they alleging that
Hurley's death was due to the refusal and neglect of Eddingfield.
The court decided that there is no obligation on the part of phy-
sicians to enter into a contract contrary to their will. In other
words, physicians do not have to treat the sick unless they want to,

Baker vs. Hancock. In this case Henry W. Baker sued Dr.
George S. Hancock for damages on account of malpractice and
wrong diagnosis, and is interesting as deciding the legal status of a
specialist. The complaint was upon the hypothesis that Dr. Han-
cock did not exercise that degree of skill required of his profession.
Xo charge of unskillfulness or lack of education was made in the
complaint. In the lower court the decision was in favor of the
doctor, but the Appellate Court revereed. In its judgment the court
says:

'^It is averred in two paragraphs of the complaint that the ap-
pellee Svas making a specialty of the treatment of cancer, and held
himself out to the public as a specialist in the treatment of said
disease of cancer, by advertising in the public press and by other
public notices thereof.' A specialist, as the term is here used, is
understood to mean a physician or surgeon who applies himself
to the study and practice of some particular branch of his pro-
fession. Scientific investigation and research have been extended
and prosecuted so persistently and learnedly that the person af-
fected by many forms of disease is of necessity compelled to seek
the aid of a six?cialist in order to secure the results thereof. The
local doctor, in many instances, himself suggests and selects the
specialist whose learning and industry' have given him a knowledge
in the particular line which the general practitioner, in rural com-
munities especially, has neither time nor opportunity to acquire.
Small vs. Howard, 128 ifass. 131. Being employed because of
his peculiar learning and skill in the specialty practiced by him,
it follows that his duty to the ]>atient can not be measured by the
average skill of general ])ractitioner8. If he possessed no
greater skill in the line of his spcH?ialty than the average physician,
there would be no reason for liis employment ; possessing such addi-
tional skill it becomes his duty to give his patient the benefit of it.
The appellee, if he held himself out as a specialist in the treatment
of cancer, was bound to bring to the discharge of his duty to

Digitized by VjOOQIC

531

patients employing him as such specialist tliat degree of skill and
knowledge which is ordinarily possessed by physicians who devote
special attention and study to the disease, its diagnosis and treat-
ment, having regard to the present state of scientific knowledge.
This is the degree of skill which, by holding himself out as, a
specialist, he represented himself to have; and it does not lie with
him to assert, after securing employment and compensation on
that basis, that his representation was not true. The instructions
given by the court upon this subject did not correctly express the
law\ The judgment is reversed and cause remanded, with in-
structions to sustain motion for a new trial and furtlier proced-
ings consistent herewith-"

MARTIN VS. BOARD OF COMMISSIONERS OF MONTGOMERY

COUNTY.

Appellate Court, June 18, 1901.

This case is of interest to physicians, for it decides that the
Secretary of a County Board of Health can not employ physicians
in the name of the county for health work, nor can he directly
abate nuisances, for both of these powers belong to Boards of
Health and Secretaries are simply executive officers. Physicians,
in order to collect at law for services rendered a county, must sliow
a valid contract with the Commissioners, or must show a law pro-
viding for such sei-vices and providing comi>ensation.

State vs. Beil, 157 Ind. 25. In this case the Board of Health
of Bluifton had ordered, as a health measure, the School Board to
have all the school children vaccinated, upon penalty of exclusion
from school. The School Board refused to act and mandamus pro-
ceedings w^ere brought in the Wells Coimty Court. E. C. Vaughn,
Judge, refused to issue a mandamus and the Supreme Court de-
cided that he erred and commanded that the mandamus \ye issued.
This does not dox^de, since the passage of the I^outtit amend-
ment to the school law, that Boards of Health have power to en-
force tlie vaccination of school children, for this decision comes
under the old law before the passage of said amendment. It will
be necessary to have yet anotlier case before the Supremo Court to
settle the status of the Louttit amendment.

Digitized by VjOOQIC

532

Isenliour vs. State of Indiana. This case was appealed from
Marion County to the Supreme Court and the judgment of the
lower court was sustained. This case involved the question whether
or not the legislature could give the power to the State Board
of Health to pass rules and ordinances fixing food and drug stand-
ards and specifying adulterations. In regard to this matter the
court says :

*"'The law says the State Board of Healtli ^shall prepare rules
and ordinances when and where necessary, regulating minimum
standards of foods and drugs, defining specific adulterations and
declaring the proper methods of collecting and examining drugs
and articles of food.' From this provision it is agreed that in
substance this is an attempted delegation of legislative povA^r to the
State Board of Health. TTie obvious purpose of the provision
last quoted was to commit to a Ixxly of learned and scientific ex-
-perts the duty of preparing such rules, and prescribing such tests
as may from time to time, in the enforcement of the law, be found
necessary in determining what combinations of sul)stances are in-
jurious to health, and to what extent, if at all, adulterations, or
deteriorations of foods and drugs, may go without injurioi^ly
affecting the health of the consumer. That which is required of the
State Board of Health has no semblance to legislation. It merely
relates to a procedure in the law's execution for a reliable and uni-
form as(»ertainment of the subjects upon which the law is intended
to operate.

PROGRESS IN SANITARY SCIENCE.

The progress of sanitary science for the past year has kept pace
with previcms years. The most prominent advance is the final
proof in Havana, by dcvstroying mosquitoes and their larva, that
yellow fever may be controlled. That yellow fever is distributed
solely by insen^ts, principally mosquitoes of a particular variety,
namely, Stegomyia fasciata, has been further proven by exact ex-
jx^riments conducted in Cuba by Drs. Walter Reed, Jas. Carrol
and Aristides Agramonti.

Digitized by VjOOQIC

633

SANITARY CONGRESS.

The International Sanitary Congress, in session in the City of
Havana, February 15*to 20, 1902, advocated the formation of anti-
leprosy leagues, under the patronage of the government therein
represented, with the object that the people be educated in every
possible way of the progress that the disease is making and the
methods of preventing its increase.

The Congress further advocated that knowledge concerning how
malaria is propagated should be spread among the people, and
especially should it be imparted to school children. It was also
advocated that tlie American Republics establish leagues against
tuberculosis similar to tliose existing in some of these Republics
and in the Island of Cuba, with the object that that with a imite<l
effort, the propagation of the disease would be diminished. .

SCHOOL SANITATION.

The medical inspection of school children for the purpose of
eliminating those who are diseased and thus prevent school epi-
demics, is no longer ccmnted an experiment Its efficacy is thor-
oughly proven and it now remains for those school authorities who
desire to save school moneys and promote the public happiness to
install as quickly as may be, the medical inspection of school chil-
dren. At no place in Indiana is medical inspection of school chil-
dren practiced, but there is great progress in the matter of erecting
sanitary schoolhousos. To aid all that is possible in this most
important matter, the State Board of Health has had plans and
specifications prepared for a one room sanitary schoolhouse, and
these are furnished, free, to all trustees who will accept them.
At this date 33 of these plans have been distributed. There is no
nee<l for delaying in this work, and it is therefore recommended
by your committee that a law should l)e passed reipiiring that
all scho()lh()Us<\s built after the going into effect of the law shall
conform to all sanitary re<|uirements, and said requirements should
l>e carefully laid do\\Ti in the law. Such a law could be made self-
enforcing by simply adding a section making invalid all bills in-
curred by authorities in constructing buildings which did not con-
form to the legal requirements. The urgent necessity of such a

Digitized by VjOOQIC

534

law appears from the fact that many schoolhouses exist where the
children have their feet frost bitten while sitting at their desks in
schoolhouses, where also bad lighting and bad ventilation cause
malnutrition, nervous disorders and diseases of the air passages.
Probably 60 per cent of the schoolhouses of Indiana are so un-
sanitary as to cause a loss of 20 per cent of the school moneys,
inasmuch as these unsanitary buildings, through their depressing
and ill-health causing influences, prevent study and progress of
the pupils.

HEALTH OF THE STATE.

The State Board of Health now secures very accurate mortality
statistics, but the morbidity statistics are as yet very imperfect
In order to secure a more or less reliable expression of the extent
of illness, the State Board of Health sends each month to every
county, what are called disease prevalence cards. These cards are
filled and returned by Health Officers and the information thus
gained, taken together with the facts concerning deaths, furnish
a means of determining the health of the State. In 1900 there
were reported 35,453 deaths, a rate of 14.08 per 1,000. In 1901
the reports gave 36,544 deaths, a rate of 14.52. By this com-
parison, there being 1,091 more deaths in 1901 than in 1900, the
health of the State was therefore worse in the former year than in
the latter. But this is subject to error, for it is plainly possible to
have an increase in total sickness with a decrease in deaths as be-
tween certain periods. In this instance, however, the morbidity
data for the two years shows more sickness in 1901 than existed in
1900. The two sources of information, therefore, force the con-
clusion that both sickness and death were greater in 1901
than in the preceding year. The following table shows the total
deaths, rates and classification according to the Bertillon system.

Note.— The table referrcni to will be found on page 125 of the report for
1001.

SMALLPOX.

The most prevalent, highly infectious disease since the last
report, excluding tuberculosis, pneumonia and diarrhoeal diseases,
was variola. One year ago attention was called to the fact that
many physicians were unable to diagnose atypical smallpox, and
persisted in calling it ehickenpox, even when it became virulent

Digitized by VjOOQIC

635

and typical ainoiig adults. It thus happens that probably as many
cases of variola escaped being rej)orted as were reported. The total
number of cases reported for the twelve months ending April 30,
1902, was 8,664, or an average of 722 in each month. The total
deaths reported as directly due to smallpox was 21, making only
0.24 per cent. There is much evidence pointing to the conclusion
that not a few smallpox deaths were reported as due to other
causes, and it is also known that many cases of smallpox were
complicated with pneumonia, and so smallpox was the chief but not
the immediate cause of death. For the reasons given, the real ex-
tent and mortality of this disease in Indiana will never he knovm ;
and our records nlu^it simply say, smallpox, mostly in a typical
form and mild, with astonishingly low mortality, prevailed
throughout the year. The disease has, however, cost the people
enormously. When in severe form, which was probably in about
16 per cent, of the instances, the patient lost not less than three
weeks' time, and in liundreds of instances townships have been
called upon to furnish medical attendance and necessary supplies.
Added to this is the lo*^ to business on accmmt of alarm, and also
the cost of imposing quarantine and disinfection. At the lowest
estimate the co^t to the State could not have b(»on less than
$2,000,000. With rare exceptions the health authorities have not
had the support of the people in the efforts put forth to stay small-
])ox. In only eight counties (uit of the 65 invaded has it. Ix^en
possible to secure appropriations from the County Councils, to 1)0
used for fighting infectious' diseases. The greater proportion of
citi(^ and towns have acted promptly in furnishing means for
putting out the fire, but a few, suflFering from stupid government,
have done nothing. The State Board of Health has l>een called
upon for aid and dircK'tion 270 times, but it has such meager
funds, and there being only one State Health Officer, it has only
been ]x>ssible te reply in most instances by letter and with a few
smallpox circulars. Had a few thousand dollars l>een avaihible
for fighting smallpox when it first a])peare(l, and had the people
lent an attentive ear to wholo.-onie preventative instructions, fully
one million and a half of the two millions of dollars lost could
have been saved.

Digitized by VjOOQIC

536

TUBERCULOSIS.

Far worse, and far more expensive than smallpox, is the ever
present white plague. In 1901 this awful disease caused 4,645
deaths. Of tliis number 3,364 were from the pulmonar^^ form.
The following table shows the deaths from all forms of tubercu-
losis for 1900 and 1901 :

TRRRUCUL0BI8 Ov

Lniigs

Meninges

Peritoneum . ,

Skin

Other organs.,
General

Total tuberculosis deaths

Total deaths from all causes .

1900.

3,864
173
1()9

127
872

4,645

a5,516

133.6
6.8
4.3

6.0
34.6

184.3

142.0

1901.

4,1

153
187

60
79

4,648

36,544

163.5
6.7
7.4

"2;4"
3.1

179.'

145.2

It appears from the alx>vo figures that in 1900 18.07 per cent,
of all deaths was from tul>erculosis, and in ItTtOl the i>ercentage
was 12.55, or expressing the conditions in another way, tubercu-
losis caused one in every 7.6 deaths in 1900, and one in every 7.9
in 1901.

The second table shows the deaths by months for the two years.

January . .
February .

March

April

May

June

July

August . . .
September
October.. .
November
December .

1900.

1901.

300
300
318
339
266
301
244
271
212
274
248
291

117

417

122

422

136

454

116

455

139

405

394

138

382

121

392

131

343

366

316

108

399

368
390
388
408
378
310
349
354
266
302
321
335

20
49
42
40
39
37
44
49
43
47
35
34

388
439
420
448
417
347
393
403
309
349
356

Digitized by

Google

537

In both years April shows the most deaths from pulmonary
tuberculosis, and the total deaths from all forms of tuberculosis
were also greatest in April. September shows the least number of
deaths from the pulmonary fonn in 1900, and October the least
in 1901.

The third table shows the deaths for the two years from pulmo-
nary tuberculosis by ages.

PULMONARY TUBERCULOSIS BY AGES FOR THE YEARS
1900 AND 1901.

Ykah.

*»

•4

1 1

1 '

asa m vm' iss

•ai. m\ m w

i3i! n3
182^ m

1116

m 29
73 m

4fi'3W

4)^1 i,im

Tliis table shows that deaths from tuberculosis begin to rise
rapidly at 15 years of age and reach a climax at 25. From 27
to t30 it is almost e<iually d(»struetive and begins to decline at 45.
The fact that the disease causi^ the most deaths from 20 to 25
indicates that school life, which is just over, is a causative factor.
Foul air being the first and greatest cause of consumption, and
as so many schoolrooms have foul air from lack of ventilation, it
secerns reasonable to believe that the schools play a not insignificant
])art in producing consumption.

There is no State hospital or sanatorium for consumptives in
Indiana. The facts and arguments for such an institution are over-
whelming. There are 1,013 toAvnshii>8 and 95 poorhouses in the
State. There is an average of two consumptive patients in each
j^Kjrhouse, a total of 190. On the average there is one consumi>-
tive in each township being cared for by township relief. At the
lowest estimate, therefore, there are 1,200 consumptives being cared
for all the time in Indiana. Every one of the patients will die,
will \ye buried at public expense, and will infect the house he
occupied. If the deceased is a parent, children will almost cer-
tainly l>e left to be cared for at the public expense. If all of these
were cared for at a State sanatorium, 25 |)er cent, w^ould be cured
and preserved to their families.

As to sex, the pulmonary tuberculosis deaths are divided as
follows: Alales, 1,705; females, 2,404. The percentages are.

Digitized by VjOOQIC

538

females, 59 per cent. ; males, 41 per cent. Of the females who
died of pulmonary tuberculosis in. 1901, 1,353 were between the
ages of 15 and 35. Eighty-two per cent., or 1,109, were mothers.
Counting an average of two children to each one, there was, there-
fore, produced by tuberculosis in 1901, 2,218 oq)lians, and many
of these have l3ecome public cliarges. This pliase of the tubercu-
losis question is certiiinly most important, for the necessary mak-
ing of orphans is bad business.

To this date no society for the pi-evention of tuberculosis has
been organized in Indiana, but the State Board of Health, the
Allen County iR^lioal Society, the Huntington County Medical
Society, the Clarion County ^ledical Society, the Wayne County
Medical Society and the Delaware County Medical Society, have
all urged through official resolutions that a State sanatorium for
indigent consumptives Ix^ established by law.

TYPHOID FEVER.

Typhoid, the fifth disease, caused 1,198 deaths in 1901, and by
lowest estimate thei'o were 15,000 cases. Large as the figures are,
they record an impruvenient over the prcx-eding year, when there
were 1,320 typhoid deaths, and at least 17,500 cases. We think
it probable that this disease will continue to decrease, for the
people are now quite generally alive to the fact that the infection
is borne to them in water. The fact that typhoid is water borne
was at first the target of paragraphers, and tlie exponents of the
truth were tenucd cranks; but now all know the tnith, and by this
standard, all are cranks.

The State Board of Kealth each month sends to those houses
which have suffered death from typhoid fever a pamphlet upon the
sul)j(»et, which givc^ an account of the cause of the disease and
its prevention in plain language.

DirHTIIEHlA.

The <li])htlieria deaths are decreasing. Tn 1900 this disease
cau.-ed Osd ch^atlis, and in 1901 the number fell to 554. This is
a decrease of 19.2 per cent. It is likely the greater proportion of
this decrease is due to the increasing use of antitoxin, but some
of it is certainly due to better care of children by parents, and

Digitized by VjOOQIC

539

gi'eater care in the schools. By ages, diphtheria was most destruc-
tive in 1901 between 5 and 10, and IsTovember was the most fatal
month.

MISCELLANEOUS 1901.

The three well-known children's diseases, namely, whooping-
cough, measles and scarlet fever, killed a total of 491, as follows:
Whooping-cough, 181 ; measles, 161 ; scarlet fever, 181. The most
feared of these maladies, scarlet fever, was the least fatal. Cancer
as a cause of death is close to typhoid fever, as there were 1,165
deaths from cancer and 1,198 from typhoid fever. Diabetes caused
204 deaths, acute articular rheumatism 103, and anaemia and
chlorosis, 789.

Diseases of the nervous system and organs of sense caused a
total of 4,494 deaths.

Diseases of the circulatory system caused 2,328, and diseases of
the digestive system caused 4,585. It is probable that less strenu-
osity of life would reduce the deaths from the above causes.

Lastly, old age caused 1,265 deatlis, which is only 3.4 per cent,
of the total.

Digitized by VjOOQIC

REPORT

Conference of Health Officers

Held at Indianapolis, Ind., April 25, 1902.

(HI)

Digitized by VjOOQIC

REPORT OF CONFERENCE OF HEALTH
OFFICERS.

Tlu^re were present at the conference, besides the Healtli Offi-
cers of the counties and some of the larger cities of Indiana, the
President and Secretary of the Stxite Board of Health of Ohio,
and the President. and Secretary of the State Board of Health of
Kentucky.

The meeting was called to order by Dr. J. N. Ilurty, Secretary
of the State Board of Health of Indiana.

Dr. Hurty : I think you all understand from the circular that
we were to do without a set program this year, and make the
(»entral object of the conference the discussion of smallpox. I
regret that the Secretary and President of the Illinois State Health
Board can not l>e with us. They were invited to attend, but were
unable to come.

I propose, if it is the wish or will of the conference, that we call
one of our liumber to the chair and start the discussion. Here is
a program which will be distributed. I move that Dr. Bence, of
Putnam County, take the chair. The motion \vas seconded^ and
carried, and Dr. Bence took the chair.

Dr. Bence: The l)est we can do is to call for discussion on the
topics that we have here. The first topic is:

'^Tlie Present Epidemic of SmalliK>x; Its Extent and (\mtinu-
ance."

We would like to have some one who is informed start the dis-
cussion on this subj(K't. T think Dr. Hurty had In'tter start it.

Dr. Hurty: I woidd very much prefer to hear some one else
on that subject. I think Dr. Probst, S(H,Tetary of the State Board
of Health of Ohio, is the best informed man on that subject of any
one I know.

(5«) Digitized by Google

544

Dr. Probst: If Dr. Hurty will kindly give us something on
the extent of the present epidemic, I will give some account later.

Dr. Hurty : I am not well prepared. We do know that small-
pox appeared in the United States shortly aft^r the return of the
soldiers from Cuba. Exactly where it started I have been unable
to learn, but think it was in the South somewhere. I remember
that Dr. Benjamin Lee, Secretary of the State Board of Health
of Pennsylvania, predicted the coming of this smallpox, and he
even went so far as to say that it would probably start near the
mouth of the Mississippi Iliv^r, follow the course of the Mississippi
north and then strike up the Ohio River, and with that beginning
spi^ad well over the United States, he could not tell how far. It
was a rather remarkable prophecy, for, if I am correctly informed,
it was fulfilled almost completely. I do not know that the first
smallpox appeared in Mississippi, but I do know that very early
in the history of the invasion it appeared there, and that it did
come up the great waterway, and appeared in Indiana and Ohio
almost sinmltaneously. In the beginning the correct diagnosis
was not made down there, just as was the case in Indiana, and
in fact in all the States whei'e it has appeared ; and it was not until
a few deaths had occurred and the disease manifested itself in
the most pronounced form that all people agreed that it was small-
pox. That is something to be remarked upon. I understand it
was in that region where the term "Cuban itch" was first applied
by the ignorant negroes of the soutli; and it seems strange that
an educated profession like medicine should have seized upon that
nomenclature so swiftly and used it so extensively as it did. It
ficrved a certain purpose, and that was to blind us to what smallpox
really was for a long time. I have heard the term "Cuban itch"
used within the last forty -eight hours.

Well, as predicted, the disease marched straight up the great
ilississippi, and it spread west and it spread east. Some of the
cases, of course, came on the Atlantic scal)oard and all along on
the Gulf Coast, but they seem to have becMi the pronounced cases.
The first known and marked case ai)pcared in Indiana in January
of 1S90. I think it appeared in Ohio before that time, sometime
in 1S08.

J)r. Prol)st : It aj)|x*ared in Ohio in April of 1898.

Digitized by VjOOQIC

Dr. Hurty: The first case that was positively recognized in
this city appeared during the session of the Legislature in January,
1899. We found out afterwards that it had been prevailing in the
southern counties eight months or possibly a year earlier than
that. It is now in almost every State in the Union. Those who
receive the ifarine Hospital reports, have probably kept track of
it. One State after another has l)een invaded, and one part of the
State after another. By the last Marine Hospital report we find
tliero were more cases and a greater area covered by the disease
in March than ever Ix^fore. I know that in Indiana we have had a
steady increase of the disease. We have been getting better re-
ports all the time, but not perfect reports, and I am inclined to
believe we Avill find it in its nonrecognizable forms in almost every
county in the State.

I have given you about all the information I have, namely, that
it is all over the country; that it is very abundant; and that the
^farine Hospital reports show that it is on the increase, and the
re]X)rts of Indiana show that it is on the increase. Its extent is
very great, and its distribution is quite comparatively even. Over
at Plainfield, Ind., yesterday, was discovered a remarkable in-
stance. I have just made the statement that possibly the disease
is in all the coimties of the State, and I have much information
and many facts in my possession upon which to base that statement.
I was speaking of the Plainfield case. About six weeks ago a
colored boy came there from Grant County. He was sick for a
couple of days, vomited a little, had headache and a little fever,
that a few inconsequential eruptions; that was all. He was dis-
missed from the hospital. Dr. Carter attended him, and I think
no one could have told that it was a case of smallpox. Now, within
eigliteen days from that time the boys have gone down by the twos
and threes. Yesterday when I was there two boys wei-e brought
in suffering with headache and backache. Others were already
broken out with snuill|X)x, one in the pustular stage. Wo now
think the epidemic came from the first case mentioned. The other
castas are verv like it, only more intensified. The only mistake that
was made there was in not having all the boys vaccinated. That
was not the fault of the physician, however.

Smallpox is going to continue until every bit of combustible

36-Bd. of Health.

Digitized by VjOOQIC

646

material is burned up. I don't see how it can be otiierwise.
Ninety rfive per cent, of the susceptible persons must have this
disease. It will not leave the State until that happens. Of course
you know there are two ways of becoming immune — three ways,
possibly. There are some who have natural immunity. Those
who have had the disease will be more or less immune, though some
people may have it twice or three times, just as a vaccinated person
may have it in a mild form. Those, however, are rare cases.
But the country. must gain immunity from having had the disease
or from vaccination. I know of no other way in which it can be
stopped. So I confidently predict that it will continue until the
conditions outlined exist; that is, until all have received protec-
tion, either by vaccination or by having had the disease.

Dr. Stanton, President State Board Health of Ohio: The
disease had prevailed for some time l>efore the war was declared,
or had prevailed for some time in Ohio before our soldiers were
near Cuba. The disease began in one of the Southern States before
any soldiers were sent to Cuba ; before that time they had had cases
in Alabama. The first case in Ohio was in the town of Carroll. A
man was brought there who had traveled in the Southern States.
The next outbreak was at Put-in-Bay, in one of the hotels there.
The disease was brought there by negroes who had been brought
from North Carolina. The next outbreak in our State was among
the inembcrs of a traveling show; there were negroes from the
South in the company. We have had at least three different out-
breaks in Ohio, coming all of them from the South, and all of them
Ix^foi-e the soldiers returned from Cuba. The name of "Cuban
itch" was given it after the disease had prevailed for some time.
Tlie disease was extremely mild from the first case, as it had been
in the South. The reason why smallpox diagnosis was not given
to it was because it was so mild. The disease had existed for a
year before war with Spain was de(jlared. I think the source or
origin of this disease can not be traced to Cuba.

Dr. Probst, Secretary State Board of Health of Ohio: The first
outbreak in Ohio was very interesting to me, as it was the first
contact I had with this form of smallpox. As stated by Dr. Stan-
ton, a man who had been traveling in the South came back to a
little village and was taken sick. The attending physician pro-
Digitized by VjOOQIC

547

nounced the disease "black measles." Four or five young children
in the family contracted the disease from him. Those cases wepo
diagnosed as chickenpox. The children were not sick enough, to
go to bed, and the physician, who was a very capable physician,
could not comprehend that these were cases of smallpox — ^neither
could I. But from those children an adult contracted a severe case
of smallpox.

The extent of this first introduction of the disease into Ohio,
as we have had it reported to us, is between twelve and thirteen
thousand cases since April, 1898. It has visited all of our coun-
ties. During the last three months we have had about 840 cases
reported in the State. I would put some emphasis on the word
reported, because I have every reason to believe there are a great
many cases that are never reported. It is our constant experience
to bo called upon to investigate smallpox, and when we try to trace
it backward we find that probably it has been prevailing in a
community for two or throe months under some other name. It is
a condition we have to consider in making up our minds as to what
is likely to be the extent of the spread of this disease. I feel cer-
tain the disease will continue. I know of but one remedy that
could apply to the present situation, and that is the remedy of'
general vaccination. I think, as far as Ohio is concerned, it is
a remedy that can not bo applied. The people will not be vacci-
nated. Ordinarily when smallpox prevails in its severe form, and
the people arc dying here and there, it is not a difficult matter in
that particular eonununity to secure quite general vaccination; but
with the present form of the disease it is practically impossible to
got a very large per cent of the people to be -vaccinated, so I think
we can look for a continuance of the disease for many years to
come.

I noticed recently the report of the Tennessee Board. I was
sur])rised at tlie largo number of cases ro|X)rted in that State.
For the year ending February 19, 1902, there had been 13,106
cases, with I think 2TG deaths in the State of Tennessee; more
cases in that one year, I think, than we have since the epidemic
l)egan in Ohio.

T)r. Cowing, Muncie, Ind. : The fact is very evident, I think,
to all of us that we are facing quite a problem today in the small-
Digitized by VjOOQIC

548

pox situation. From our own experience at Muncie and in Dela-
ware County in the last twelve years we believe that smallpox
has come to stay. It comes in upon us from various points of the
compass, and after we have stamped it out in our own county,
it comes in again from adjoining counties. Not long ago Dr.
Spickerman, our City Health Officer, had to deal with a case, that
came from Tennessee, in a colored family. Shortly after another
case developed in the western part of our county. This case came
from IS'ehraska. A young man came into the city on th^ inter-
url)an cars with a well-developed case of smallpox. We isolated
liim and stopped the disease at that point. Not long after that we
found some cases that came do\\Ti from anothei' part of the State.
The history has l)een with us locally that the disease comes in
u]>on us from all (piartors. In spite of all our precautions we find
the same infernal disease that in 1893 killed twenty-three people
out of 150 \vlio had it, creeping into our midst. As I have said,
in some instances, to those who think it is nothing but some mild
trouble, if we look closer we see the claws of the beast in every
case. We can see the same old features every time; they are a
little disguised, but they are there, and they have come to stay.

It seems to me that until we can train public sentiment and
train physicians to diagnose the cases we will have to encounter
the disease. It seems to me that a school for physicians where the
diagnosis of this particular disease might be presented to them,
in the form it is now appearing, should be established. It would
be a great help to the physicians in localities where they have not
roco«riiizod it. But a few days ago Dr. nurty came to our city and
greatly aided us in making a diagnosis for five physicians in one
locality where I was unable to convince them we had smallpox,
and ])lonty of it. Until those physicians wore convinced, nothing
cotdd be done to get their co-operation. This is doubtless the ex-
])ericnco in ether States. I believe this disease will continue until
wo liav(» convinced physicians that we have the disease we had
years a^o that killed so many of our |)eo])lo, only it is in a milder
form. In our county we are well prepared to handle smallxx)x.
The opidoniic of 1893 cost the city a great deal of money and did
a aroat <loal of damage to business in general. I think this pon-
f( n nro to consider the future spread of tlie epidemic is verv' timely

Digitized by VjOOQIC

540

and very important, and it certainly gives me great pleasure to meet
Dr. Stanton, who is one of my old professors, and Dr. Probst, whom
I have met in the State Board of Health of Ohio.

TOPIC No. 2.

^^Shall the present epidemic be dealt with as radically as if the
(loath rate was 15 per cent?

Dr. Commons, Union City, Ind. : I have had one experience
with this epidemic. Beginning with Dr. Cowing's epidemic in
Mimcie and Delaware County in 1893, and continuing up to the
present tirne I have managed to keep it out of our town until last
Xovember. We stamped it out between November 1st and Decem-
l>er 21st, but the infernal thing came in again. That seems to be
its disposition. It bobs up in unexpected places and under unex-
pected circumstances, and you never know where you are going
to meet it. If we take Dr. Hurty's decision in the matter, and
Dr. Probst's, that the thing is here to stay until the material is
burned out, why not let it go and have one great conflagration and
l)e over with it, and then have some peace? It is disrupting our
social relations among tlie profession in some cases. Since De-
cember, 1861, I have \yeen mixed up with smallpox, and I never
got into an epidemic but that there was a doctor's quarrel before we
were through with it Although the animosity over the cases in
Union City has died out, we still have smallpox; in fact have one
case now.

I suppose this is to be an experience meeting. With the small-
pox in irimcie and Delaware County in 1893, it certainly was
there for some time before it was recognized. I saw a case that
came directly from Muncie on the 11th day of May, 1893, and I
saw it within an hour after it arrived in Union City, and I was
convinced it was smallpox. I telegraphed to Dr. Covdng, and
he said he knew nothing of anything of the kind in Delaware
County. The case was secluded, and placed in charge of lie child's
grandmother, an old lady who had had smallpox. The case was
not severe. T tried afterwards to vaccinate the child, but could not
accomplish.it. Tlien the disease slipped into what is called "The
Settlement," nine miles south of Union City. We quarantined

Google

Digitized by VnOOQ

550

the whole district. A family of American citizens of African
descent had come into the place from Muncie, and one of the
children became infected with smallpox. Two cases resulted from
this almost immediately and both died, one before the eruption
appeared, the other had confluent smallpox and died the fifteenth
or sixteenth day of the disease. Two others had it in mild form.
The district was vaccinated, and there was no further spread of
the disease. The Rouse in which it originated was burned. It has
appeared in the vicinity of Union City several times. It reached
Winchester, but they succeeded in stamping it out at onoe. Last
August a young man came from Mercer County, Ohio, .where he
had been drilling oil wells. He had Cuban itch, so-called. A
physician saw him when he was in the fever stage. He had a high
fever and was suffering a good deal of pain. The physician said
lie was coming down with typhoid fever. About the fourtff day
he was free from fever, and the eruptions began to appear. The
]>hysician said he had broken up the fever, and had done it so
(juickly it kept the jx)ison in his system, and his patient was having
eruptions on his skin in consequence. That man was not seen by
any other physician. He was living with his father's family. The
physician was attending a meml)er of a family in the neighborhood.
The hired girl in this family had ciilled to see the young man wkile
he was sick, and either she or the doctor carried the disease to that
family. A lady and a little child were sick, and this same physi-
cian attended them. The young woman began to be indisposed
and went to her home in Jay County, and there the disease came
under another doctor's notice. I knew nothing of these circum-
stances until a little girl ciirae to school one morning and said her
grandmother had smallpox. I was notified, and started out tx>
hunt the grandmother up. I found that she was on the Ohio
side. I went to the attending pliysician, and together we investi-
gated the matter. The physician said the old lady had typhoid
fever, and he had been successful in breaking it up, but that the
patient had broken out. When I saw her I knew she had smallpox,
and notified the ]>hyftician over there. Soon there were sixteen
cases. A quarantine was then established. Five physicians went
over from the Indiana side on invitation of the Health Officers,
and tliey diagnosed the case as impetigo contagiosa, and scared

Digitized by VjOOQIC

551

the people nearly to death, until they were told that it was small-
pox. However, they took off the quarantine. I told them when
it came on our side it was smallpox, and they might call it impetigo
contagiosa, or whatever they liked, and if we could not do any-
thing else we would quarantine against the whole town. Then
Dr. Probst and Dr. Hurty came, and they at once pronounced the
disease smallpox, called the Board of Health and the Council
together and read the riot act to them. Then the quarantine was
put on again. But among the six members of the Health Board
there were six different opinions, and the quarantine was soon
taken off. They had that disease in Union City, Ohio, all winter.
Now, if we take the suggestion of the State Health OflScers
that the thing is going to continue until the material is all burned
out, I say let it go and let us get through with it. But if we are
to act judiciously we should quarantine every case and destroy it,
no matter how mi)d it was. Then we should try to influence legis-
lation so as to remove the restrictions that prevent compulsory
vaccination. My experience is that vaccination is just as good a
protection against smallpox as a previous case of the disease. Make
vaccination compulsory, and soon tliere will be no such thing as
smallpox in the world any more.

Dr. Carl Proegler, Fort Wayne, Ind.: We aro not going to
s|)eak of a diagnose of smallpox; we are going to find and know
whether we are going to have any measure that is radical enough.
I say the measures ought to be as radical for a mortality of two
per cent as for a mortality of fifty per cent. You can only l>o
radical enough when you have a strict surveillance of all casc^, and
have physicians in charge who have stamina enough to call the
disease by its right nama There have been epidemics of smallpox
of mild form as long back as we have records. Tliey used to call
it the "pest" or "plague,'' and when that was dying out the small-
pox came in virulent form. We are going to reach that stage if
we do not do something radical. When it comes to that stage we
will have a havoc of deaths; and this will come in a couple of
years if we do not go to work.

Dr. A. W. Brayton, Indianapolis, Ind.: To the question,
"Should an epidemic with a death rate of two per cent, be dealt

Digitized by VjOOQIC

552

with as radically as an epidemic with a death rate of fifteen per
cent" ? I should say, Xo. An epidemic should be dealt with in
any disease according to its nature and its severity, and the sense
and judgment of the medical profession expressed as well as it
may be in the Health Officers that may be elected. I say this
because of the fact that this is a widely disseminated epidemic
through the West, and the three years of its continuance has not
given us, except in one or two instances, the severe form of the
epidemic. It is well known to you that we are liable at any time
to have an importation from New York or New Orleans, where
they have had epidemics with twenty per c6nt. of deaths, in which
the per cent, might be very considerably increased. We have had
$30,000 of smallpox in Indianapolis. We have had five or six
hundred cases, and we have had four deaths, one an infant of two
or three days, one a woman of seventy-five, one w^oman of thirty-
five at the City Hospital, complicated with miscarriage, and re-
cently a death from secondary' infection, which, so far as I know,
is the only death in Clarion County due directly to smallpox with-
out complications. That is to say, we are dealing with a modified
form of smallpox. The providence tliat looks after these United
States and after some diseases has dealt very leniently with us,
and I don't feel that we are called ujwn to use those extreme
measures that the people of Mimcio carried out so capably imder
their Health Officers, and which were reported several years ago
in our State Health Board meetings. With the present epidemic
I would say it should not be dealt with as radically as if the death
rate was fift<^n per cent. I say tliis after a very careful consid-
eration of the case. I say it irrespective of the fact that over the
State we have physicians who call it impetigo contagiosa. Very
few of them, liowever, are calling it chickenpox now. I think the
profession pretty generally have determined that smallpox occurs
at all ages, but that chickenpox does not occur in adults.

I say no, we can not treat this epidemic as we would an epi-
demic that would i)rodnce fifteen or twenty ))er cent, of deaths. It
would l)e costly and irrational. In X(ivv York the epidemic is
more severe than in the West. Thoy have no conijnilsory vaccina-
tion in New York; they advise it. If it were to become a custom
here to wear a red string on one's arm, as they do in London, to
show that one has been vaccinated, people would rush for the red

Digitized by VjOOQIC

553

.-triiigs. I think you should all try to make vaccination popular.
Try to do this through the newspapers.

Dr. Bentz : I see Dr. Ferguson and Dr. Wagner here. I would
like to have them speak on the next topic. I should also like to
hear them speak on the third and the eighth topics. Could we
not take up these two topics and discuss theija while they are here ?
They may not be here at the next session. I should also like to
hear Dr. Brayton speak on the same topics.

Dr. Brayton : I think it would be better to take the topics in
their order. I think Dr. Ferguson, Dr. Wagner and myself have
interest enough in the proceedings of this conference to attend
the next session, and we will speak on them when they oome up.

Dr. Dale, Marion, Ind. : I have just spoken to Dr. Hurty .
in regard to the term "radical." The point comes into my mind
whether a set of guardians day and night confining people to the
liouse and keeping other people out is best, or can we keep this
disease as we do scarlet fever and measles and diphtheria, by
placing a placard on the house and warning people that they will
he fined if it is interfered with ? I would like to bring that matter
up. Is it possible to restrain people as we do in cases of scarlet
fever and diphtlieria? If we can, it will minimize our expenses
very much indeed.

Dr. Carl Proegler, Ft. Wayne, Ind.: Dr. Brayton made a
remark about being too strict. I think he took exception to some-
thing I said. If we are going to be lenient we are going to have
smallpox to the end of our lives. If Germany had dealt with it
as leniently as we do now they would have smallpox. As it is,
they practically have no smallpox. Smallpox can only be pre-
vented by the strictest quarantine and the strictest regulations
possible.

Dr. Cumming, Indiana: T see no reason why we should not be
as strict in one case as in the other. I am satisfied that by a strict
quarantine and a general vaccination smallpox can be wiped out.
If we expect to have it for all time to come, there isn't mudi use
of doing anything. I am in favor of compulsory vaccination — ^I
want that understood at the start. We had an epidemic of small-
pox in Jackson County a few years ago, and have had a few cases

Digitized by VjOOQIC

554

since. I have seen this thing toeted. In the familiee of those who
have been vaccinated, the members who had been vaccinated never
took the disease. I believe in vaccination, and revaccination if you
aro not satisfied with the first. The only way to wipe this epidemic
out is by being as strict with the mild cases as with the more viru-
h^nt ones. ' ' ^ M i !

Dr. Bentz : What is the sense of this meeting in answer to the
(juestion we have been discussing?

Dr. Probst: This question would be very materially changed
by changing the first word. We might say, "Should the present
epidemic," "Shall the present epidemic," and ^^ill the present
opideniic," etc. I say it should be. We may resolve that it shall
1)0, but I don't believe for an instant that it will be. We have to
liflve the public with us in dealing mth any such question. The
public must supply the means for us to fight this disease, and so
long as it prevails in its present mild form we will not have snffi-
f^iont support from the public in fighting it that we must have if we
are going to deal with it in a radical manner.

It has been my observation throughout this entire epidemic
that this form of smallpox is not only very mild, but it is very
feobly contagious. We have instances that could be multiplied
very many, many times of exposures that ordinarily would have
resulted in a large number of cases of smallpox, but which result
iu none at all in the present epidemic. Take the case of a man
who comes int>o a crowded church or tlieater where several hun-
dred people may be exposed. If it had been a malignant form
of STuallpox, we would try to quarantine the whole congregation.
As it is, we do not think of such a thing, for in most instances
no cases result from the exposure.

Dr. Charles Ferguson, Indianapolis, Ind. : Not being the
Health Officer at present, I do not feel like speaking on the sub-
ject I think we often stultify ourselves as Health Officers by
quarantining the people who have been vaccinated. Those
who refuse to be vaccinated, I would vaccinate or keep shut up.
The greatest difficulty we have is with the floating population. We
have very little trouble with the residents, because we can keep
track of them. Invariably the floating population that comes here

Digitized by VjOOQIC

555

to the city prove to be unvaccinated. The people who do not wish
to be Vaccinated aak us why we worry about them. They say if they
don't want to be vaccinated to let them go. I think that argu-
ment does not hold much any more when it has become dangerous
to ride on the street cars. I know of houees where I have put a
quarantine on and vaccinated every person in the house except
the person who had smallpox. We had to keep the people in and
feed them. In my opinion, that is a practice that should not be
tolerated. The people who have the smallpox should be taken
to a hospital, and we should have a hospital where we should not
be afraid or ashamed to take our own families. The great trouble
we have had is in the fearful condition of the pesthouse to which
we have to send these people. They are put in the care of people
who are not trained nurses and physicians who are young and in-
experienced, and there is a great fear on the part of the people
about allowing their friends to be taken there. If we have a small-
pox hospital that is kept as well as our beet hospitals are, then the
smallpox cases can be taken there and the rest of the family vac-
cinated and let go. Then we would have less expense.

Dr. Speicher, Muncie, Ind. : In Muncie and Delaware County
we deal with smallpox something after the manner Dr. Ferguson
said it should be dealt with. We allow the people who will get vac-
cinated the privilege .of going about; those who refuse to be vacci-
nated we quarantine. Is the candle worth the flame ? Is this ex-
penditure of money worth the while, where we have such a death
rate? Why not have people on their honor, the same as where you
have cases of diphtheria? We don't feed these people. We put
a sign on the house, and' if the people do not stay in, we fine them.
Why not do the same with smallpox ? I think the i)eople of In-
diana want smallpox. I know some of the doctors that seem to want
smallpox. I saw a doctor last week who had smallpox. He didn't
believe he had it, because his wife and baby did not have it. They
don't seem to realize that this thing is mild. I think our Legisla-
ture wants smallpox in this State. A bill was presented at the last
session that would seem to indicate this. If they want smallpox,
let them have it, and, if a few of them die, it is their own fault.
In Muncie we are going on the supposition that we are going to
have some more cases, and we have provided a hospital and take

Digitized by VjOO^IC

666

them there. We have objections, but we overcome them. They
are all well pleased after they have been taken to the hospital, and
they let this be known after they come out. The best people go
there. We haver tried to eradicate the name o:£ pesthoiise; we
don't like it. We call it the isolation hospital. We keep the hospi-
tal well furnishetl and cared for. We don't do any quarantining
in the houses. I keep my family vaccinated, and you can do the
same; tlien let the people tliat want it have it, and we need not
care.

Dr. Commons : Are we to have any definite conclusions on tliis
topic, or are we to speak our little pieces and then let the ques-
tion go?

Dr. Cole, Green castle, Ind. : I think there should \ye unanimity
among the Kealtli Officei-s of this State in regard to this. If one
county its very strict and another county is not, you may wipe it
out of your own county and it will not be more than a week until
some cases come in from the counties where they are not so strict
If we aim to use strict measures and liave a rigid quarantine tx)
stamp this thing out, I think we should all do it. But if part of us
are going to be lax about it, the counties that are strict will suffer.
I have had considerable trouble. Every little while we get it
stamped out, and then cases will slip in from other counties. We
have had a death within a montJi from this disease. The attending
physician called it "black itch." We had trouble in keeping the
case quarantined. While one County Health Officer will be strict,
another one will be a little lax, and you can not keep it out of the
State. I think if there is unanimity in regard to this, it would be
l)ctter. I have been fairly strict, though I do not quarantine cases
that have been exposed in the prodromal stage. In no instance
has any one ever taken it. If there is imanimity among the Health
Officers of the cities and coimties of the State, I think we could
stamp it out much better.

Dr. ^Commons, Union City, Ind. : In order to get a definite
expression from this meeting, I wish to offer a resolution :

Resolved, That the present epidemic, with its mortality of two
per cent., should be dealt with as radically as if the mortality was
fifty or one hundred per cent.

Seconded.

Digitized by VjOOQIC

Dr. Stanton, (
follows :

Resolved, Tim
than two per cei
will permit, or sa

Seconded.

It is not possi
demic as it woul
when the mortali
Health start ont
that time, the pe
don't believe in ]
safe to let the ir
laxed, but there i
ment of quarant
resolution was cl
c<jmplish all that

Dr. Commons

Dr. Carson, C
(lit ions will pen
disappointed bee
out. Why have tl
Officers working
It takes money U:
retary. Who fur
hut I know out i
new thing, and ti
any more, and tl
lows them. If I
Board of Health
money for us, at
$50, what can wi
demies of this so
missionei"s tell th
tells the (^ommij
what they allow i
IToalth Board ar<

Digitized by VjOOQIC

.558

If it is true that we have all got to have smallpox except the
immune and people who have been vaccinated, and this epidemic
is going to be more virulent, if we can get them all to have the mild
form before the virulent form comes upon us, whj not let tliem all
have the mild form ? I feel like moving you that the Health Offi-
cers of the State of Indiana be declared tliis small per cent, and
that all the other people be declared to be the large per cent, and
the sooner they have it the better.

Dr. Bentz : The best thing a Health Officer can do is to get into
politics a little, and get on the right side of the County Commis-
sioners and the County Council. If he does that, there will be no
trouble in getting an epidemic fund. I have had an epidemic fund
of $250 lying in the treasurj'' subject to my order for some time,
out of which I have not drawn a dollar. The incidental fund fur-
nished has been sufficient up to this time, and we have had the
disease among us three times. But the people know what I will
do. I hj4ve prosecuted and convicted three people in the county,
and now every one knows that if they violate the law, they will be
])rosecuted ; so they keep the rules. Get into polities and have
your epidemic fund ready. I hope the motion will be carried.

Dr. Commons : The resolution now reads :

Resolved, That the present epidemic of smallpox be dealt with
as radically as possible.

Now, as mover of the motion, I have a right to close the debate.
I shall ask the chair to make a ruling that when I close Dr. Proeg-
ler will not say a word.

Tliis matter must be treated as every other matter must be —
with conunon sense. We are to manage this smallpox epidemic in
the very best manner tliat we possibly can, all things considered.
As it is, the statutes of this State now provide that no person is to
go into or from the house where smallpox prevails, but the sense
of tliis meeting is that we are to act up to the very best of our judg-
ment in this ease, everything considered — the expense, the proba-
bility of spreading the infection by vaccinated persons, and all
that.

The resolution was adopted.

Google

Digitized by VnOOQ

"May we exjx^ct an i
break in the fntnre?"

Dr. Stanton, Oliio:
theria or typhoid fever
were to ask this qiiestio
the history of smallpox
We now have a mild foi i
an epidemic of small po i
time the epidemic was i
been known there. Thi
the type of the disease,
expect another change,
than it is now. That if
diseases, and we may e::

Dr. Wagner, Indiann
but, as I told Dr. Hurt'
me of a meeting I attem
chiefs of police of the '
distant relative of mine,
lot of fuss here al)out
Anarcliists and such i
with them now." He S!
we wouldn't have anyth
I don't know that this
smallpox among us, in \i
form I have seen it in
rather have the type of
the types of vaccination
the German professor, c
identically the same dif
smallpox, whenever it
chickenpox, and there a
And here is where our c
fully and be in hannon;
of the Health Boards
physician. The man wl

Digitized by VjOOQIC

o60

sis of smallpox does not exist. If he says he has never made a mis-
take, I say he has never seen a case. I have made mistakes, several
of them. Take a typical case of typhoid fever, with the roee-
colored spots, the headache, the backache, and yon can look for a
serions case of smallpox. I was badly fooled in that sort of a case
once, because I had a case of typhoid fever in the same family.

So far as the C^/uban itch is concerned, gentlemen, that is not
bashed on total ignorance. There is a disease in tropical and semi-
tropical climates, caused by an insect that produces a disease almost
identical with the first stages of smallpox. It is a form of the
Cuban itch, so-called.

There is another thing I might mention here. The Health
Boards and physicians must go hand in hand. We must be loyal
to the Board of Health. There may be a mistake made sometimes,
I know. I am frequently called upon to go and see cases where
the knowleilge of the Board of Health is questioned. I tell them
I do not want to see the case; they must submit to the Health
Board's knowledge. I am often appealed to on the question of vac-
cination. 'IVo])lo want to know if the children should be vacci-
nated every three years. I tell them that is the rule of the Health
Officers, and it must be followed; it is not a case for my opinion.
I would not hesitate. today to tell any one of my friends, if the
» Board of Health want^s to have thoni taken to the pesthouse, to re-
fuse to go, and, if the Health Officers try to drag them out there,
to shoot them on the s|*K)t. I have yet to see a proper pesthouse,
and I have seen a great many in this part of the country and in the
South. I liave not yet seen a jx^thouse that was fit to keep a sick dog
in. You would not want your daugliter or wife locked up in a dirty
hole with a lot of negroes. About six weeks ago I found, in a promi-
nent block in this city, a young man with the smalljwx. He be-
longed to a good family, was a young man of means, but what was
to l>e done with him ? He was there in that block where hundreds
of people go in and out every day. I went to the Board of Health
and the Secretary went to the man with me. I told him I wanted
a good place to take him; that I did not want to put him in with
s(^ven or eight negroes; but he was put in there and kept there, and
that was the c/mdition of things. If you find me fighting you, you
niu>t not.be astonished. A man who has any self-respect or any

Digitized by VjOOQIC

5(>l

regard for the health and well-bein i
to such rules. If you claim the i
Iiouses, they have a right to ask of ;
treatment.

Now, so far as the large number (
vaccinated is concerned, I feel verj :
Jameson, a doctor whom most of 3 1
the friends of a certain man to go a
him from drinking, said, "Well, I 1
don't intend to tear my shirt to pr<
the gutter. If he wants to roll, let i

I agree with Dr. Brayton that,
cemed, each attack ought to be trea 1
the czar of a certain community, w <
much injury, I think I would corrf
them all together and inocculate th( ;
or three weeks.

Another thing: You are going to 1
you have communication with Cub i
between that island and our country
case will diminish.

Dr. Probst, Ohio: I have never ( 1
do not know whether we may expec
the virulence of this disease. When
I told people we might expect it to b<
as yet it has not appeared to l)e an\
know what to say about it now.

Dr. Taylor, Crawfordsville, Ind. :
all the epidemics we have encounters ]
they have been mild. Scariet fever li
cases it could scarcely be detected,
change, and we may have soon a ver;
pox. The fact is the world is full oi
tmue until every unvaccinated or sui
My opinion is that conditions change
virulence.

I want to say a word in regard to
terized of old as "i)esthouse." I wai

3^Bd. of H«aUh.

Digitized by VjOOQIC

562

])revalent that all the detention hospitals are like those spoken of
l>y Dr. Wagner, of Indianapolis, I would invite yov all to come
to Crawfordsville and see our detention hospital. We have one
that is a credit to any city.

Dr. Wagner : I shall be over to see it within a week.

Dr. Taylor: The people who have been sent there have been
satisfied. No word of criticism has been uttered against it. It is
jupt as easy for a municipality to have a hospital of tliat kind as to
have one that is a reproach to the city.

TOPIC No. 4.

"What are the duties of State and municipality authorities
in dealing with smallpox epidemics ?"

Dr. Hurty : This, I think, relates to our legal duties, not to our
opinions. We have covered this ground somewhat, and we have
had opinions expresBod on all sides, but we might profitably dis-
cuss what are our real legal duties in the matter. The statutory
law, not the rules, says that Boards of Health shall take prompt
action to prevent the spread of infectious and contagious diseaees.
We are appointed as officers of the State- to enforce the law. I have
asked the Attorney-General, imder this statutory command, "Is it
the duty of every Health Officer, county and municipal, to go forth
and enforce that statute, or is it the duty of the Board ?" His reply
was : "The statute commands the Board.'' He said the question
was a difficult one, but he believed the courts would rule that the
Health Officer should go forth to enforce that statute, as he is the
executive officer of his Board. It is certain that no court would
ever decide that the statute was wrong because the Secretary of the
local Board had enforced it. It seems we should put forth the ut-
most endeavor to do what is nee^^sary and what is reasonable to
prevent the spread of infectious and contagious diseases. That
would involve another question. What is necessary and reasonable?
That would depend upon the conditions we have in hand. Per-
haps it remains for you to decide whether or not the mild cases
shall be treated with the same severity as the very bad cases. Dr.
Br ay ton says not I suppose if he were a Health Officer, and it
was optional with the Health Officer to decide, that he would pass

Digitized by VjOOQIC

563

the mild cases over and the severe cases he would quarantine. Is
that a fair conclusion?

Dr. Brayton : That is unfair, and is not what I meant.

Dr. Wagner: I understood him to mean epidemics, net ordi-»
nary cases.

Dr. Hurty : Then I withdraw that statement.

The question leads me on to say that if we know a case of mild
smallpox, no matter how mild, if we know it to be smallpox, and,
knowing that a severe case can proceed therefrom, possibly fol-
lowed by death, that mild case should be quarantined very care-
fully and very thoroughly if we can possibly do so. There are
times when we can not do it ; the people will not support us, and we
are left alone. But we have put forth our utmost endeavpr, and
therefore we are acquit. I think we should enforce the law as thor-
oughly as we can, and should put forth every effort to keep small-
pox and all other conmiunicable diseases from spreading.

Dr. Goldman, Monroe County, Indian^.: While I realize that
the State is making an effort to stamp out this disease, yet I can
look around among my patients and see people who have been
quarantined unjustly — many of them unjustly. I had a case of a
young man who was in very poor circumstances who had been ex-
posed to the smallpox for three or four weeks and did not take the
disease. He was working in another family, and they took the
disease from the man he was first exposed to. After he was re-
exposed he was quarantined, and was compelled to stay in quaran-
tine imtil six or eight of that family had the disease. Was it right
to keep him there continuaHy exposed imtil all the family had it ?
Has the State that right? It seems to me there is an injustice
there. How are we in the smaller districts going to avoid this?

Dr. Taylor : That is a rather important question. We had cases
similar to that in our epidemic. We had eighty-four cases, and,
wherever a party like that would consent to go elsewhere and stay
away from the family, we vaccinated him and let him go, after
thoroughly disinfecting him. Where this could not be done, we
compelled them to stay.

Digitized by VjOOQIC

566

promulgate thoee rules and see that they are executed. But I would
add to this that it is also our duty to act with judgment and discre-
tion. And it is the duty of the municipal authorities of State and
county to pay the bills that we judiciously make.

Dr. Pitcher, Boone County, Indiana: This question of small-
pox diagnosis is, in my mind, a query yet We had Secretary
Hurty at our place not long since, and he said we had smallpox at
Lebanon. The case came in from another county. The local Sec-
retary and myself saw the case. The man had some breaking out
on his arms, but claimed that he often had similar eruptions be-
fore. We quarantined the premises where he was, and kept him
there for twenty-five days. An uncle was with him, but this man
had been vaccinated. He did not take smallpox, and no other cases
followed. About twenty-one days after he was quarantined we re-
ceived a letter from Crawfordsville, where he had been prior to
coming to Lebanon, saying that several people who had been with
this man while he was in that city had come down with smallpox.
The question I wish answered now is. At what stage can the disease
be transmitted ? It seems to me that if this disease was smallpox
we would have had other cases among the man^s own family, or the
man who stayed with him while he was quarantined.

Dr. Wright : I have been in the habit of using the room quar-
antine. I placed the room quarantine on two or three boarding
houses, and I have placed it in families where a portion of them
were compelled to work for their living. We quarantine the small-
pox patient in a room and exclude the family. In no instance have
we had an outbreak from it. I should like to know whether I have
a right to do that.

Dr. Hurty : Dr. Ferguson has stated that persons who have been
oxposed and vaccinated are allowed to go at large. That is not the
rule of the Health Board. The rule says that persons who have
bren exposed shall be quarantined for a period of fourteen days
from the date of last exposure. When discussed in the Board, the
question was asked, "Shall there be clauses or sentences in there
qualifying that?" and "Shall officers be permitted by the controll-
ing authorities to vaccinate the exposed persons, disinfect them
and have them go at large?" It was the unanimous opinion of the

Digitized by VjOOQIC

567

Board that that would poeeibly be the proper thing to do; but the
argument was made in accord with the decision of the National
Conference of the State Boards of Health that the quarantine
should be absolute. That is the rule at the present time. It is not
being observed ; we know that very well. Individually I say this :
A person who has been expoeed to smallpox should be vaccinated,
disinfected, and allowed to go about his business, provided he will
return to see whether or not the vaccination is effective, and pro-
vided he will report to the Health Officer within five days, and that
observations can be taken as to whether or not the vaccination is
becoming effective. If it is not, he should be vaccinated again, and
then, after a period of ten or twelve days, the person should go
into voluntary isolation or quarantine until the period is passed
when there would be pretty good reason for believing that he is not
going to have the disease. It seems to me that would be the rea-
sonable way to treat such cases. Is it, however, the practicable way
to treat them? Will it be done? The other is not done, hence I
judge it is not practicable. In my mind it turns on that point, but
I have expressed my individual opinion. I have followed that
course in the State. I have told people if they would permit ue to
vaccinate them, and if they would proniise to report to the Health
Officers in five days, they could go about their work and they would
be furnished a certificate that would permit them to continue at
their worL I '

Dr. Carson : Would you allow the person to retain his residence
at the place where the smallpox existed at that time?

Dr. Hurty: No, sir. One condition should be that he go else-
where and live wherever he could. We proposed that in Green-
castle, in gome cases that came under Dr. Preston's notice, and Dr.
Preston said there was no place for such persons to go, as no one
would take them in, therefore they had better stay where they
were. I would not have hesitated to take them in. This is all ex-
terior to OUT work, of course.

Dp, ^ Monroe City : Is it right to force that man to go

back to the infected house?

Dr. Hurty : No ; he must take his own course.

Digitized by VjOOQIC

508

Dr. , Alonroe City : Why should not the State take care

of him ?

Dr. Ilurty : Does the State do that in other cases? He should
provide for himself. He is not dangerous to the community, and
the comnnmity can not lay its hand upon him. He must work out
his own salvation.

Dr. Ilimter : I want to ask Dr. Hurty a question. I understand
that vaccination, where it docs not protect, leaves the person liable
to have varioloid. Smallpox can be contracted from varioloid.

Dr. Hurty : If the vaccination does not prove effective, the per-
son should be again vaccinated. I said the regulations should pro-
vide for the return of the person in five days.

Dr. Hunter : I know a family where all except the mother es-
caped the disease. She had varioloid, and I had her quarantined.

Dr. Hurty: Varioloid is smallpox. One is mild, the other
severe.

Dr. Ferguson : I don't believe in vaccinating a man and turning
him loose, l)ecause I have seen men with smallpox with a good scab
on the arm. They had been vaccinated too late. The vaccination
was not quick enough. The vaccination had been done under the
order of the Board of Health or the family physician. I would not
indorse vaccinating a man and lotting him go unless I believed he
was a man of honor and could be depended upon to report. The
floating population we have here in the city I w^ould not treat in
this manner. I would vaccinate them, certainly, but I would
quarantine them until all danger was passed.

Dr. Hurty: Do you think the further provision that they
should go into voluntary quarantine at the end of twelve days after
the last exposure is necessary ?

Dr. Ferguson: Yes, sir. When I spoke we were discussing
the question of how to obtain a proper amount of money to take care
of smallpox cases. I have seen seven or eight colored men, strong,
able-bodied fellows, who had been exposed to the smallpox, and,
although they had good vaccination scars, they were shut up with
the other members of the family. Tliose men should have been
turned out and compelled to go to work, while the members of the

Digitized by VjOOQIC

569

family wlio had the (li.sease should have l)cen taken to the i)est-
house.

Dr. Beiity. : That brings up another question, and that is the
length of the quarantine. Dr. Hurty says it should be for four-
teen days. Wliat is the experience of the doctors in regard to this ?
Is fourteen days long enough ?

Dr. Pritchett, Vanderburgh County: We have smallpox in
Vanderlnirgh since the first of October. I have had as high as
sixty cases in the City Hospital at times. We had eight quaran-
tines that were taken off on tlie fourteenth day, and on the nine-
teenth and twenty-first days we had twelve cases of smallpox, and
had to put our quarantine back. I am surprised at some remarks
tliat have been made about quarantining. We have been under the
impression that it was the duty of the Health Officers to quarantine
every one ^ho had been exposed to smallpox. We have been doing
this, and have put watchers over them in the city and in the coun-
try. We change watchers every twelve hours. Our experience,
as far as vaccination is concerned, has been that vaccination after
ox})osure to smallpox has done little good. About twenty per cent,
of the people whom we vaccinated and on whom the vaccination has
taken, broke (>ut with smallpox in from fourteen to twenty-one
days. As far as the time is concerned, our experience is that in
the ]>rimarv stage, even during the first twenty-four or forty-
eight houi-s, more people have contracted it than at any other stage
during the disease. That has been our experience.. I don't think
fourteen days is long enough to quarantine people who have been
exposed to smallpox. In the southern part of the State we have
come to that conclusion and we would like very much to have the
time increased for our potection. The people know that fourteen
days is as long as we can quarantine them, and at the end of that
time we have to raise it.

Dr. Bosworth : T have had some personal experience in this
particular matter. ^ly father's family had smallpox. I was then
nineteen years of age. We all had the smallpox except my father
and mother. They had been vaccinated years before. I thought
I had esca|x>d. We had l)urned everything that had been used in
tlie rooms where tlie ,)atients were, and had disinfected the house

Digitized by VjOO^IC

570

completely, had scalded and washed and scrubbed, and thought
there was no more danger. Twenty days from that date I took
smallpox. I had confluent smallpox and was confined to my room
for ninety days.

Dr. Bentz: I had some experience of that kind. We had a
place quarantined, and yet some of the people took the disease
nineteen days after exposure. I believe this conference of Health
Officers ought to ask the State Health Board to extend the time
for quarantining to twenty-one days. I quarantine them twenty-
one days in Putnam County in spite of the State laws. This ij
an important question. We have the Ohio State Health Board
Officers here, I should like to hear their opinion about the matter.
This question may give us trouble some day. I would like to ask
Dr. Stanton and Dr. Probst their opinion. They certainly have
had plenty oi experienoa

Dr. Probst: Our limit in Ohio is seventeen days. The rules
of the State Board of Health provide that any one exposed to
smallpox after the eruption has appeared shall be quarantined
seventeen days after the time of the last exposure. We have had
cases reported to us where the incubation seems to have been longer
than seventeen days. I think when we are dealing with the ques-
tion of quarantine that we must remember the great many thou-
sands of people who never contract the disease, I think seven-
teen days is not too long, but I should like to have some further
expression as to whether it is necessary to quarantine a man who
has simply been exposed to the smallpox during the fever stage.
From everything I can learn cases that are contracted during any
stage preceding that are exceedingly rara

Dr. Cole: The last outbreak of smallpox we had in Greene
County was seventeen or eighteen days after the last exposura
I am satisfied there were no exposures after that time. Now as
to the infection being carried in clothing. I think there is some-
thing in that Where the cdse has been exposed to the infection
in clothing we do not always get the infection on the first contact
with it. For instance, take clothing tliat has been in the room
with a case of smallpox and it has not been thoroughly disinfected.
A person may have been exix^sed to a case of smallpox in the in-
Digitized by VjOOQIC

571

cubation stage, and twenty-one days after that develop smallpox,
when the disease may have been contracted from the clothing only
fourteen or fifteeii days before the disease developed. In all the
cases I have seen — over two hundred — the rule was that the dis-
ease appeared before fourteen days, between the eleventh and thir-
teenth days nearly always. Most of them took sick on the twelfth
day. It seldom reached the fourteenth day.

Dr. Taylor, Crawfordsiville, Ind. : I have here a very important
resolution that I would like to introduce and have referred to a
committee before we adjourn.

Dr. Taylor then, read the following resolution :

We, the representatives of the State Boards of Health of Ohio, Ken-
tucky and Indiana, together with the representatives of the CJounty and
City Boards of Health of Indiana, in conference assembled in the city of
Indianapolis, April 25, 1902, in view of certain documentary evidence be-
fore us, do resolve as follows:

We view with surprise and alarm the acts of the Governor of Cali-
fornia and the Mayor of San Francisco, in attempting to suppress the facts
relating to the presence of bubonic plague in that city. We are surprised
at such attempts because we regard the facts as fully established and be-
yond all question. The Bodrd of Health of the city of San Francisco,
composed of honorable gentlemen, distinguished for their scientific attain-
ments, and holding the entire confidence of their associates and the pub-
lic, published the facts in their monthly reports to the city government^
submitting therein all necessary data. The existence of the plague in said
city was afterward confirmed, by an expert, sent there by the United
States Marine Hospital Service, by an expert employed by the State
Board of Health, and finally by a commission of eminent bacteriologists
of international fame, whose sole Interest in the matter was scientific.
We view with alarm this attempt to suppress the fact of the presence of
an epidemic disease, the most deadly known to medical science, because
with bubonic plague and cholera in a number of ports in direct communi-
cation with that of San Francisco, and with the energies of the Governor
of the State and the Mayor of the city directed to the suppression of fact
rather than the plague, what guarantee has the Interior that It will long
be exempt?

We condemn the acts of the Governor of said State in attempting to
discredit the competency and veracity of the experts above mentioned;
for forcing the resignation of certain members of the State Board of
Health because they concurred in their verdicts; for seeking to unduly
Influrnco tlio T^nltrd Stntos Tronsiiry Depsirtinpnt. nnd for mnkinc: a canfll-
tlon of fippolntment to the vacancy enufte<.t by the above tv>iL if hhi.

We condemn tbt? nets of the Mayor of Han P'ran^iaco in ^ '* ■■[' niting
wJlh The Governor as above, and for r<*mnvii>p: from office the Olty Board
of Health of San Franclflco for no other reason than that in the faithful

Digitized by VjOO^IC

discharge of the duties imposed upon them by law, and their endeavor to
protect the lives of and health of the citizens of that metropolis, they
published the presence of the plague, and maintained their honor against
all influence brought to bear.

We further declare that it is beyond our comprehension how any
member of the honorable profession of medicine, conscious of the dignity
of his high calling, and zealous for maintenance of that dignity, could
accept api)ointment to vacancies thus created, under the conditions ex-
Ijressed or implied.

We call upon sanitary associations, boards of health, medical and
Rcientiflc associations throughout the country to join with us in the above.

RESOLUTION.

We affirm that in every State, Territory and municipality of the United
States where the representatives of the people have enacted laws for the
protection of the lives and health of their citizens and have appointed
boards whose duty it is to execute those laws, the citizens of said States,
Territories and municipalities have a right to hold said boards to the
faithful performance of their duties, and to the prompt and effectual use
of every means which the law allows and sanitary science approves for the
prevention of the introduction and spread of epidemic disease dangerous
to the public health.

We lurther affirm that in the employment of such means it is abso-
lutely necessary to notify the public of the presence of said epidemic
disease, point out the locality in which it has appeared, indicate its prog-
ress, etc., in order that the public, being aware, may co-operate in its ex-
tinction.

We further affirm that, in pursuance of these measures and in answer
to the rightful demand of citizens for protection, infected houses should
be placarded conspicuously, and, if found necessary, guards employed and
detention and isolation hospitals erected, in the employment of which
measures, together with general disinfections, publicity should be courted
rather than avoided.

W^e further affirm that, where the responsibility of protecting the
public Health rests solely upon said l)oards, no other authority, however
high, should thrust itself betw^een them and their duties, and %vhere indi-
viduals or corporations interfere to prevent the discharge of said duties,
such should be made amenable to the law.

Dr. Bence: You have heard the reading of the resolution.
\Vliat is your pleasure regarding it?

Dr. Taylor: I wish to submit tliis document to your com-
mittee and also some reports of the Boards of Health of San
Francisco.

Dr. Benoe: Do you desire the committee to consist of thre^
members ?

Digitized by VjOOQIC

573

Dr. Taylor: It is desired that at least one iriember from eac
State be on the committee.

Dr. Hurty: The gentlemen representing the State Boards <
Ohio and Kentucky will meet with the State Board of Indian
Perhaps they would like to take separate action on this.

Dr. Taylor : It has been suggested that the State Board be re]
resented on the committee, and also City and County Healt
Boards. I think seven members would be better than three.

Dr. Bence, the chainnan, then appointed the following con
mittoe: Dr. Stanton, Ohio; Dr. Bailey, Kentucky; Dr. Cowing
Muncie, Ind. ; Dr. Buehler, Indianapolis, Ind. ; Dr. Taylor, Crav
f ordsville, Ind. ; Dr. McBetli, Fort Wayne ; and Dr. Clarke Cool
of the Indiana State Board of Health.

Dr. Stanton: I suggest that Dr. Bailey of Kentucky, be mad
chairman of the committee.

Dr. Bence: When the committee meets it can arrange tha
matter.

The conference wat^ then adjoununl to meet again at 1 :30 p. m

574

SECOND SESSION.

The second session was called to order by the chairman, Dr.
Bence, at 1 :30 p. m.

Dr. Pitchett, Evansville, Tnd., presented the follo%ving resolu-
tion:

"Resolved, That wo, the Health Officers of the State of Indiana, here
assembled, ask the officers of the State Board of Health of Indiana to ex-
tend the time of quarantine of persons exposed to smallpox from fourteen
days to twenty days."

Seconded.

Dr. Smith, Howard County: T would like to hear from Dr.
Hurty about that. The State Health Officers have studied that
question very thoroughly, and I would like to have Secretary
Hurty 's opinion on the matter.

Dr. Hurty : I am in favor of that motion.

'Hie motion was then adopted without disvsenting votes.

Dr. Hurty: I would like to have some one introduce a reso-
lution expressing the opinions of the Health Officers on the question
of vaccinating, disinfecting and permitting a person who has been
exposed to smallpox to go without quarantining him.

Dr. Carl Proegler, Ft. Wayne, Ind. : In our county a card
is put on the house whore they have smallpox, and I have a strict
guard kept for three weeks. At the end of that time if everything
is not well in the house the guard is kept there. The county
assumes the expense willingly if the family is not able to pay.
At the same time if a man is perfectly able to pay the expenses, and
we know that he is, he has to pay the exjx^nses. Wo pay the physi-
cian. He has nothing to do with that, but he pays for the man and
for the disinfecting of the premises. We do not let any one suflFer
on account of the quarantine. We take care of them as long as they
are sick ; and afterwards, if we find the i3eo]>le are able to assume
the expenses we make them do it. The county pays the physician's
bills.

Digitized by VjOOQIC

;>M>

and the other he thinks is not reliable. If he lets one go free and
confines^ the other, would not the one he confined have a proper
action against him for damages for depriving him of his liberty ?

Dr. Bence: I am not a court. The courts would have to
decide that.

Dr. Sholtz: Almost :my one v'a.. get people to testif^ to their
good character.

Dr. Bence: I think the people in the neighborhood of a quar-
antined house will see that the quarantine is obeyed. 1 find that
my telephone bell rings at once whenever any one violates the
quarantine I put on. I find the neighboi*s are pretty good guards
in these cases. In rural communities and small towns we have
no trouble. The only trouble would be in the cities.

Dr. Proegler: If any one is ex^xised to smallpox, it makes no
diffei*ence. Whether he has smallpox or not, the very moment I
have a case in my city or county I don't allow that ])erson to go .out
without a card, "exposed to smallpox."

Dr. Wright moved that the motion be laid on the table. •
The motion was seconded by Dr. Smith, Howard County.
The motion to table was lost; 14 votes for the motion to table
and 15 votes against.

Dr. Bosworth: I would have them report in five days. A
person can have smallpox and be wdl in twelve days.

Dr. Spichennan: We make them report in five days. Will
this motion interfere if we insist on their appearing in five days
or sooner?

Dr. Bence : That five days ought to be necessary to look after
the vaccination.

Dr. Ferguson: Suppose there has been a common infection.
Suppose I find that there is a case in a family and several persons
liavc been exposed to it, and some of them may be slower in de-
veloping esses than others. If you let one person go for twelve
<Uiys you may have him spreading smallpox all over the country.

Dr. Commons : There is nothing in this resolution to prevent
Ilc^alth Officers requiring a man to report every day if they wish
it. It says that he shall nuike his report within twelve days.

Digitized by VjOOQIC

Dr. Hunter: When it :
resolved on this thing, the
tempt to impo«5o any differ
trouble al)out followinir th-

Dr. Fitch, Boone Cour
that this clause l)e five da

Dr. C-oninions: I acce}
resolution was l(»st, there

Dr. Fiteh : I hoi>e that
this resolution will give us ;

Dr. : We don't

to get the people to follow t
enough as it is.

Dr. Koss: I suggest v
have been playing at that
nothing. If we had pass
anything t>o the ]x>ople ex(
something in contradictioi
has done. If we do anythi
adjouni.

-How shall Health ()ffic(
aid of business men in the

Dr. Benee : There isn't
even if it is in the famill
res[)ect you. This questioi
do not have the confidences
nities.

Dr. Anderson, Swayz(Hs
))ear in our t/>wn and quarai
man and if we (juarantine
family had something to e;
eery man to send him thing!
they would not ])ay the bi

37-Bd. of Health.

Digitized by VjOOQIC

578

said there was nothing in the statutes that would compel them
to pay it I want to know what to do.

Dr. Loomis, Vermillion County : I have had the same thing to
contend with several times. It have written to Dr. Hurty two or
three tiriies to have that point settled. I think I have it settled to
my satisfaction who is to pay for the doctor and who is to pay for
the quarantine. The Attorney-General has made this rule that the
County Health Officers outside of incorporated towns shall quar-
antine and the Board of County Commissioners have that bill to
pay. If you are in an incorporated town or city they will have
to pay for their own sick. If they want any assistance from the
County Health Officers they call them in. The town or city,
however, has that bill to pay, because they do their own quaran-
tining. In case it is necessary to have a physician for a poor per-
son it is the business of the Trustees to provide for the poor of their
township. If people can not pay their own bills, the Trustee hires
a doctor and pays the bill.

Dr. Shepard, Jay County: I think this is simply a business
proposition and any city or county selecting county secretaries
should first get it into their heads to select a man qualified in
every particular. Let the man be a business man as well as a
physician. T^t him go to the people and say, "Which would
you rather do now, spend so much money or have smallpox ?" If
you present it to them in a business-like way you will get what
you demand every time.

Dr. Anderson : They would not do it in my town. I presented
the matter to them in that way and they would not pay the bills.

Dr. Conmions : The way in which the Health Officers should
strive to acquire the confidence of the business men and the au-
thorities is to do their duty in the premises strictly in accordance
with the statutes of the State and the rules established by the State
Board of Health and afik no questions. They should go ahead
strictly with the business according to the rules and let the results
take care of tliemselves. Smallpox is a disease, an epidemic of
which may be considered a special thing. We have no trouble
in our coimty that I know of. In quarantining such cases as we
have had we nailed a flag on each house where they had the dis-

Digitized by VjOOQIC

ease, placed a special police officer on guard, and said to our Coun-
cil that they would have nothing to do with it but pay the bills, and
they have done that without any questioning.

Dr. Anderson: Sometimes you get Councils that will not
listen to anything of that sort. Our Council said they would not
pay a cent unless we could show them the law compelling them
to do it.

Dr. Powell, Marion, Ind. : The gentlemen are not speaking on
tlie question under discussion, but Dr. Anderson haa a question
that to him is important I don't know whether it has been dis-
cussed here or not. I have submitted the matter to the Attorney-
General for an opinion and I have no doubt what his opinion will
be. The question under discussion is not the liability of the Town
Board, but the question of dealing with the business men and the
general public. As far as my experience goes when a matter
like that is placed before a business man when you go to him and
say, ^^Here, Mr. Brown, we have a case of smallpox in town," he
will say to the Health Officer, "Go ahead and do whatever is
right and proper to quarantine the case and prevent any spread of
the disease. We don't want our town injured by the reckless ex-
posure of the public." I have never foimd a sensible business
man to answer that question in any other way. If you let small-
pox spread it will hurt your towns and hurt the business interests,
and the business men of the town do not want that.

TOPIC No. 0.

*ninw iiirry i1h>sp physifiiuifi Imi^ iuiumgt.'fi who diagiuwe typicnl
?4TiNillpctx £i!i <'1u(^kr^u[N>x, nnc! !4tiek in it» ulthniigli every gymptoiu
of .sniallptx is pre?>enf/f*

Dr. Benre: There is one way those fellows couUl have Wti
^^t at, but thiit wrmM linve nc^cessltatcd begitinirig with thoir
grandfathf^rs.

Dr. Proe^ler: Tt is snppo^ that every Healtli Offit'er is very
well versed in rliagnoi^iir^. In Fort Wayne the physicians know
that I know my businef^s, anrl when I say a case is smallpox aiid
stick fn it, they Irt it ^o at that. A vf^ry few weeks ago T had a
man of great fame come to me and ask me how I diagnosed a case.

580

He said he diagnosed it as chickenpox. T did not, and a card
went lip, and he never said a word. We had Cuban itch, we had
impetigo contagiosa, we had ahnost anything else but smallpox.
Where do you find any impetigo contagiosa? Only in small chil-
dren. '

Dr. Fitcli : There is a simple method of avoiding trouble. I
sim])ly take a smallpox card, when I have trouble in diagnosing
the case and turn the name do\m. I quarantine the house witli-
out naming the disease.

Dr. S])ickerman: We do that Wo have signs which read:
*K'ontagion within. Five dollars fine for tearing Uiis card down."
We have a right to do that.

Dr. Wright, Starke County: The question is how. shall we
educate physicians? How^ shall we get them so they will not. do
these things? That is the question.

Dr. Ferguson, Indianapolis: The doctor has brought up the
]K>iiit T wish to speak al>out. The question is very easily settled.
If we re(|uire, under the law, that everv^ case of chicken ]X)X \)o re-
porto<l to the Health Officers, then let the Health Officer with a
]>r<>|x?r man, a man who is an ex])ert, investigate a^d see whether'
or not it is chicken]K.)x. If it is small]K>x the case is taken out of
the hands of the man who said it was chicken]V)x. We can put up
a card that does not name any disease. We can card the house
''Contagious disease," and the doctor who says it is chicken ix)x
will agree to that. If we know and feel it is smallpox, don't l)e
afraid to ])iit up a small])(>x flag. Let the ])hysician bear the odium
of the mistake, the ])hysician who diagnosed the disease.

Dr. Cole: I think we have instructions from the State Board
of llonlth to notify all physicians to report all skin diseases. The
(piestion is, what shall we do with the physician who reporti^
smallpox as chickenpox^ I have had some trouble in that line.
In one case the man had to pay a fine. Ho was very obstinate,
and caused considerable trouble and was responsible for some
cases breaking quarantine. He called it "black iteh" — a new dis-
ease to me. He ])leade(l guilty for not re|X)rting the case, how-
ever, and had to pay a fine. In another towai T had one physician
who resiste<l the diagnosis, and said I was wrong to quarantine it.

Digitized by VjOOQIC

(disorder that might occur under his observation, and also requir-
ing householders to report any acute eruptive disorders. That
gave us the opportunity to make the investigation we wished to
make. Some of tlie physicians that made the diagnoses were hon-
estly mistaken. They had a picture of snaallpox in their minds
that was entirely different from anything we have encountered
in this epidemic I came at in this way: I asked them if they
believed smallpox was prevailing at that time in the United States
and over a great part of Europe and Canada. They said they
did. Then I asked them if it was prevailing so extensively over
the United States, why not admit that it was prevailing in Oraw-
fordsville? There are thousands of ways by which the contagion
can come into a community. I found this a forcible argument.
It started them to thinking and finally they became convinced
that there was a possibility of its prevailing there. After that it
was not hard to get them to believe it was there. Some, for the
i^ake of notoriety, will insist to the last that it was not smallpox. The
measure we adopted was a good one. The adoption of a measure by
a Board of Health is not so good as an ordinance of that. kind.
Have the City Council adopt the Board of Health rules as ordi-
nances; then if any man violates the ordinances he can be prose-
cuted for it, and one prosecution will about settle the whole thing.

Dr. Procgler: We have experts in surgery, in ophthalmology,
and in other diseases. A man to be an expert in diagnosing small-
pox must have seen smallpox, and when he has seen the variety of
cases I have, I think he may justly call himself an expert in
diagnosing smallpox.

THE DIAGNOSIS OF SMALLPOX.*

By Dr. Carl Proegler, Fort Wayne, Ind.

To form a correct diagnosis of smaUpox. it Is necessary to have had
exporionco in diagnosing quite a large number of cases, and in mild cases,
lilie those now prevailing in the United States in endemic and epidemic
form, it takes an expert to come to a correct decision. I have seen In
my lifetime many thousand cases of variola; I saw them in an epidemic
in Hong Kong. China, also in Buenos Ayres, South America. After the
surrender of Aletz by the French in 1870 we found nearly 15,000 cases,
half of which were of the hemorrhagic variety. The Chicago epidemic of

'^Read before the Allen County Medical Society, Fort Wayne, Ind., February 20, 1900.

Digitized by VjOOQIC

583

1871-72 was also seen by me, not to speak of smaller epidemics in Illin(
and Indiana.

The first appearances of variola are knot-like projections in tlie ski
which a careless observer might take for measles. The projections are d
veloped in the middle layer of the epidermis by a fiuid which invades tl
whole network of epithelial cells and presses them outwards. Accordli
to Kluge the fluid contents of these granules at first contain no pus cell
but after a time all the alveolar spaces are filled with pus. It is chara
teristic for a variola pnstle to have at its base an umbilicated tapering (
dent. The contents of these pustles are always purulent, or to make
more clear, they contain nothing else but pus. These pustles are alwaj
umbilicated and always surrounded by two distinct infiamn^atory areola*
This is so characteristic that a diagnosis may be made from these sign
alone.

We distinguish variola discretae, coherentes and confluentes, accordiu
to the varieties. We also have variolae hemorrhagicae sen cruentae (blacl
pox) which is caused by blood extravasation in the pustules. In sever
epidemics, as for instance at Metz, where nourishment was almost ni]
scorbut and dyscrasia of the blood produced pyaemic conditions, and per
sons so afflicted literally rotted away.

Smallpox is found In the mucous membrane of the mouth and throat
also on the outer edges of the tongue and between the lower lips, verj
often interfering with deglutition and mastication. We also find smallpox
on the ciliary edge of the eyelids, and severe conjunctivitis is also always
present.

The period of incubation is between 10 and 14 days, sometimes between
5 and 20. No outward symptoms in the very early stages are noticed,
though with a prevailing epidemic around us we may surmise variola.

The stadium prodromorum iff generally ushered in by a chill, followed
by quickly rising temperature, sometimes from 102 to 104, the fever last-
ing from 2 to 5 days. Headache and backache are in this stage nearly
always present. Delirium, vertigo, general malaises, anorexia, a thickly
coated tongue, nausea and vomiting are generally present. Another con-
stant sign in this stage Is an enlargement of the spleen. The eyes are
swollen and painful and light Is Intolerable.

After the end of these initial symptoms we invariably find red nodules
on the velum palatae, and also on the mucous membrane of the mouth.
As careless observers have sometimes diagnosed typhoid fever in this
stage It is well to remember that a careful examination of the mouth will
settle the diagnosis.

The eruptive stage usually begins after three days, and the eruption
begins on the face. A firm shot-like sensation is conveyed to the finger
by the papules. The exanthema progresses from the scalp to the soles of
the feet There is also a tendency of the eruption to appear more pro-
nounced on exposed surfaces. The inflammatory areolae around the pus-"
tules, however slight, is characteristic of smallpox only. The exanthema
of no other disease presents this double areola.

The appearance of the pustules within the mouth, on tlie eye, on the
palms of the hands and the soles of the feet are certainly valuable cor-
roborative symptoms.

584

As soon as the eruption is about 2 or ,T days old a perceptible, never
to be forgotten odor develops from the patient, and is seldom absent.
This smell is one of the most valuable signs for diagnosis, and I am per-
fectly astounded that it is hardly mentioned in any of our text-books. But
at the same time I want to emphasize that this smell is sometimes not
present in mild forms of the disease and ocensioually is absent in well
marked cases. When present it Is a valual)le diagnostic symptom. (In the
case of Mrs. Axt, who has recently been released from quarantine here in
Fort Wayne, I diagnosed smallpox from the odor before I entered the
house.)

The last stage is the stage of excication and decrustation. The pus
contained in the pustules dries up to brown crusts, which aftei^wards fall
off from their base, leaving st^ars, the well-known pock marlcs.

Bacteriological examinations have so far revealed nothing regarding
the nature of the contagion of smalliwx.

To the keen observer smallpox can never be confounded with anything
else, and it is certainly humiliating for the medical profession that so
many diagnostic errors have been made. The common error among phy-
sicians all over the United States where smallpox has appeared is to sub-
stitute chickenpox for variola, though there is not the slightest affinity
between them. Varicella is a disease sui generis. In a large experience
with smallpox I have never seen a single case of chickenpox in an adult,
and it Is certainly as rare in adults as a white elephant in Slam. Before
you make your diagnosis, find what disease is going around.

W\* tind varicella epidepiic and siwradic, and children will get chicken-
pox even when vaccinated, which fact ought to l>e well remembered. The
period of incubation is about fourteen days. In some of the cases we no-
tice fever of a mild type, in other cases hardly any. The exanthema con-
sists of sparsely appearing vesicles, which are seen first on the scalp,
especially on the outer edges of the hair and the hairy part of the scalp.
The eruption spi-eads in a few houi-s all over the body, contrary to the
eruption of smallpox which takes from 2 to H days. The vesicles rest on
very light hyperaemic bases, are never umbilicated, have no inflammatory
areolae and the contents of the vesicle contain nothing else than a water-
like serum, extremely seldom pus. After twelve hours the vesicles burst
collapse, and dry up to a kind of crust. Tlie marks left behind are always
even and disiippear entirely in a few days without leaving any trace be-
hind. (.Mii(*keup<)x is a very lieuign disease and rarely calls for medical
treatment. It sometimes attacks children more than once.

Impetigo contagiosa has also been classed among the diseases which
might be confounded with smallpox. Two renowned skin specialists of
St. Louis made this error, though they wer(» afterwards convinced by other
physicians that the distvise in question was nothing else than smallpox.
It passes my comprehension that such a thing is i)ossil)le. We older phy-
sicians designated the disease Impetigo scrophulosom, thus indicating by
its appellation that it only appears in the underfed and poor, whereas
smallpox attacks rich and poor, clean and unclean, sick and well. Im-
petigo is always due to inoculation of contagious i)us. independently from
the source. Scratching leads to purulent lesions in children, hence pedic-
ull capitis are a very common cause of impetigo. Crooker mentions the

Digitized by VjOOQIC

686

twenty pustules on it, yet the very first of the prodromal symp-
toms was convulsions.

Dr. Probst, Ohio: There is an old saying, "All signs fail in wet
weather." The doctor gave us a very excellent description of
smallpox as we ordinarily see it and as we read it in the text-booka,
and I think any smallpox nurse would recognize it readily. That is
not the kind we have been having in our State. We have been
having smallpox where the children have not been sick at all.
Go into a family and talk to the mother about the case and she
vvill say the first thing she noticed was ttn eruption on,the child.
If it was sick before it was not sick enough to attract the mother^s
attention. The physician has not been called in until the erup-
tion appeared. The diagnosis has also been largely baaed upon
watching the case from the beginning to the end. The attending
physician usually has that ftpportunity and the Health Officer does
not. He may be called in and finds the case at a certain point and
he wants to know at that time what it is. I have made some
mistakes in diagnosis and I probably made a great many more than
I know. If I felt a doubt in the case I said it was smallpox and
swore to it and stuck to it, and never admitted I was wrong. In
this way I have probably saved myself from being criticised. I
think the mistake we make is in trying to teach the diagnosis to the
physician by continually holding up typical cases. Those are not
the cases we want to teach them anything about. I would not
agree in the statement that we always have umbilication in the
eruption of smallpox. You may find it in some, but I am satis-
fied I have seen many cases where the majority of the pustules
were not umbilicated. We occasionally have smallpox where there
is no eruption at all and it is difficult to diagnose that kind of a
case. I have a great deal of charity for the physician who fails
to make a diagnosis of smallpox in some cases.

Dr. : Can a patient have smallpox and not have erup-
tions ? !

Dr. Probst: Yes sir.

Dr. Boswell: We have smallpox without any eruption. I can
give you two instances. I could give others, but these are typical
cases. I saw a family where there was smallpox. One case was

Digitized by VjOOQIC

a diagnosis for me. I was called to see a negro in a block in a
thickly settled part of the town who had made his own diagnosis of
his own case, and asked to have me see him. I went to see the
case and there was the man completely covered from the hair of
his head to the soles of his feet, including the palms of his hands
and the sok»8 of his feet, with immensely extended vesicles which
on being- punctured did not entirely collapse, and which were
tilled with pus. lie said, **This tiling came out on me all at once.
I had no fever and no chill, excej)t when this eruption came out."
He said he saw it on his chest and back first. He said it came
on his face in a few days. The case was so interesting I took sev-
eral phys^icians t<.) see it, among them Dr. Bray ton and his son.
Dr. Brayton's son had seen hundreds of cases in the smallpox hos-
pitals in Xew York. The patient was j)erfectly honest and gave
all the symptoms. He went to the pesthouse willingly. A photo-
graph of the case or a description of it would lead any of you to
say this was a case of smallpox. In fourteen days after he was sent
to the pesthouse he was taken down with intense symptoms, the
prodromal symptoms of smallpox, and went through the typical
eruption, ahuost confluent, had pustules, and now bears pits from
both of them. The first pits are the piti^ of chicken ix)X, the ixx?uliar
sharp pits we have in that disease. It was a ty])ical case of chicken-
pox in an adult, or he had two cases of smallpox inside of thirty
days.

As to umbilications. There are forty-one cases in the pesthouse
now and I venture to say that a careful examination will not show
ten |x*r cent, of them umbilicated and on those ten per ceni you
will only find a few. A patient died there last week with smail-
lK>x where there was no umbilication. In chickenpox in persons of
nearly adult age we find something that kx>ks like umbilications.
A necrosis forms there and we have to look at it through a micro-
scope to determine whether it is umbilicated or not. If you find
the eniption on the fingers, in the palms of the hands and the soles
of the feet, it is smallpox, yet chickenpox eruptions come there too.
The eruptions in the mouth the doctor speaks of always como in
the mouth in chickenpox; I never saw it to fail and I can not tell
on that thin mucous membrane the difference in the eruptions of
chickenpox or smallpox. Dr. Corlett in his recent book on con-
Digitized by VjOOQIC

tagious diseases says that he has never seen a case of chicken
in an achilt, and lie limits the definition of adnlt to a man
woman above the age of puberty, lie is a recognized authority
the quc^stion and he has seen thousands of cases of smallpox. I
remembf'r four eases distinctly, one not long since, a young mar
his twenty-fifth year. He was taken down with chickenpox.
sent him to an isolation hospital, not a }>esthouse, and he recove
promptly and was at his business in a few days. He had h
successfully vaccinated. In the case of the negro I was labor
under the impression that an adult could not have chickenpox.
must be careful not to send to the pesthouse patients who do
have smallpox, liecause it is dangerous as far as the law is c
cerned, for I think a man should be indemnified for it, especij
if we send liim to such a place as we have here; but it is nc:
pleasant thought for a man to carry to bed with him that he
sent a chickenpox patient to the smallpox pesthouse. Not h
sinc^ a negro was sent to my ofiioe by a doctor in the town,
walked into the office and wanted to know what was the matter \\
him. He had a pustular eruption. I told him he had small}:
He said no, that he had syphilis. He had the primary lesion,
careful study of the case revealed the prodromal symptoms, i
lie was sent to the pesthouse. There he recovered from the sni
pox, but still had syphilis. One case came to the City Hosp
in 1894. I saw the man coming into the door and called to 1
to stop. He said he had syphilis. That man was dead in less t]
three wet^ks from septic infection. It w^as one of the worst a
1 ever saw. It is the only case of pure pustular syphilis 1 li
ever seen.

Either I have been making great mistakes, as well as Dr. Bi
t(m and the rest of them, if we have no impetigo contagiosa in 1
country. ' Come to Indianapolis, Doctor, you are too clean in T
Wayne. Many times I have l)een sent to see what was the mai
with a child that had imj)etigo contagiosa, or that had an unknc
disease. It is something whicl\ confounds the laity, and it i
disease which will confound the ])liysician who is on the look
for smallpox.

Dr. Probst: Does thir. occur in adults?

niniti-7Cirl h\/

590

Dr. Ferguson: No, only in children. Not long since Dr. Bieler,
the City Health Officer, asked me to see a case with him. He was
puzzled about it, and when he is puzzled the rest of us may
well be puzzled. In this case tliere was an eruption on the soles
of the feet and over the entire foot, and on the hands and in the
palms. This was a typical case of vascular smallpox? The absence
of the eruptions anywhere else led us to believe it might be some-
thing else. There were the typical prodromal lesions; in fact he
was treated for the grip, as many cases have been which after-
ward proved to be smallpox. The physician who makes a mistake
in the diagnosis of smallpox may be excused if he makes a mistake.
However, the physician should be taught to notify the Health
Officer if he is in doubt The county will have to pay for an ex-
pert to decide the case. There is no -reason why a physician should
l>e worried about these cases.

Dr. Proegler: I am very thankful to the gentlemen who have
listened to my speech, and will say that I do not know all about
smallpox; but will say at the same time that if a man has seen thou-
sands of cases of that disease, and has seen them all over the world,
I do think he comes near deserving to be called an expert. At the
same time I will say there is a good deal in intuition.

Dr. Taylor: I regard it as a somewhat dangerous thing to admit
the possibility of a case exhibiting the symptoms Dr. Ferguson de-
scribed as chickenpox. I would rather regard that as a case of ir-
regular development. The patient may get over all, the symptoms
and may feel well enough to go on the street. I think the man had
the smallpox first, and when the secondary symptoms ^et in he had
it for good.

Dr. Ferguson : Do you refer to the negro ?

Dr. Taylor: Yes.

Dr. Ferguson: They all dried up. I am willing to aduiil ihrtt
he had two cases, and then I can say I was never mistaken.

Digitized by VjOOQIC

591

TOPIC No. 8.

^Uow may the mildness of the present smallpox be explained?"

Di. Bentz: Dr. Earp, how do yon account for it?

Dr. Earp: I am not a Health Officer at this time. I will say,
however, as far as this one point is concerned, I find it a hard ques-
tion to answer. I would like to have some one enlighten me as to
why this is a mild epidemic.

Dr. Bentz: Dr. Probst, I wish you would answer the question.

Dr. Probst: There have been many theories advanced; none that
I have accepted. I can only call attention to some of the theories.
Dr. Hyde, of Chicago, it seems to me, got on the wrong tack when
he said it was due to the fact that it was imported from Oub^ by our
soldiers, and that they brought in a very mild form of the epidemic,
and that it propagated its kind. Another theory is that it is. due
to the hereditary effect of vaccination. It is said that children of
parents who have been vaccinated, even though the children have
not been vaccinated, have the disease milder on that accoimt. I
don't think we can accept that at all." Another theory is that the
good sanitary conditions that have prevailed in late years accounts
for it. So recently as 1893 Chicago had an epidemic of smallpox
where about 33 per cent, of the cases were fatal. It seems to me we
have not been able to change the sanitary conditions of the cities
so rapidly that it would cause the disease to be of a milder nature.
For myself, I can only plead ignorance of why the disease is of so
mild a character.

Dr. Stanton: I have heard a number of persons express the be-
lief that the practice of vaccination for so many years had led to %
modification of the disease, because the protective influences of vac-
cination had been transmitted. The epidemic in Cincinnati in 1893
was as malignant as any we have ever had. We have had in the last
few years as severe epidemics as havje prevailed at any time within
the last one hundred years. I don't believe vaccination has any-
thing whatever to do with the mildness of the disease. I don't think
we can account for it; but I do not think it is going to continue in
its present mild form always.

Dr. Bentz: Dr. Ferguson, what is your theory ?

Digitized by VjOOQIC

592
Dr. Ferguson: Same as the others; I agree with them.

Dr. Bentz: It is sometliing bevoiul tlie knowledge of man, I sup-
pose.

Dr. Ferguson: Why is the epidemic so bad in New York at
tlie present time ? Why are there so many deaths there?

Dr. Brayton, Jr.: T had an opportunity last spring to observe
eases in Xew York, and these eases originated mainly from cases
tliat Aven* brought over from Itidy in the immigrant ships, most of
the immigrants coming from the vicinity of Naples, and Naples at
that time was pest-ridden by a very severe epidemic of smallpox.
The first cases which occurred in New York City were cases that
occurred among the Italians. Tlie outbreak occurred at least one
year and a half after smallpox of a. different, or rather milder, form
had Ix^en prevalent in the Western States. It has been said by Dr.
Hyde, of Chicago, that the smallpox we have in the Western States
is milder, p(>s8ibly, lHx*ause it has run its course in Cuba and Mex-
ico, where it is much milder than it has l>een in Europe and in the
Kastern States, which is nothing more nor less than the European
type. It is very inten»sting to know that in New York (^ty there
is a higher rate of mortality than there was last year, a mortality
of about thirteen per cent. I noticed in the Ncav York Medical
Times today that there were seventy-five cas<\s reported last week,
and twenty deaths. This shows a very peculiar ccmdition of things,
one which is to my mind ahnost inexplicable. Wo can sj^eculate
on the^e things, but exact theories we can not give.

UEPOKT OF (H)MMITTEK ON REvSOLTTTTONS.

Dr. Stanton : The committee to which was ref(»rred the resolu-
tions offered by Dr. Taylor present the resolution as offered by Dr.
Taylor without amendment.

T move that the resolution be adopted.

The motion was sectmded and carried \)\ a unanimous vote of the
conference.

Google

Digitized by VnOOQ

*'\Vhat are the coinplici

pox ?"

Dr. Bentz: What has I
had the greatest experienc
treating it ? You men wh
great deal of it might give
ject.

Dr. ITnrty : I have onl
a g(nitleman from the Ea
fonned in regard to the pi
formed about smallpox, an
my guei«, we \vill find in f
cations will apjx^ar in man}
something like the complic
will he affected in some ii
liver." I asked him his re;
and he told me that some o
and Philadelphia by some
were not quite ready, hov
give any evidence.

Xow I have been watclii
ago they had a fearful epic
there were several deaths i
wBether the death returns \
trouble, especially among 1
sequelae back very readily
that as yet we have no ir
point to any STiclr conclusir
it will come in time. It
doctor from the East said
but he would not be surpr:
would follow, especially in
will observe that this is exc

Dr. Ferguson: I would
number of cases, how man;

38-Bd. of Health.

Digitized by VjOOQIC

594

or abscesses. That has been one great trouble here. Whether we
have the germs gathered together in the pesthouse that attack these
people or not, I do not know, but the discharge of these patients
is greatly retarded by the presence of abscesses on different parts
of the body. The abscesses are very severe, and we have to ke&p
the patients in the hospital until these are healed. Probably four or
five per cent, of the cases of smallpox that have been there have
suffered from boils and abscesses.

Dr. Hoadley: So far as my experience go^, I have found that
the patients, when well, were as well as we would expect them
to be after any other diseasa We have observed no sequelae so
far, and the cases extend back three years.

Dr. Taylor : We have had in Crawf ordsville 84 cases. In one of
these abscesses appeared and in several cases boils appeared. I shall
speak of one interesting case. In a neighboring county there was
an incipient epidemic of smallpox. The Health Officers met with
vigorous 6pposition on the part of a certain physician. He went
around proclaiming that they were not cases of smallpox, because
he had vaccinated the people and the vaccination had taken. I saw
some cases which apparently had taken and many that did not. In
two instances that I remember very few of the vaccinations were
effective ; in the others they were. What is the experience of others
here who have had experience as to whether they regard that as
confirmatory of the fact that they were not genuine cases of small-
pox. 1 •

Dr. Stanton: In a smallpox hospital all the patients were vac-
cinated and it was found that on many persons the vaocinajtion
took. In fact as many cases took as where revaccination was tried
in a short time after a successful vaccination. That is not proof
that this disease is not smallpox.

I would like to call attention to one peculiarity of this epidemic
and that is the extreme mildness of the disease in the case of chil-
dren. We read in our text-books that smallpox is especially fatal
in the extremes of life. In this epidemic, so far as I have seen it in
the last three or four years, and I have seen several hundred cases,
the disease has almost uniformly been of an extremely mild type
in childhood. Not in infancy, for many infants have died, but in
early childhood it has been extremely mild.

Digitized by VjOOQIC

695

Dr. Oawing: That has been our experience in Delaware County.
The cases of little children are very mild. I have seen in the last
week fifty children who have had smallpox and very few of them
have been sick at all; while the adults in the families who have not
been vaccinated had pretty severe cases of smallpox. In one locality
the mistake was made by five physicians in the diagnosis of the
disease as chickenpox, because it began among the children and
only became severe as the older members of the family took it. A
close examination of the children, however, showed the typical pus-
tules as they were drying up and going away. Closer examination
showed that the life of the pustules was too long for chickenpox,
because they lasted, in some instances, ten or twelve days.

The greatest need today, I think, is a keen, intelligent ability on
the part of the physicians to quickly diagnose the disease. Dr.
Spockerman and myself have come to this conclusion from the ex-
j)erience we have had during this epidemic. Until we get that on
the part of the physicians we will not be able to control the disease
promptly. We must have the co-operation of the physicians and
they must be informed as to the diagnosis. It matters not what the
public think, if we have the support of the physicians we will
usually be able to control this disease. I think we must have an
appropriation from the next Legislature, and this thing should be
presented in a plain, practical way throughout the State, not only
to the physicians but to the laity. I am sure a properly prepared
pamphlet would be helpful if it was distributed among the people.

TOPIC No. 10.

"How many physicians could be induced to take proper precau-
tions against carrying smallpox?

Dr. Bence: I tkink that it ought to he broadened a little as I
have just written here :

Resolved, That the State Board of Health be requested to order every
physician In the State to provide himself with a modem antiseptic suit
to be used and worn when visiting contagious diseases, and notify County
Health Officers to report all who do so.

I think physicians are too careless. If there is another anti-
septic suit in the county besides my own I do not know where it is.
The physicians there are probably on an average with the rest of the

Digitized by VjOOQIC

596

physicians of tlie State. I do not think there is any law that would
compel physicians to wear these suits; but if we had a special circu-
lar to be sent out to County Health Officers, they to distribute them
to the physicians, it might* help matters. The circular could state
that the physicians were to report to the Health Officer that they
had purchased such a suit, and if they failed to re}X)rt he should
send this information to the State Board of Health. In this way
we might get something done.

Dr. : What about the undertakers ?

Dr. Bence: Speaking from personal knowledge of our under-
takers I should say they are extremely careful. There is not an
undertaker in our county that buries a contagious case who does
not come to the office and get sprayed with formaldehyde. They
always wear rubber coats. I do the disinfecting for them and have
for several yeai^s. Our undertakers are extremely careful. They
have families and do not want to take contagion to their own horae*^.
They are as much afraid of the disease as others are.

I just read the resolution as a suggestion. I do not intend to offer
it without the advice of Dr. Hurty and the other secretaries here.
I want to know if that would be the best way to got at the matter.
AVe sliould find out how many of the physicians will obey an order
of that kind. Everyone will not; you can not make them all do it,
but if you get half of them to do it you will have made a great im-
provement.

Dr. Hurty: Such rules have been adopted but never promul-
gated. Why? When the health law was passed in 1899 an editor
of a paper who was a member of the Legislature sent up an amend-
ment providing that the promulgation slioidd be by publication in
two newspapers of different denominations in the county. That
was a newspaper graft. The method adopted by the Legislature
was a veiT objectionable one and when we sent out the rules to the
different counties to be promulgated, after the first day or two I
was afraid to open my mail on account of the storm the method of
pi'omulgation aroused. An editor brought that about. It brought
upon the State Board of Health abuses of the most serious char-
acter. We opposed the method. The county attorneys and County
Councils and County Commissioners all were united in saying that

Digitized by VjOOQIC

507

the StAte Board of Health was an old nuisance in imposing ex-
penses, ek». They supposed we had that law put through. We
don't care to go into that again, it is dangerous. I think we can
get that clause of the law repealed at the next Legislature. We
have this suggestion to make. It has already been made by one of
the most tlioroughly known judges in Indiana. The suggestion
that a law be passed controlling this matter of infectious and con-
tagious diseases. This very judge had before him once a physician
who had refused or neglected to put on an antiseptic suit when he
was visiting a scarlet fever patient, and he fined that man ; but he
said to me, ^'I don't know whether there is a law for that positively
or not, but you should have such a law passed." I asked him if he
would revise such a law and give it the true legal flavor and char-
acter. He said he would and suggested putting a clause in it pro-
viding that any physician who transmitted disease or carried it in
his clothing, if shown, would be liable in any sum not less than
five thousand dollars. He said, "Put that in and then let the Board
of Health promulgate a rule for the protection of health and it will
rec»eive attention everywhere."

I think such a law can be easily passed througli the next Legisla-
ture, especially if our six hundred Health Officers in this State
Avill buckle down and see that it is brought Tip. It is like that
laboratorv'. If you w^ill all work for that laboratory we can have
it. If we do not get it it is because we have not worked for it.
The quarantine law should also go through.

Dr. Taylor: I wish to offer a motion with reference to the
resolution that was passed here today. Our object is to get this
before the various Sanitary Boards of the United States and to
bring about co-operation in the matter.

I move that the Secretary of the State Board of Health be asked
to notify the Annual Conference of the State and Provincial Boards
of North America, and the American Public Health Association
of our action here today. ' ' *

Seconded. ■ ' ;

Dr. Bence: It would be well to send it to the medical journals.

Dr. Hurty: We will do that and spread it as broadcast as pos-
sible. We may get it published in daily newspapers as a piece of
news.

Digitized by VjOOQIC

598

Dr. Taylor: We depend upon these ports to keep such diseases
out of the interior of this country. The disease is Kable to affect
every great city that has a submerged population that live in tene-
ments and on scanty rations.

The motion was carried by a unanimous vote.

Dr. Hurty: I have been asked by two officers when their terms
expire. The terms of every Health Officer will expire on the 31st
day of December, this year. All Boards will have to re-elect their
officers in their first meeting in December for four years from the
first of January, 1903. Every town, city and county Health Officer
serves four years.

Dr. Ferguson: How about our officers here ? We have a char-
ter.

Dr. Hurty: Indianapolis is, I think, relieved of that. It may
be, however, if you bring it before the courts you will find that the
City Health Officers here, have a tenure of four years despite the
administration, because the law was passed after the charter was
given,

I would like to read here a letter we have just been handed by
the Secretary of the State Board of Health of Kentucky:

Dr. J. N. Hurty, Secretary State Board of Health of Indiana:

Dear Sir— Under Instructions from the State Board of Health of Ken-
tucky, Dr. Bailey and myself are on a tour of Investigation of the condi-
tions of the smallpox epidemic In Indiana. Ck>mplalnt has been made that
this disease exists in nearly all the counties on the Ohio River, and that In
many instances the officials of such counties are making little or no effort
to protect their own citizens or the people of Kentucky. We are aston-
ished that the disease has assumed almost epidemic proportions In nearly*
every part of your State, smallpox existing In sixty of the ninety-two coun-
ties. It will be our duty to make a full and frank report of this state of
affairs to our board, and unless prompt steps are taken to bring the dis-
ease under control we will recommend that Kentucky establish a quaran-
tine at the Ohio River, and that no person be permitted to cross without
a certificate of recent successful vaccination and that the person has not
recentiy been exposed to smallpox. We will regret exceedingly to adopt
measures which seem so harsh against a neighboring State, but importa-
tions of smallpox from Indiana to Kentucky have been so frequent In
the past, and the expense entailed upon the municipalities and counties
thereby has been so great, that we feel that Justice to our own people will

Digitized by VjOOQIC

(

demand it. I think It proper to gh
public of Indiana full notice of tht
the hope that such action may be ta
antlne unnecessary, or, failing in i
for it. Very res

Secretary of the S

Dr. Taylor: I for one am w.
invitation to the Health Officer
State and make an examination o
motion, as an expression of the o]

Seconded and carried.

A vote of thanks was extended
of the States of Kentucky and O
ference.

Dr. Stanton and Dr. Bailey thf
tCDtion to the visiting Health Of

The conference then adourned

Digitized by VjOOQIC

ANNUAL STATISTICAL REPORT

FOR IHH VF-AR 1902.

(601)

Digitized by VjOOQIC

Deaths ill Indiana Dt
Statistically Classi i
lOOfiOO Popnlatioi [

9a
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
26
26
27
28
29
30
31
32
33
34
35
36
36a
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
63
54
55
56
57
58
59

I. GiNI ]

Typhoid fever

Ezanthematoas typhus .

Recarrent fever

lotermittent fever

Malarial fever

Variola or 8 m fill pox

Measles

Scarlatina

Whoopingcoagh

Crnnp

Diphtherin ,.,......, ,

IfiMuonr^a , ,*.*,.,,►

MitinrjT fever *..«,k

At't^ilie cholera ,.,„, ....

Cli'.il(»ru. ficistrntS ,..

Dyi<.,nlery .„.,»..

B^'^J^'rJiC' pURa« ., ..

Yc';l(i>w fflver

Lt'i'rosjr , , . .. i.

Erv^ipolai

Ol f J 1.' r e pide m i c affu c ti out
Pur 11 Sent ftnd HeptiefDiaic! [

Ghiinl»i'fl ntid fttrnry

MOii^nant pastiilt aoJ ni I

Rui.i^-

AcHnomycoiitt trluhinoaj

P<-ltnfftJ^ _..

TntxTculoiis of Ibrjnx^.H
TiJif^rcMiIo^iBoriunw....
Tu^< rcuioait of mentn^e^
All 1 luiniLl toberculoiii .
Pcfr-' 'it?4'aae--,- ...... ...

C<' : ■ -Si., ,

"W ilihK .

Ol ' ii u I ftr ajTeotioD

Gf-nrsil Luhercnloab

Scr.fula .

Sjr-ilMB....

Sc'ii < hmoere r. , ..*,..,

B]i iii]t>rrhAj;iA of the ndii t
Giiiurrho^nl &0VHUJoni of 1 :
Can er pitid other tiimon c f
Ctf' er md other tiimora c I
Csn-'sr and othtr tumom c ■
Cii St' or \\i\A other tumon o :
Cfcfi i^ r rijui other tui^jors o '
Cft rj ' I r ji ihI other tumari a [
Ca [!' or »ud other turners o [

0th. r Euoinr« ..-...,

Ae uT<! articulArrheumnrtii i
Clirunio rhcuutatitm and S'

Scifi^wtBt .,

Di'.i.fitoa ..„

Bx ' ' ^-hthal tn to roitm .,,«...

AtMi-on> diSfiH&e .,.

L< 'itveTnu^ — ^

Ati .►■ "in ■Tul i-iilr.ri.-ii.?

Other general diseases

Alcoholism, acute and chro

Saturnism

Other trade intoxications . .
Other chronic poisonings . .

Digitized by

Google

604

TABLE 1— Continued.

CAUSES OF DEATH.

525

61a

100
101
102
103
104

lor>

lOISa

10»'.

107

108

109

109a

110

111

112

113

114

IK)

116

117

118

II.

Local Disiasis.— Disbasis ok thi Nervous System and
Groans of Special Sense.

Encephalitis

Simple moninffitis

Epiaemio cereoro-BpiDal meningitis . ,

ProgTessive locomotor ataxia

Other diseases of the spinal cord

Cerebral congestion and hemorrhage.,

Cerebral softening

Paralysis without specified caase

General paralysis

Other forms of mental alienation

Epilepsy

Eolampsla (non-paerperal)

Gonvulsions of children ,

Tetanas

Chorea

Other diseases of the nerToas system ,

Diseases of the eye and its adneza

Diseases of the ear ,

III. DiMRASES OK THE CIRCULATORY SySTKM.

Pericarditis

Acute endocarditis

Organic diseases of the heart

Angina pectoris

Affection of arteries, atheroma, aneurism

Thrombosis and embolism

Affections of veins

Affections of lymphatic system

Hemorrhages

Other affections of eiroulatory system

IV. Diseases ok the Respiratory Sybtrm.

Diseases of the nasal fosses

Affections of the larynx

Affections of thyroid body ,

Acute bronchitis

Chronic bronchitis

Dronche-pneumonia

Pneumonia

Pleurisy

Pulmonary congestion and pulmonary apoplexy.

Gangrene of the lung

Asthma

Emphysema of the lungs ,

Other diseases of respiratory system

V. Diseases of thk Digestive System.

Affections of the mouth and its adnexa...

Affections of the pharynx

Affections ef the wsopna^us

rioer of the stomach

Other affections of the stomach

Diarrhcea and enteritis (under 5 years) . . . .

Chronic diarrhoea and enteritis

Diarrhoea and enteritis (5 years and over)

Intestinal narasites

Hernia ana intestinal obstructions

Other affections of the intestines

Diseases of the anus and fecal fistulas

Icterus, grave .•

Hyatid tumors of the liver

Cirrhosis of the liver

Biliary calculi

Other affections of the liver

Affections of the spleen

Simple peritonitiH

Other affections of the digestive system . ..
Appendicitis and phlegmon of iliac fossa.

133
509
187
40
139
1.272
119
762

118
37

339
78
6

162

58
146
1,860
179
W
44
11
7
64

304

178
44

302
14

366

5.2

20.2
7.4
1.5
5.5

505
4.7

30.2
2.7
2.7
4.6
1.4

18.4
3X)

0.3

2.3

5.8

73.9

7.1

5.4

1.7

2.5

2.3

290

11.5

194

7.7

417

16 5

2,:^0

9n.3

2.3

363

14.4

110

4.3

162

6.0

1.6

2.4

580

23.0

1,779

70.6

126

5.0

9.4

9.0
12.0

7.0
1.7

12.0
.5

14.5

145

6.7

Digitized by

Google

119
120
121
122
123
124
126
126
127
128
129
130
131
132
133

134
135
136
137
138
139
140
Ul

142
143
144
145

146
147
148

149

160

151
152
153

154

155
156
157
158
159
160
161
162
163

VI. DlSKAHK!"

Nt'iihritia, ueiita, »...,. ,

Olh«r 4)i]$t'!uiioi« i)( kidni*
Cafi uLi of th« urmmry
DiiJK'Aieai ijf Ibc bludrUir
Diirastiii i>f tUe urtithrii
Diseftfif^^ of ttiQ lni1'D'*tiit4

Mi'tTitia - .

Uti tiiio tumor.

Olhar jlipenfie^of tbfl u
Cy^Jts jind otht*r ovaniir
OlhiT diauaic^i of fvttiml

VII.

AiMu^ients of pre^nnne;
Piii-riHTfll bcmi.>rrba.|Ee.
Olli^^r ftiiiiik^nti of Imbn
PuinrntTttl ftel^h^^erDin . .
AlliuiJLLhuriA and j>uer|.
PliltiL^tKiUin al'iii dol^n^
Olhur r>u«r|>LTal scridoi

VIII. DiSKASES I

Gangrene

Carbuncle

Phlegmon, warm abscef
Other diseasQB of the sh

IX. DlSBAS)

Affections of the bones .
Arthritis and other dise

Amputation

Other affections of orga

Malformations

XI.

Congenital debility icte
Other diseases of enrly
Lack of care

XII.

Senile debility

Sisii^ldebj poison

A-f^hj'Jtlfi ,

HimirinK i^t strangulati

Dri'wninff

Finiirniin

Cuttipg iiii^truments...
Jumi-iniir TrHtm high pla

Crujhinnf

Otboi" suiiiides

Digitized by VjOOQIC

606

TABLE 1— Continued.

CAUSES OF DEATH.

«M

1^^

164

B.—AeeidenU.
Fractures

190

723

177

111

740

178

217

1,914

7J>

166

Spriini

166

Other accidental traumatisms

28.7

167

Burns and scalds

7.0

168
169

Burns from corrosive substances

Insolation

.1
.3

170

Freezing

171

Electrical disturbances

1-5

172

Accidental submersion

4.4

173

Inanition

29.4

174

Absorption of deleterious ^ases

175

Other acute poisonings

2.6

176

Other external violence

1.6

176a

G.—Bomieide.
Homicide

1.4

176b

Jj.-Mob Violence.
Mob violence

177

XIV'. Causes Ill-Dkfinkd.
Dropsy

7.0

178

Sudden death

179

Ill-defined or unspecified causes

8.6

180

XV. Stillbirths.
Stillbirths

76.0

All causes

34,069

1353.8

Digitized by

Google

DUO

.£

o
O

*09ao[oi^

*jeoa«o

•HIOIODI^

-d9s ivjodjen j

*i{za9npax

'BpiSaiaoyf

■viaoianoaj

•qanoo
aaidooq^

*e9i8«ojv

• JOAB J %9\1V0^

•dnoJO

•vuoq^qdid

J9A9 J pioqdXx

'8iBO|noi9qnx
josmJOjioq'^O

'aoqdmnBaoo

•J9A0

9AT8Ill9nj 'f <ni

• j«9X X J9pan

•Bq^Jiqims

•uon
-mndoj ooo'l J9<I

9q) joj p9)ioa
.9H Bqi«9(i i«^ox

'0061 '6n8a93 ao
pasvg aoi)t)[ndO({

^»MCJ (o^9>«} t;Hb-eCi-H f-j eo<OiO;«a» a>c4io^^

'=*SS§8

0»«0OC4 C^iO«OiA OiQOOiCfi O*

13 '^'~' "^ ♦^'^

rN . •rH C* -rHO* 04

Aw^ rHMNff^ 'eOtO

rHiAp^ -04

e^neoocio c4iou3^t>-

e4iMC9 -^fp^ .^ r-( €4 IrlOOeO C^^ -00

a*-;3» S"*^^ a^S'^ i S^'^as S5SSS

i5*Sg3 S^;2;S §:JSSJ2 S S«*3?§ tiSS^sg

00 w^T-i coc^ -o

eoco (Nd

r-ti-H .' t-C* -CJ

t-iCO -T-l

KHCQcqeo «c>«« --^

8 ^^ :

^f^OOrHC^

«o-^eoiA cotocoro i^«o«dco

OOl^Mji;!:^ QOaQi09«>0

''U^St:

NCO coe4<NM

s-^sigj ss^rt 5!83a;2: I ^iS5S5:§? ss;2sa

$??«tt SS5J8S SSS? 3 SBSwPlS SSg5

t* '"'p:*'* ^ '*'^^'*';5

2223*f: 555S"^ § g3SSS:$ ^SS^S'"

(or>oo (MiMoot- t^^ana

gia^JS ssss^g gssso g^ g^agje sg^sj^

jo^«c2 c2«,^co g3t:;jo« I ^gj'^sS SS'-SS

S5g§ 2§S? i^gs i umm g?S§55

ssgss ssss

m^^ I 5ss*^^ss a^'Scsa

I I

ifJl 1||^ llll g III;;! Iltll

S;2;;z;pl. P^MOQM ^^!^^ g »«m50 OP&Mfetx*

Digitized by

Google

610

o
O

MoadjoiA

'joaavQ

■dag i«jeajdn j

'uzaangax

ivujd'g-o'jqojd^)
Q japaq *hd«va

'Biaomnoaj

qano5
JSnidooq^

'89[eV0|^

'J9A0J ^.i^jvog

•dnojo

-HU9q)qd[(X

J8A0J pioqd^x

'Sisoinoiaqnj^
JO suijoj jaqjo

aoudain-:no3

•J9A0

■OAisniouj'^oix

JiVBX I JopoQ

•sq^jiqiins

-non
-nindo^i 000* I i9<l
»1«H R»'®a l«natty

•2061 J«9A

Oil

oq) JO I po^jLOi

0061 '809093 no
p98«s aoi|«indo<i

eoioo»«o ro^otAi*

OOiX)l- ^COOO OOfNOO

i->rH -CI

caca coi-^MCi

«?3S$g ^J'-'gSS ::;5SS
^?K^5 §^S&a 22?2gJ55

•MeCQOO i^ • •« b-iOCC«

OOOOjQO OtiAiOOO -9<0-«i0

SgSSS S5:;5$5 8g35§?

^SSsS

^2«!SS SSiSS iSS^S

«§5g?2 q;SSS SS§SS

SSS55 s^;2;i3 sssSS

tocqooq

<0 7>aeco>

ssasi g§§§ s^ss-

-sssg^

:^^n^

;; ss .s

feS feto?

o a b o a>

Digitized by

Google

612

a
o

Digitized by

Google

613

:-<D'^CCiA OO-^MOC^ •-« -COOiA o»-i

£.B §.2 S

.2 '•2'=^ 2 6^.^.«

te « « S ® •£ > > S *

C V ». (0.5^ e9 V"' O 0;

5.2 0) § S fl.2 S.2.2

. or. BO

J--J ® «/ ©

■; " at, B» «o

2 fe oS ofi 98

e « o 0^ «

J^fl (O W (A

0J3 ^C

fc « o o >»

el S 3 *. fc4
o o » o s>

OD to OB Ci,a

pSppo

614

o»ci -a* IOC4 -^co o>C4QQ 'oo oeoooeoc4 ec • 'C^c^ ci

c^ .o> io« ■•♦to o»

«0

S*;2;

S*«

gSS

g^S

a
o
O

-*1

^ ^

s a

!S IS

;9 s

l-tfi rfoo

S«&

S^ 8 :?5

S^ g^g?

a^ 8

?^a

s«si

o>o §5^g5

s*^ s^'g?

00 Ok^X^

a sio«

<0 t>-AiOi-^C4 to

l^ c»®^

:s s;s-*

J5 ^s-*

eo '♦^oi

lO torfieONao -^r

«» 3i:ffi*>'-<!2

•-4 04 •!-<

^eO©i-«£Q t^rH

S-* S'^^

S S3'-

a :^

:2 S-

;5« SS'^IS

O cOtQC194CD CO

O CO^'

w .3 £ '^«M

• . *— o
rt « aj < -
o o a> a r

tttS2

c o

I? 1^1

•si 5.5 S

'•S

■-I ■
lis S :

. u n .

3 ■" 5

•^ c o-r 2

■** a. *-*»"^
«^ ww »*-■•*

® ® c * 5

tJ 1* ©•cJ'2

*" S ft. ** OJ

2 ® = 2 a

. a . «,

ao ® ® 3^,

!«M «* •

5® • « 2

2® : §2
C..2 \afl

rS -ai

■D a «.

a *.s.5.2

O ah'**'**

S
S

ca T_ w

V ^ t *iw

Digitized by

Google

rti'^i+ized by

Google

G16

o
O

•ac<4i-i .00 CO«-;J

• ftf^a* a*

:S2 -5;

•t- fNI-

:g <^'•

9 O

S'B o « £ o rt

Digitized by

Google

-♦■^

~Vv •

-*- o

- 5r

??^ <:j

:.^^

« S

SI S

o tw

•c: O

fe; §

•t-i

-^^^

rv '**-'

Colo,
Bert

-r Oi

' >-i

js" ^'^

-IS «o

^■1

S-

ss^

•"•

g28

S3j§

^•S2

^34

^2^

•-*

§52^

•"

^2g

?i2^

:25o

•^

o Oiti

»c ^o

♦Jf— (

V^l

s
s

*"•

t-^

rti'^itjzed by

Google

618

• o**!* ot>-o»a»aQ oo«Of-4 'oo

:-s» ociiS'* •

90«o -Qoea

«3g

1 e« ;i-H

%2}S

: i«*«S ^§35:;-*8 ^*?3 JS

jrHf-f C4<«'^ |f-l

ttfK^r-ttOO

:S£8

- i^*^ »2S3«^ ^'-^ is

•0« |CJ lO ;CJ jiO

:*"■ :-

S5S

• eowjg ocgjcoicg^ scecb- jo

jec-^c^ «oooi- \

e4<^ JMA

• •^c^'^ «or-o>^o» cO'^'^ "Oi

•rHPoec ?o-^«e •

coa»eoe«o»

^5S

e« r-t ;

^^^t:- ooaa^&9<o r--*^ :-

* ri itA :n <* :« *.»-«

MOIflOboO)

S2-g

• e^

i-li-H f^

: : r :

•c

C<l9><«<r-4eC

CCSO "O

■|MC4 • <0»-4iO -r-l

»^ -lAO

^3^

: "

■ eo — » ic-9"^

•b- ^b-W -at

:_^r- M 'X "^

-<4«OiO -cr:

s?^«'

• «

^e^

McCf-

:^ ,-it«?4 -x ^ : ; : : r-r-i'^ ^i-h

■ei««« 'i—

S2g?

: : : :

• •*

c^ ^^'^^ •

^ 1-NCCCO X

^f-i :« eaci— ^r-

«000«D CI

851^1

;_._,„

•i-i •

OCt^ •»

•1— -N -^C-l '•

C4t-r^ -C^

J22a

QOfrl l-

• • eo ec • • «->

t^tceo— 1-*

•-•♦-i-H

: : :e4 ^i-^ • •

1 r-«lCf^ 'OO

C^l'M-M -t^

•«ss

rieON ;

- ' : '. -r^

eOrMb- CI

- -;-

: ^'^ : i""

: : : : '^^ : : ;

0|;^i0 JCI

rH •

■"" : !^

•a;j5 r

»-«

CO 1

: : : : '^'^ : : :

ss^-^-

S :S

^l-H

rH j j j o>eo ' • •

!jgo-22

*»

• -

-a :

II:

S 5 •

: 0 : :

■ 'a '■ :
. 0 • •
• >« • •

li-
re

.S« :

:-8 :s

O n

BgJJ

"■

lu • • •- 2 a S

-5:5 : : OS* 0
co2 : S?5 .3

•

f perito
r femal
f the br
f the 8k

idls 11! II

* 5 » ® 2

o c c o c

S*.s^s

•Sf^ga -Sil-S

|;is^

QQQQ

c e

5<5

e c

5<3

i.
ee

Ills

other

Lead
Other

Digitized by

Google

t)15>

^ — fc^CO iflC^l f-t

a-g

•^SS ^gJ" ^

'*^SS'« SI

sj-- a

- ;? i^'Sg SS^

<ll-l KONNOO^ CJ

;:j^

»09aooo c«>-4

0>i-^r-i0|^ 252''^ ^

•HrH toMooagco <p :^ : <>o

5-^8

tOcptOCO CO

e<"*o •♦toeo

i^t-^e^ifi.O r-*w^^9

«|io<o«o>^ aoc4

^OOkQ l-iOiM

«Ud9>^iO "«• ••004

'^•«55'

iot«-fc-t- *n^

«jji-t^ooei» j^'^

«<cit«^^ao lOeo

3-^

«OrHt-« t*e« •« • ^fteotei

f-iiO^ 00»-«^

■^103; cot^^eo

^i-« • doo icci ■«rr-<-t«o>3

i-Nccr-eo «o -p^

rHeOlOjJ^ r-rH

f-<rH«DQO00 0»

M "OO • O

1^ to 'Ct

f^di-t co»5»i{*:^ c^i-Hcot-eo c^io

■^oicogji^ QO

• • 2

a :S 3

tC • .t-iiM

CI CI C^ «-> CC

<IC««t-l a»r-> .1-iCJ

^SiiS

Jt-tOSOQi-t OWrl

i-« ^C<«-4

S-

2.S

So±'£Z &3 3 = S

g<M«^g5 ^rH

CJ 0»t-iG^^

?5'"^?§'^ S

I -

s s *

o Cj •- >»

£=.--^:^ ?LcSo-^® *2^'®

• « ^' ® »

* - . ^^- •». «^ « •r-— * « «

•^ a

OJ3 -

a ©

■ n

>. - * o 2 c eats

o « c ea*»

3 alse«M

p © 0

iB.i

©"S-i-S.s

oaft*<0 OWQ Q Woa«Q

5g£a5 gSj^ri. SSS^g
- — "'.*.2 '^'^

5Sp5o

Digitized by VjOO^IC

620

o
I

0502 •?
ft) s 9** "/t

III! "I

000a <

Digitized by

Google

'^COeOMr-l rHC^

to 09 PH CD

* s

.2 9

m u

O trt

««•

O 00.2 B !=^

S a cu3^
S ® «—•■.->

9 a O 9 S

0»»-i c^>-ioi

0»t-i C4N»-l CN

OOeO •^HrH »H

WrH r-n-l

C^f^ C'if^

59 o S

£« 9

2g.2

• CO •♦f-IC^I ."*

S V " a o

** 2 »- S ®

9 < © g B

>- 5 fc. Jf ^

9 rt 9 fl >;

= 111.1

gaga's

'^^ i S S ^

? * 2 '" ci *

-^«*- S S d
s l^ O "• i« «•
; ^ ifi w 9 ^

^ ^ 4 *i*^ k

5-55 3

Mi p

•OJCCb- 1-f

• ooi-Hoo ec

OO 'Cfl -t^ 1-H

eOr^C<JWO» COt-i

rH '^C^fO

t- -FHrHCO 1-H

S :-"^«

-^'S I

Qf-« •»-• T-icieOT-i

rH p^eOri»-l

•00 »-l3<t-

•^^ t^iOCCp^

gt»COi-« rHC4t^

gJtO -Ol rH<^lOeOr-

« c * t, e » T3 h"^ = ^
R =-e S e "^ a 5 o £

__. 5535g S^Sg-g

OO-OOtL. QoPQOQoQ CE(PE]<<»q^

622

o
O

S3g

S3^

S^8

ooo

c<a<M . .o c««

8 ^S

.«©.-l'* rHt*

5 o

5S a

Digitized by

Google

624

•l«1ox

*pO)JOd

■peiiopiAV

•pdUJVJI^

•©isnig

*pa;jod
-OH ^OK

■nSiojoj

'uvauamy

a
a

o
I

Hi
H

•pajoioo

•IIRM

ajiOU3(an

S5g

225g

f?2id

l-Hl-H^« .f^ . •« i-H •!-<

'^;:J^ ^SSSSP S2«

C^ 1^ r^

?5'~'!S:*^S i^oNiorj o^go"*

oo •^oeii

i-< •« eo •c4i-^eo -c^ieQ

t-iCOON rHdOdaOCD CO-^irt

S :$Sg ^S§^g ^^^

^ -to i-<^Cfli-<^ ^t*t*

i-< -c^i c«i-i -i-ieo -Nc^

MCO i-t

COtO C4CslO>>OaO «-ikO«0

fuj ■*t--ooooQ eooa

i-ieotCr^ ^uiosao-"* «oeoao

08 « .

o «

o o

* u
S ce

o o o o o
, h h ft' ^ »« »« l«

£C^ &,B a e a G c a

eoo>co (oco

S2S

Mi-li-iCCi-t

eif-i • tok^Oi

V- '^'-'J22§? gSSS

« <^-;f;?:gf5 g^S

rH eOC4i-l

C.2

ft. 9 a > o
JO 3 ^ 9 <a

ii fl ® S

'^ £3 o 2

'-a-s

lO eoc4 -00

S :»g

glS;3s^f:2

'^ Saf2S58

N00r-liC»-i

c^tococqeo

i-i'*f-i rl

c^-*»-i»-ieo

ft. &> o

«-3 S.S »

fl A< S ;^ S

efl ««^ «. J B 4) B - o

08 08 fi,
S ft.*

•S3*
;.2 £3 S

Pi ■ « at Z X.

Digitized by

Google

626

WOX

•poMopiAV

£«§-§

i-ie^ -co lO

ae 5 S'

S' i=i

ec • 1^ -eo

SS;:: i2«55

SS3SSS cjj«i-^o g|5;s

r-l i-l«0 •i-H'* t-i

I>'^i-«« as

iM -co MiAr^

•p91JJV)\[

B S=*

ss S^S?

« g§§8'-fe S

eccocj S«o^

•©iSaig

gS58^g8 g*

«« g-^

*po)jo<I

-0J£ ^O^J

'QSIOJO^

9^l«0 -04 >C

©« • N -iC

r^ OOt— i^rlCi rH

rlUJ •©* OCi-H

$«> ^^§5

'avouomy

S^ g2|

rH tHO> r-t

•pojo[oo

l^POOi "^ QO

o
O

CO
<

r- . o -oo

eo ooco • o

$? : •=

rH ^ eo

•»iiqM

gg§'-s r s^ §-^

52 ^SSSS §S«*--^^ aS5S

■OMoaiinn

S28

^5g

25"

S55

SS^

■■*• f-iiOi^

■^ OJrH »OlO t^l-lOO

•ti .ti -^
C C go

5.255-3

B c c « 2

* .*— a
0 t. o c «

ttfclg

•5 >

i-i ooo-Meo

?? s

§5^ fc

B O

-B - ^ £

.- « w 2 «

1 c c^ 2

• ® E „ *

» •^ *f fti^-"

o «s

ft-.
0 o

•r S i =^5
^ ® « «-

5^feS3

«T5 U.2

5'3 -So
^£ *is
®5 .22

S S.S • «
2 > - c a

.•§•55

s«s25

Digitized by

Google

628

<x>

o
O

•mox

paMopi^

'poui«pj[

•©isnig

'poqjod

•uSiajoj

nv9U9iny

•pojoioo

•o^lRM

aiioa](ii|-^

sll

S-»«S

^3g

R=S«^S? o^

SS2SS

'«'*'« :a :a

Nt^—lOi -rj

S *8

.5®

fl o

ooaSp

*J2

9 O

Digitized by

Google

630

58^

S^cSS

^SS

sss^

^eceo

;;sg5

S"^*

S3S

SS9S

$8S5

5;S5S

ss^s^

s^ss

t^or-

S5:ssi

SoSS

S3;st;

'8^:::

•-8

9SSS

9c^ri

8^8

SS8

2i;:;«

!I?8S^

5S2S

as;;8

SS:::^

sss

SoSS

s:ss

coaoio

j.««

8S55

a«^

SS*

^•S3

«9

CO
»
l-J
H
S5
P
O

5s:2 5;?g58 sssa ass •»-'" ?sss as:;* j^'^a ss?^

8s;s fe?is a*s ioJss s** a*2 ass 55** as**

3SS SS5:; 8f;s ss* s«^ ssj^s sas ass as*-

3SS sas SS8 gjSci s«'« S58^ 2:-^* asss ss«

$83

^;^^ $88

8SS S*""* SSSSJh

S«g| s;::s 35^**

5?8t;

$as^ ss;:8

|g82 2:«S SS32

8^S 8i"S 5^«*

giSS 3Sa 588 5?SS 52**- 5523 SSJ:; SSSI SSS

§5iS 5iaS 5i5S 532S as*- l8c5S 3^*- 852S asS

3-28 3-fa 5-£g 3-|g 3|a 2-=s js|a 5^a 3^a

HS&M h;^&« HSta h:^6m hS6m HSfM hZPm HS&4 hSPm

Digitized by

Google

3;5* 5SI2 ^^^ SoSS

3sa as$3 55a?4 ^'^^ ais*

3583 J5<»« g8J:S S''* J^SS;;

SSo^

^^'S

SS^

«««

[:§§§

s^ss

;ss^3

coc3«.

5:^=3;

S^ec

^S8

^SS

OQOC^

S53g3

?o$oS

^oooo

g5S^

lOt^oo

8SSSS

^S8

?l*;s

SS5§5

00 aao>

22c:;S

^CSSS

833

sss

oooiOJ

%?5^

s;i:2S

8S*

SS^8

c5;;2

5SaS

^^S:i

s;=:s

SSe^g^

oooaa»

8852

SS92$

oo«oesi

^^3

JSS^

5Sn

3-59 js-fl S-la i-2a 3-?a

HS(^ E-Z{^ HSPe4 H^^Pk HSCx I!

0
Q

Digitized by

Google

(;y2

s*^S «ss ?S;2;s St22 S^S ^J:;S S^5:;S '**^" &S-'

tf^mc^ io«oo» eoacio pjj:;^:^ ?5S?2 S*S §S»H* »«'*'^ SSS'"

SS* S2233 ?i2S S2S ??2S SS^ i?S;2 '^'^^ SJS

ss^ fer2 s::S SS;:: 5S83 S5t:;S :5S5:; "^"^"^ «SS

S !

S::^^ 5523 83J2 SfJS ?§;5gs S^J^^S ^S22 S2^^ SSSS

>; I ^^^ 2^2 555:;'' ^§3{^ ^'^^ ?J-- ^'^-S ''^'^ S«^

•-3

(1>

i-Hft«0 r-i-*!- '^•♦O C^li-HrH SOC<l"5 "S^lO £>£zS «C-*CJ S3*£2
CsJr4 e^i-t W»-ir-l frai-^i-« e5^-r-l Csir-li-l eOr-<i-i ?< r-"

j£3QOt- jooo t^ooo* g^^g j^weo rHO;2 gjgg o^..-j 2555*0

g^a.;* glt-iO CJ;:2;h c^j^ci gccjc ^'^^ ^-c^O j^o-r. jgcgg

S525:: ^^^ ??;2^ ^?i;3 :??12 ???3^ ^\^^ 2*^^ icl^?

paoci 0VO3. 5><Mt- tr':;<c £\2~' ;3;'=^2£ 5S£J3 t^cioo gcggjo

aC'OtO TC-r^tO cCCJ-r l-rOh- S5^^ Ju'"'^— ' £JaJS £JI-»ft SSSZS

K . . 00

X . . w . • as

; : c : .

>. ^ .E o ►-

Digitized by

Google

633

5?2« t:^S J^'-S SJ2;2: ?cS53 5:;'-S J^«;S SSsjgJ S5SS l2$gS 122 SiSIS

3SS S°^^ ^'^'^ 5^12 §?S2 S**^ S?SS 8S5^S &S;:5 S!5S gSg SSS"^

J5SS S*^-* SiS*' 5S5S5 g5«'- fZ'^^ gi^sS ^§5;: 53:2:5:; S5SS ggg SISS

3158 J:;*^ S^JS 53;22 §8S8 ;2;*-'- 5S5S ';§8S aS^ g58S gSg $5;S2

Sas 8S^ 5?S2 52^2 SS^ '^'^*^- SaS 5g3§3 §?St: gSS gS^ S^S

OkO «oo>t>

JS5S22 $3*^*® ?3''S 5fi2 ?J*2; S""^ ScSS ^3S S^IS feSS §Sg 55

^wo* 5jo>^ 1:50210 oogg g;2:j2 o>io^ ^2g^ g^« gjrHoj joq;g5 gg^ S^S^IJ

g3i::;s S^2 *'«'*' i;a?5 sss s*S i^^t^ ^^S g3;2:* U5§? ggs ^^^

SoSa 2*2 S-^S S?2:2 ^22 S^S3 S?ic5 ^8S ?J2^ 38?^ ggg 1^22

>ic«40 o)«oeo «ot~0)

ll?^g5 §52?S SS« Sg?i5 §8?355 SSS S^^g ggg 2*2

3«S2 S*^S2 SS'"- l?§3;2 ^;::2 2^;:: ^2?:; SS^S S2JS S^§8 gg^ ^'^''

, v":: , tmTl , no*3 —*d .M"><d ,--«o8 —^w* ^^waj ^-■'flS »-?ad .^«el ^^""oS

3^§ sst ££t s^e 5-2a 3.|a s^s s^a a-fs jS-Sb l^a -|a

H^pc4 hSp«h hS;«^ hSSu H?;^ hSP^ HSSfi* E-iS6^ HSfN E-'SP^ hSP«4 HS&t<

OP : a e .-eroa*

^ W

•J

Digitized by VjOO^IC

634

wd^ ificOM aooco r>o»ao <PO>r-4 eoaoud 90'^30 cOMr^

Deoc4 aooco r>o»ao fio>'-< «^'

cjt-io tOOi^ Sioo'^ t^eoa* <&t^o% o<d<^ -^o-^ eocii^ lotoa

tH • eOw^r-t OI«-4f-^ CQ-^r^ ^^ »-< w^r^ iH

«t^<o «aioo fcot^ o>'4io c»eoo» co^e4 eo<ot^ lOr^-^ n^«o

^^1- £3<o^ S"^** *^^S i-"*^-* ct-eo 9^^ »ON« **2J»<=

0
<

t««oc4 spoooo st^«o sjtot^ cD«o o^«o <09a^ ao«De« aft^'«i<

f-l r-» WrlrH OQi-ltH O0f-4^H ^r-«i^ r-l tHp^

a
o
O

4
»-8

or^eo SR^^ i«r-ao goo fCrnt^ oioor-i o>^.o eOi^e« ij^*'^

S^« SSIS 8^S SStS SS**- »«»« 8:;S;S -^o^^ ^-^^

to t>c4>o o»o>o sS^S o-Noo >oece>4 ::(:co-4 <^eQf^ a»*0(O

rjSiS S*2 g§5SS 83

c5S;3

aoo»o> Si^iA '<^«-ieo ^toeo i-to^ c^<;ot& aooao r^^eo eotAa

WS S::^ ^Sa 55SS 52

gO>f^ »j-Qt- gj^^o Q'-'''^ 0>0>0 <OW* *'~'*2 tON-^ B^^o

H
►-(
H

O
C

as* SS»:;S §5S*^ ^;::?3 :2*^* 52*''' SSS •^^''^ S'^'S

« ..• ..OB ..• ..«0 ..« ..«■ ..« ••*

o .o ••« .V ..« •& ..« •• :**

3|| 3i| 3|1 581 ill 5|1 i|§ ill ill

HZCic< HSu< HZ^ HSS< H^f»H h55^ H^>4 hSSn --««-

.2 c

® ® o jd

S 52; » Q

Digitized by

Google

636

c
o
O

SSS

25:;

<3>t-Ol

s«s

S^fe

0»^iO

SSi

JHOO«

►

SS^

^;3S

«DiO,-i

rHOO

iH2gSS5

sss

•iriook

SSS53

jo«oo

^;:;:5

OCOI-

cot- CO

?2^5o

sss

^ooto

:?S2

to 00 00

53S2

SJSS

00(0 74

gr-u.

S^95

n^'^

a^oc

qJSS-

55S*

^S^S^

=?5=;s

fcOOJO

Oiif.'*

S^§5

JcS2

5h'*S

SSS3

^^52

ss;::

^*;:

iO0S«0

OiiO-*

s^a

?522;2

ooow

5^3-

§1^:*^

•-3

jocoos

g^S;::

t-iAC4

^t-t^

SSS3

^s*-

oo«cc^

S22

;?••«

9
^

«5;2a

§^;s»-

to-^oi

om-v

SS^8

JOj^'O

JCIOO

^^^

r-ot-

q!?;^

gJSJ:;

ooooo

?122

$oS^a

^28

igt-oD

^^^

iCtOOS

§?S8

gS*::^

c<j«o«o

?i22J

i25S5

§§;::2

«OQO0O

^SSi

8S^

g??!;:!

?S2:22

Oiift'*

NQO'*

S5^?;

85S;2:

J^''2

SS^

s;;s

•

2SSS

§5SS

wt^<o

l-C»X>

lifSRgJ

%'5::i4

iO0»«0

^8S

aa«

•-3

i is

3|1

ill

i is

0 * ®

3|1

■ '. V)

. ■ 4,
o<«

:• is

ill

3|l

COUNTIES.

i
1

c
«

or.

Digitized by.

GoQsIe^

'gJ

Digitized by VjOOQIC

638

-T3

o
O

Oitft-*

l«§

r-^

o»»o^

C40

«>»

H!=-

^sq

i-^i-^

COCDO

S-t|

ri »-H

— r

r^OkCI

»-i» ! ^

ass

rHt--*

»-«i-i

•->

a»ao^

•->

jgost-

•-5

^"♦O

go^oj

rlr-l

sa«

li.

■^

5S53«

•->

-gl

« ® c

HZP^

• 5 —

"•5 5 ;

!f 1 i

II o

Be- 1

1 ^

Digitized by

Google

t}4:U

^s^

fc^^ j(;C<lC^ lOOatO Oit^C^ tOC<)eO C!?iOOO 0)09» •^OO-^ r-i-»«t>-

S3^

t;!S!!5 JS*'** a»oo> ooeoua o»«oeo ooooo Oir-CM n&io t-^ot-

{g53

^-QOOs o>F-*oo -^Okio eOQOus eo •«

QO'*««'v o»'«*<tri -^ooo

S5S

«3g

52"^'

OSiO** sp-^n OOOri r-lt-'^ l^<OrH N^OO t^i-^» OO'*-^ OS-^iO

r^io«o wxiio t>-QOc> «rro»<e oeot'- eooooo looioo «om'* osc^ir-

COi-^t-< rH r-4 rH f-H 1^ f-H«-H

g?2o

oect« tCL^oo mtoa* okcotc oio

COrHrH i-H r^

-<•• U»-^r1 tO-^M

S5^

SS~'I2 o^ceo rHr«-«f< t^-^M io?oo> i-<»oto o»«oco ■»i"QOo

^5g

t-«n SR^oo ^«oao ooooo I'sc* t-oiM o-^co ooc^«o cmi>.u^

c
Q

S2^

t22S

S53

«i2o

OOC^HO r^l^"^ OiiO'^ OOOSOi CCOOiC OOt-r-l t-O>00 OC^OO -^lOO^
I— li— I COf-HrH rHf-if-» f-l r-lr-lrH r^ r-l

cgeoo fioo ootooi ooorH c^oo? coob* ootooo o ^o ocieo

o^tO't cC'<*<ci r--^eo i-Hioto i^ecr-i toeoeo «o

r-l 0»«»-4

r-'ooeo i^'^eo

?5?3S

OOiCCO b-tOC^ eCiOOO ^C104 <0'««C5 ■^»-i«o

(N»-H^ COrH?^! C0C^1»-t

O «n »0 rH rH

00 .e«0 tar-t'^ "«<€CrH COri-^ f-l rH COCO

OflrHrH •^i-HCC COCO

r-co^ rHt--.f fh«oio -^nc^ oocoto oc^ieo i-e^ua t-"f»»eo

-TOO. rH^O g^S^CO '^^^

^^'^ ;::

rH-^t^ «Dl-3i ^t^r-

8SS SSS^ SS§^ jeg^ SSS SSS !385S

3.|a 5.2a 5|a 5.2a s^a 3|i S^^a 5.|a 3|a

hS&^ HS&h HSP^ hSPm HSSfe HSaE4 H^Cm hJ^Ob, hS^&4

o
o

Digitized by VjOOQIC

i-iC»09 -^t^t^

641

s?ss s** sss ssa* as*- s*"^ s"^* sss ssss asa

SJ^;:

ot«eo

^255

«OiAf-4

85;«

^tOiO

04040

s«s

0'«#-H

S5JS

JSS*^

S;:^

SE:*

C9kOt«

5?:ss

3S"*

^SS

ot-00

oo»o«

iooot«

§5S2

5;g2:3

^cocj

•gooio

53?;*-

Oifoeo

5oS;S

05U3'*

OSt»<M

ou,«.

os-^io

ooioeo

toa»(o

358S

t^ooo*

0>t«C9

^^^

omio

ss*

ooiAco

•oeo 1

o»<x>eo

oeo*-

5iSS

a><^io

oxoeo

^'^^

r^-^ft*

S^<*

l^CO-^

S5S2;2

i-'i*«eo

S^«

a»eo<o

OtdMi

8;:;:2

<Dt»0>

C<iOt«

S?2S

CONi-*

51«S

•^eor^

lOt-oo

«'*•*

ootoeo

iAe004

■^Oiia

g5*S

oOWiO

^lOOk

S;::s

o»«<o

SSS

«Dooeo

s;2«

<0'*C1

0OCOU3

COi-lO«

OOQOO

S5^S

oaoo)

o>in<«

?oSS

W'^OD

^OJO

lO^r^

^O>00

0«0'«««

OOlftCO

t-ec*

C4*Ot^

I8S8

;2:^s

S'^;^

g^ss

•^tAOt

««^

o^«.

S;::s

OiOO

f-<eooo

■^ •■^

J^;::**

S5SS

8*53

o«t-

S5S

eo^Dt-

§^;::s

iO"*r1

WlOTO

<CC»'*

CO JM

t^'^f'eo

s«^a

SS2

S^i:^

•^eOf-t

O"'*'®

0«0'*

oc^-*

i«COW

cit^cq

-^tOf-l

<DC4-««<

iO<Meo

jl^osoo

sss

o>«eo

-* I"*

5ecc^ kCNeo Cir»i-- tcc^-^i' p'^<« oooec <o«o

a:s^

j<«-<eO -vxto

55SS

t-'^eo •Ht*'^

C4^CO

'♦rieO

«C0 j

o»oo«

eo jeo

l-» .»H

CM ©4

eow»H

tO-^OJ

•*rHCO

**-*«

t^^c^

(M j(M

OtiO-*

©«N I

te-^fc^

ecr-iesi

00«iO

OOON

00^-^

•*©«(N

Oift-*

OOr-t^

«>C«4«*

<oe4<«

«ceoeo

^COI'^

OOfHCl

f-l [r-

r-cO'^1"

IC<3>»

Oft'^O

COQir^

o^<^ ^'^*r> ^f-io at'^eo '-c-^c* «or-o> ««o

SSS §8S S5SS SS"

E^s^s :^^n ^$g^ ^ss ss^io ^^13 $s^s^ ^^;^ &S9 gss s^$ ^e^ss

III HI HI III III ||§ 3|§ 3|i 3|§ 5|i'l|l 5|S

hSen hSfn hS;x« h:^;:^ hS(>4 hSpn hScm h^^ hSp^ h^cn hSpn hSpm

»
iS

"«

Q » h

41-Bd. of Health.

i^Uiid

..Coode

642

c
Q

SS^

S3s

S^**

^o»io

«f*o>

$5** 23

SS'«

8^?J

gog^o

o»^io

«3(M

3^3

S*«*

00 to 00

S2«

53;:iS

asa

S«"

00009

OrHfiH

JJ.0O*,

S2g

ear-iA

oooeo

OiOiO

OU3«

o«oo

oo^

ooot.

-i^r^eo

Ot*«

J§5g

o^t^ao

«o •'«

comeo

j^OXN

t«*H«>

cj«o«>

S^S

^«r-

j^0«0

55;$

ACO«0

r-iow

t^o^ao

j5«oo

£;^S

j5«>ao

gi>«

OOCSr-i

ooeo»o

^-2§

ooww

osio<*

o^o.

f—^eo

a*-^

'^ttiOi

;2;«;:3

oo«-4e>4

ts^s

^2s3

^5g

83g5

!55a

S2;5

»o2g

aS22 55»« a;?^ SaS 55*^* g*S tSS^ ^'•'^'^ ^g'^

rH"^r- ^s^eo 0f-40) cJO*h oiuat- rHto>o f-r-^fc- <<»ieOi-( t-oiio

C4Q0^ oo-^-^ r~eo-« eofot^ a»«oco '«oo«o ^*a^ . "^coi-* eocot*

OOCOtO r^iAtO <OiOf-^ ^iA«0 fiOlOO

^s*-

ooooiA oatA'^ 0400-^ eo«&»« Mcooi oe>9ao ooi-Ht^ cocceo f-4r-io

Oiio-^ rx-Hto lO-^r-i tooieo ■^fHoo ^««e«e4 e^ous

■^ t^-<^eo eoc<

t«-^ec ^rHco ■«C4c^ ^eoa» Ot-tr-* «Oi-im

rH '^e^C^ eOr-lC4 <N»-I»H rHr-l

C<1 -N »-li-l

ino9eo lOr-f^ tcc^i^ eornc^ lOri^ i-4coeo CO -co oeoc^

t^ot^ oioio eat'io t^'^co ootow «oo« eS^® ^om'* t-^^o

§§§S 5!S;S ;jg52 ?2^^ g:?:?.' SSS SSS SSSS |S5S

•5 • m

^""sl ^"Otf ^"°d >-«*d •-M^^eS .M^d _i'°d _>*tf .M*tf

5-ia 1-|i 1-23 3^a 5|a s|b 3-|a 5^1 3-fa

HSPh H^Cm H^Pb HSC^ hS&m hSC£4 hS^ hS^ HSte

Digitized by

Google

>»i-<.-i 0-^«0 t^OCO 2t?3^ 0»0»0 CO'

O-^Oi C^lOt^ l-aOO» COi-ttO OJrHOO 00

coot- t^fOOk tO-^C^ QWt* t-iCW ifi

i^toic '^e^M c^«o;o ooo i-iooao o^'

f-i I— I C^^HfH r^

eorot-

O»r-IQO

ece*50

■^r-t-

C^;0<£>

iC»

^^.x>

T.-^^a

'rrC-lCq

'»-!fC<l

in^<*

as<

<oo«o

toed"*

S-^2

ClOO»

JO»Or-J

-^T

J^^^"'

t-'^ec

occr-

OOGCO

oeoN

(d:

00 tow

^»oo»

OXMt-.

S5SS

s«s

•^f

C1CCC5

^r-iA

Of-i"<««

SS"^

NOO-*

-re

OlM'*

CC(Mr-l

WN 1

l^iON

»OCOC<I

coc

t-iCM

•^MC^

-^eoi-i

^1-^tw

Ci-^iC

-^rieo -^WiM i-H

^ -M^r-t

■^COrH 'XCCeO OOdrH C^

CCf-iC^ Cfli-ii-l

Wr-lCN

o«t-

^-"<•«oo

(Mf

OiO«

s^?:s

l^«Of-<

■^O

fiss ssss

S?JS

g^s

£28 ?5

JS§

9
—

^iia «*fl cc^a ^-8 ^^1 <*-
HSfe HSSfe hS&m HSta H5?fc hS

Digitized by

Google

644

c
o
O

piio ^J0033

^-l"-

""* ^SS S*^"* I— *eo ;5J;;t- *o^»a «OfH«o

82j8

^«>- 53;:g

t'WO o»r-e^ eooOiO iccon r-t-^t- iA'Moo «or»'^

!82g

«Cff«'*

c5S2

QOi*'* 'j;3*J5

»o

kO iAi^'« 0»^0 lAiA

t-CO'^

eO C^ rH If la OJ

O'*-* «Oi3>»-

r-K^t- r-l

1 aO'^<«

eon=^

«0'<«<C^

S2a

tOl-Hlfi

«oa>i-

OiUi^

eo«or-

i^tOCO C'lr-I^

(0<4ir;

•O^n ^ -^^i

5S5g

^S4

•ccvirt

oi-eo

iO^«-

CO-HOJ

loeoc

lOCOC^

OC^JW

eor<r-i -^rici

»o

"Hi<t-.t-

iO-X>0)

Oi-l-*

^-lOc^^

«,^

10 5004

•^«ox

eoric^

S?2§

■^

r-l

«OM

^5^

0'«t<«

oeofc-

0>03>

O"**

r-IrN •

9»eo<o

«oeccc

8S«

«o«ot-.

0>tD3C

r^oT^i

r-Irt

OOtDT^

conr-

t^-*>»

85^

»-«ic«o

teoooo

8^S

CC^OJ

•ncoff

^-M-H*

o»ie«»

eor«ri -^osoa

S2S

" "

^ccce

X)eo.rt

o:><cec

e«i-ifi

«C«M

•*r<CM

00^^

^ «H .rM

r-H-»iR

O O,^

eOC^ri

ioc^co

eocc

ff^*a:C

'««Wf-<

riri rH

«i«pH

«« i

r-.*-S

•OSOCS

rHiOtO

aoiocc

OktO'^

rN|-«

»o«r

OOtfl

r-ilOCO

lO ©o

CO 1-1 c^

Mr-ti-l

eco^r^

rlrH

OJnrN

rlrl

^74 04

« e^rlpi

"•^-OJ^N

r-l

nrl

r1 -r-

0« "OJ

c«cq

tOC^J'*

«CC<I'*

C4rHi-H

«n^

n-^

ort

■N

f-«

r-l 00 :«

^o>cq

tO'^fN

8'"=

^^-'♦

l-OOJ

0?J«

CO tor-

eor^rj

-^COi-i

•^

r-l

55KJ

?:523

S3S

S?SJ

««i*-:

?ii::;:

;??i?

oo^o 5g5J5

(r
e

■

3| =

3|l

3|s

o * «

3|i

311

5|h

3|S

' III

i
ii

c
e
>

]

e
?5

Digitized by

Google

645

*/sr*QO A^oo a»0»o i>>'^eo coiaqo '^tr-a» b>*H(D aooao) co^a> ooooo ccioao ioccc4

t-^ r-i f^ cN 1^ f-it^ w^ fm r^ nt^ f-» »-i t-^

OtO-"**

;2J«C»

jjjooco

04 00^

^t«»o

o^«»

00-*-*

oeoM

QOClJtO

00 '^'iH

CJOO"^

lOOJCO

Oi'ViO

;2;s^

<0'*'N

U?QO»«

OiC^t*

e0(3»'^

•.-•^

•^oow

eoooio

co?et*

^:^-^

eooo :

COfHM

ooor.

ooeoto

<OQ0 00

"^COi-l

^t-^

eci-i'?<

S^S

00-Hl«-t«»

o>eo«o

5««

t-^eo

tCdcq 0«0'^ OiAiA t^C^iO aOtO?0 OOCICO «OiOr-i aOCOiO 9»^iA Ar-itO '^'MC<I r-l

f-ir--* ao84«o o>fr-74 CO •« ooirteo ^^i^ -^e^c^ «OrHio eotooo ■*t«Wf-< ot^co r-n-t

o»eo«o

ooeoiA

•>*r-l«

'*QP«0

S**^

o*^

eoc^i-^

lO»H<«

^00 00

eo>HM

ooeoo

0«eHf-l

««f-4tO

o-^o

oito«o

eoi-irj

«0«Oi-i

jeait-

eo»H5^

^o«o

riwo*

«r<i-H

«o«co

WNtD

S*^"^

wc^o

iM^OO

j300«>

.««oo

l-<Oi-i

t^C^iO

t-c^io

OiO'*

OICOCO

(NU3t«

«ei-iio

0>-«iA

JlJJt-t*

0»iO^

S*2

OOWiO

*:;*'S

t-eo-^

igr-QO

55*^5

rHCOOO

o^«

IflPN-^

oiua-^jt

t-'^CO

C<liAt^

jCt^OO

^aoco

S5S2

■* i"*

ocot-

cot^o

'^♦•G^C^

oeoeo

o»»oo

c»<oec

i**WC^l

■^co^

tocoeo

ao lt «

t-.c<no

•*■* ;

os«oco

eoi-iift

eoi-ie>»

IflCOCM

-* j-^r

^ :**

»oc^ieo

eonr-i

ss*«

«cecM

Ol-CO

<0'*S^

•"• I*^

oo«»c

r^i-l

««•«

U5-H^

*-^i-^ j

r-lrH •

l^-**"??

r-lr-i •

'•j'eci-t

r-l -r-l

(M JW

rH |rH

'-*'-' :

r-lr-l j

<Ml-l»H

iC**-*

^^ :

OrHiO

r-l :^

rjOO'*

etr«i-i

cin j

r^i-l •

COf-lN j 1 \

t—*eo

CCC^»-<

cO"Hi<c^i

ig«oo»

■^1-HCO

00-*^

eO-Nr-l

j-«iO

»iOi-i

*aeoc*

■^r-^Cfi

<o«co «5;;J"*

e:JSS

gJt;^

^•^ :

?S;::3

•OWC^l

aO'.««o*

OtO-*

0»»-'N

tOC^I-^

O'*!-*

SS^' ?2;!5§8

5§?5

S$9

S?5'^

SS§8

gS?5JS

^^^

t^^eo

5^^

loSt:

s«;5

3-Ss 3|a 3-2a 3-|a 3|a 3|a 3|a i-fa 5-|2 3-|a s^a a^a

hSEn hS^ H^Cm hS^m hSSPm hSEx hSPei H^^ H^Fs* h2^P^ hSPm HS^En

III..

O PL4 - p4 pLi

£ (2

.r 0

Digitized by VjOO^IC

646

n3
P

o
O

550

S2S

o>oo>

jjjoo<o

<*COi-l

oo»oeo

{c§5;5

JO-^N

o^«

9SiS

t^-iTC

SSS

55«J2

OOi-IIV

U5C1P3

oooco

g5;ss

C;J«tO

jl^SOiO

8^*

1-C4 0

S5g

;a;s^

jHt*-*

<*eOfH

t^cqto

53S53

i.OO>«D

«oeoco

8*;2:

ot^eo

«5s

or^co

w^-o

eoe<ii-i

«0^<N

S2'-

OOlCCC

»o j«o

joo>r-

aoiocc

S59

S'^'S

«ot^

OOiAOO

Of-c^l*

fe^2

^.oo»

r>C4ic

SJ:;^

o>^«rt

33$

w»r-

eocoo

-^i-ICO

r-co-*

^*S

oeoi^

C^Cfl I

iot-00

?t?if-i

85s

00'*'*

'*WC«

Oll-K-I

•*C<1<M

^sa

oo<oe<i

coe4'*

«t.o»

#-f-»<0

iS5s

10 100

t«aoa»

O*'*!^

-^rHOO

gJSJ:;

«oeceo

t*iOC>l

ss«

^ •■^

828

o 0,0

«32

33*^ S!*®«> oi-eo -^o-*

^^•^ I8S8

aOOO lOt^OO coe^r-i r*C<9iO

S2S safe

tOTHiO CDOOX t»>HCD

0^«0 lO-^r-l <M .CI ■^COfH

55SS

t»-*co -^

•* o>r-M t^S'ikn

o-^to t*-<i«eo c«<M

lOMCO "*0-^ r^iOM iii-i • OO-*-* «>'«i'N

c.««o

O»eo«o

C^rH rH

i"^

eoi/ioo

•OeC(M

-"♦•NN

oudtc

co^ca

corner

«©coeo

f-1 |t^

OiAiO

«««

COCMr^

(Mi-l,-t

eOf-fM

lOiO ;

<M |<N

G<»e»i \

«>«o^

t-ci»o

1-»»H I

l-« 'rH

«ocoeo tO(MM ■«4<«-4eQ ^cic4 ^eo«o -^c^c^ -^c^M <094-* -^-^

t*r-l«0 COeOO lO'^f-J "^r-lCC

g:'3S §3;:!:::

r-"*eo r-«*co o^-w

feSS? 2S5:s SS^S g32

i5Ss

SS58 ^??2! 885^ SSS

iS'^a ji-fa j^a j-si 3|a 2|i &^A 3|s 3-si

hSceh H^;!m H^Pm h!I^(^ HSP^ H^Pc, hSek* hS^ hS;«4

: : : ^ : 2 g

o : a » § t: *

*3
CO

Digitized by

Google

iOCOC»l Vii~l

i-(f-4 fHfM ^eOrl i-l

59)3

oaoOtO U3Tt<«-4 eo»>«0 fc-«0»-<

8SS5 S^*- ^«^

SS5^

0>i«"H|<

§?as

o-^to

CO |eo

S^S

•O(NC0

SBSiS

OJ-^iO

3««

n?aS3

r^QOCO

5as

j3^r^

•^ClC^l

<OiO<-i

C;^t«iO

5523

O"**©

•4«C4C4

eCN^

2SS

QOl^r-l

55§:s

•*eo»H

eCC^rH

3a«

QOiOOO

85:;S

toeoeo

00 US CO

•*<MOi

SS5S3

'*?0l-<

2SJS2

•qoof

t»iO<N

^i^-S

S'-^

S=IS

•*eOf-<

o>«o<o

r-tr-l '

s?ss

Oiifl-*

5;ss

^t—«

«^M^

oo««/i

lACOtM

8I3S

o^«

eoc«i-i

«©««

^?3«

OiCiO

??8S

ooeoio

"^eic^

ooot-

oswt-

O>rHO0

oeor-

•^i-HCO

<OCCCC

$?^S^

ooco»o

sss

cowr-

(N j«

ts^s

c,«5«

feS?5

O^CD

toeoeo

t-'^^V:

5!5::;5

ostoeo

Ss:;^

S*^S

G<I^f-l

^"^^

ojcqt-.

S5*S

giooo

OfH'^i

S?J2iH

«ceoco

cSS;5

jgcc^

"H|<W(M

i:^eo-«*»

l^OOOk

sis;:

o»o«o

00<«94

-■

;2:s^

^cc^

^:^^

cctoi^

MrlrH

»«COC^

«OC^-*

r>o>ao

C^f-4f-<

lO^"*

c^r-i.-i t-i^o eooit-i 9}00» t^»-i«o 1-ii-f

eot»«o UD"*!-" fccO'^ t«i-(<o toi-^to

J:iSS

r^,^^

Wrli^

iCN«C

eoc^flpi

« |c^

<Mi-«f-t

eo jeo

lOi-J-^

l-H jf-H

"^riCO

j 3SMO

<MF^i-t

t-iOC^

iCCOM

r-l |i-l

-^COf-l

CCi-lC<l

t-eo-*

«©<M-f<

^r-

•^tOQO

lOeoN

c5SS

<Mr-lr-t

COC^-H

r-«oi-i

eoc^fH

C^'^OO

eo<Mi-i

eo jeo

: ??ii53

SwS

r^'^eo

»cc^eo

2?3^

b-»OC<4

«g«oo

^tOiA

C^OO"*

-■"- iSi *^"^ sSS ^'^ ^"* ^'■'^ s*^^ *'* ®^^ '^'^^

5|i 3|i 111 3|§ 3|§ 5|§ 5|i 3|i i|i 3|§ 5|l

hS&^ h5S&^ hScs< hSpm hScm nSSfe hSpl< hSps^ hSpn hS;i< hS^ps^

'%m

«9

648

'■X3

s
o
O

S5g

a«»-

S3S'

s-*

r-l

S38

ooeoiA

S258

-^0404

??28

Oi*»

S5iS

t«iOC4

g?2^

«l-4lO

§§

^2i8

CDrHUd

g35S

«oeo«o

§g

^S^

«0-^C^

r-l

^S^

useCM

§1

£
n

O OiO

tnnen

§§

«2S

"*cie^

jsi

H
Q

•*

r-l

•^

f-»

•-«

i-«fH j

r-J

C4MF4

5;;sss

•a

■3

0
H

Digitized by

Google

•WOX

«l

•po^jod

-©a 10^

•poiiopiAV

SSR c

•p©ujiiw

S«5 1

•»I«aig

§ss :

-OH ION

■aSiwoj

aas 1

'Qvouoaiy

|6g s

•pajoioo

*•

•a^qAV

Slg i

'QAioasfaf^

8§S

-^i-ieo <x

S5g -SS i^

ess

sss s

gsg , """ s

at
g

—

Digitized by

Google

660

0
O

mox

I -nvoudmy

ss§ §s§ §§g Mi§ s§s 9§§ iss m^ i§s

S2-*

'♦Wi-*

eoeo j

t-ir^ •

0»i-(ao

lOCO-M

•-«f-l 1

^-i»^ :

•paiiopiii

S^S3

SSHS

$SS^

SS9

8*^

S:SS

g?15

S8%

'S=5^

•poujiiK

gsss

|SS

§3S

gss

S5S5

gss

835^

SSa^^

SS2g

••I»aig

iS^

ss?s

§3g

I&&

rHs§S5

§sS

2^3

3-^

g^S

'po^od

^.^^

SG^

US'* 1-1

-Ni-lr-l

^ |rH

eOf-ic^

■^ C0 1-1

'OXlOJOJ

!SSS

53223

^^^

«o«o 1

-««••<«• \

ss«

^«?1

aoooo

512*

iijs Sai Iga i§« gss gs§ iijs ggs iga

•pajoioo

o^io*' cai-iii

•oeoio co.-'o^ eo«-i?i

••^mw

'UAOxiy[U[i

li§ ill 3is ^il 2§s I§1 Wz liEi iSS

Wi— 1-1 ice^eo "^f«c^ci Wi-<rH ^-i.-

>*co»-i •-in

ICMW ■^C^CI 1-1 't-i ^rir^ -Mr-irl M-lf-f CO • rt ift

S28

§5J32

^SS

;2;2^

^55*-

aot«i-i

^SS

?JSS

?^:i;:

?5^*®

^5g

ass

as:2

acaoo

82S

^OO-f

ss;:

ss;s"

8S2

?55?52

^3^

Aceeo

aS2

?5;=l?i

S2S

cotor-

g^cco*

^'r^::

?J*5

5*S

5|1 3|1 3|l ill 3|1 5|1 i|l 111 3|l

hS&, H53pt< nSfe HSfe HSfx^ H^^fe hSpm hS&. nSfe

Digitized by

Google

nm m% m% m^ §sa

OiuO-^ ^li-lrH fOtOr^ f-ltOiO « CO

eocCI^ Q-^«» (DiM-^* :$t»0>

f^>?5to ■^i-i« i^-^i— «i-^iM

?J3 ^^5 IS* s?5a |SS

r??2& gSjg Sggg gSS

t-t- J

•ri !<?»

•^iftrH

CJ-M j

eocc j

^ss

$S!<3

sass

eo*-!M

g?5?5

?5§S

III

SS3

ISS

tijCIO

r^rH •

c^ jc^

S8S3?I

giS fiSS sgi SS« 5gs

■^CC-* CCTIi-^ i-*r-l

l'-»»»rO f-i -r^ r^r-t • wiw^ . COCN|»^

5!^2

js*^*^

523?^

OC^lOO

?SSt3

ys^

ooeoiA

5is;5

riot-

Q0O»O>

fr^;::;^

xssos

S??^?5

ri«o?o

?5SS

3li 3|§ 3|§ 5|§ 3|l

hSCm H^te hS(^ H>%Pm hSph

Digitized by

Google

652

•l«1ox

■po')jod

iS2 SSS gSi SiS sgg s«s lis s^s §ss

eoc4i-i eoi-ie«i ccc^rH mc

«D«OCSl i-*rH

•p©MOpi^

•paujv]/^

•9i»aig

'pe^jod

-ajidjoj

'avouaozv

•pojoioQ I

■•IIHAV

ijss ^^g sass S8g g§55j gS5^ fegss ;2;'*« 5SS8

8SS ssi^ 8«$ sss ^ss ^s^ sss ssa;:; ^S3

g^S SJSS? g^S |g!g giSS: gss 2$g S^Q gs^

C4i-H^i4 rHrH

Ol^rl C^Ol

o-*-^ ui»-i"* loc^co oo»oeo c^oo-^ «?2S §5

cor~ l-h-O «DC0CO

gg| §Ba S2§ ii^ sSg sSa iSi «ss g§s

t~<0(-i '^»Heo QOiCico ooccc^ coc^^-i O'^co

iS2 IBS ess iis §§S §3S i?§S S«s §SS

o
O

'aMoa3iu;][

C<|f>4r-4 eOC^r-»

S28

"o i

loc^rt tool-* ■»»'eci-« »oeoc>i irtNeo -^i-Hec C5»-<i-i ,Mr-i

s;::'' c2«o» ^o;* g3«p; g^oec ^;2:^: g^s

^OO <oo<"^ ftcci--

SS2»^

cjoo"^ cc"«*«04 u:>o>«o cS?iO* £3'~'!:2 JS''^!£ J(??:z* •oeow 22**l2

ooui I S522 S'-* SS« ^S^ §is;: S2;:*' 82

O?00 OO'^'^ -vrook

S|§ 3|§ 5li 3|i 3|i 3|i 3|§ 3|§ 3|i
1^1 gll ^^£ ^^dS ^^£ ^1^ ^a£ ^ai ^afi

•^

Digitized by

Google

653

gss iSB %m un sis §«« §§s ssn iss ijs p.i iss

Cl^FH

1-^^^ !

Wr-lr-l

sjs I

oo :

f^rH •

• c^**

iSSsS

l-4«H •

s^$

^;:s

;;sg5

sss

S85

52§§

551??

Ig?il5

5;?^ So

gss

sgi

SSJ58

l^s?

S§!5SS

g^8

S^lr

gfSi^

$2^9

sss

|gJ2

85S

g§s

gis

SS5

Se3«

sss?

?82?2S

SSI

SS8S

S?sa

§25

S2§

|§{c

§§s

5JS

gs^

^^rH j

rHi-H 1

c« jc^

ecw^

rHr^ •

— Oi-l

-^^oo

-^r^eo

t^iC-M

3^S

f-H^H 1

wjr-QO ©;£

SSS;^

;2:25$

Q-^CO •-lQ<*-< m*^'^

SSccrH SjjSi^ e1r-<S

«s!S |sa |§| gsg $s$ gfi jtss §|g §|g f||§ I2S

a*s

i/teCCi QCC1?0 r-"'*!^ i-H.rH

isS

ggg

s«s

r.is

l§S

SSi^S

Ss§

SBS

is3

2,831
1,481
1,350

290
153
137

eCCIrH

CI |ci

eo?*^

^,-1 :

1-t jrH

^ ;•-«

•^Tiri

occcl.-:!

^H I»H

j-jaoeo

«;=i^

o^co

rHi-i 1

Wi-iCl

CI?J J

•*C4S<1

'♦eCr-i

eo?ir-i

§5J::S

r-< |i-4

S2S

•OI^QO

Cll-^

o»o»o

S:iSS

r^t-o

j2jno

^SS

?^*Z4

JSSS

gi3S

SS^*

c%oo

r-i.c;0

eciAoo

«c««o»

?1S=:2

«©iC^

^S8

i::^S

2^1 ?1^

gss

ciS"^

ssa

O — - ««<

S2*

assj

S^S

§??52

§J?i::S

iSS"*

^tiJ:;

S^S

sss

3|1 5|1 5|§ 5|1 3|1 3|1 3|1 5|1 3|S 3|1 3|§ U'a
a& ^T.£ a£ ^s£ ^IpS ^s£ ^I£ ^si ^1^ a£ &s£ ^sl

e
iS

4
^

►3

Digitized by

GooqIp

654

•l«tox

g88s SIS gag isg gsg ass gss sss? sss

iMi-^ • C«C<1 ■ '^r-ieO

^ : : ; cceo j

j eqc^ j

•poMopiAV

^;::;2; gs^ S;??!! SSS ^SS JS^;5 sgSS S'^*' S*a

•p9UJ«}^

•ai»nig

^S^ S5S Sr:S 8BJc35 55?55S gSS ^SS SS5:

S?S§ SSS SSS 5gS SS^ :g^S St?g SSS §5!$

•pa^jod
-OH ^OX

•aaioioj

coco • Oiia-^ ^^r-"^ c<irHr-« ucwsc ■<*cci-i ^'^^e

■avouotay

•pojo|O0

•o^RAV

•UMOUnafi

SbI

I S2g

f^S^

|SgSS

sgg

gsS

gss

§S2

as5 §S|

SSeo

s==i

l-ll-^ 1

loweo

oooe^

•O"*^

r-l -iF-i

CiCO®

(NN •

gScS

iss

gss

iSi

§ai

SS5 SS2

sss

S^S

c«aci ;

<MfHr-l

1-lr-l .

OONl-l

OCOOQ

t—^eo

rH :r^

eo^-z-i

COf-<Ca

P^rlN

Wi->ri

CMO^ J

■^CCr-<

« joa

co-^c^) t:fr-o rt'-io gs<s>2] cooc^ os*.':!'«»« rrcjo eoc^ri «ci-os

C^rHrH c^rHi-^ CCr^'N t-^ CONr-« »-^

ioecc<i eS^JS S*'*^ >G'^'* S*®*** "^wc^ «DOib- r-eo"* t^e^io

Oi'^eo •s^'-'^ S®®

j5 sss sjas? s«

QOCC QOl-p-4 OCO-^ ^C^'N -^^O

8^3

,^ eo jj „ 1

3|i 3|| 5|fl 5^1 i|§ 3|i 3li 5|i 3|b

HS^ hS;^ hSe^ H^ta hSEm H^Px4 hS^ H^^ HSEb«

Digitized by

Google

•mox

•p9M0piW

*pauiii|i^

••l»ms

656

g^S §£oS ^g| ggg |i^lc gg^ ^3

lOt-*-* OQCl

riO»5q '<«<^ . f-lf-i . OaOC4

^'J:;g? 5gs^ S«?2 5IS^ 2S;8 SJ:;§8 S^^S SSSS: So3S2

2J£3 |S5? g?J?3 t:§S3 ggS gSS S8S |§?2 fS^JSo

jess loSS S^^ g53« ?3S fcS;S g^JS 8Sg 2?i;f

^3
a>

a
o
O

►J

'p9)J0d

C^»-i-^ OOiAOO r-trl • tOCOC^ UteC?^ ^'* • »Hf-i • 0)03) ^C^

'aSiajoj

t*or^ oji-C'i 2\

t^^ jj^eo ^^ : 25-^ o

^:ibi oioo o»«!co

S3S9S

■unoiiomy

SSIS

•paioioo

g§ss

?i2iS

O "^C^rJ C^^rt O»00r-t

•»iiqAv

gJ2S IfcS gjg ggg gJiS §|§ §g8

*aMoaiiaf|

8s S

.-^ ^?:i-* coi-^'M eo eo teri'^ »flccc^ ri •*-! oo^-^ r*i-t

S3g

oct-r-i toeoeo Sjaoao JNWaa

aoao JNWa

cco> cjoc-^ ?&■«'♦■ ri r-iirt«o £2iG°°

JlCCOl c-j

cciftoo oiao«-» a»i-'M coxto ^o»

^?li-i ri rH ri ri OCrlf-l C^i-l

RB^

^«UO JJj-.^ g^^JJ

aoooo Qoeoo *r3R)R •OOia

.« ..<Q ..OQ ..on ..» ..« ..V ..n ..n

.Q) ..« ..o ..o .•» ..« '-^ .-« .•«

wTi -'""S -""5 ^ ^rt ^ «Ert -ffirt -'"as -js* -s'3

l'3

51 5-11 5|s =51 £-2a S|a 5|s «|a 2^1

^'^ hS;^ hS^ hS^ h^^ h^^ hSpm hScs4 hSpm

: : : : : -o «

: -^ '82

CQ Cfi CC Cfi

Digitized by

Google

658

Wox

gSS

-paviod

^^ !

•paAopiAk

9^S?

•peiiJUK

fc^S?

•»i««is

8^?5

00 r-

•pe^aod

lAeOM

"§g

'aJi9ioj

•2S*^

*a«ou9my

Bss

J2;5

•poioioo

eON.-(

■a^iqAV

gfe«

'aMOU]|af|

^.-^ :

gs?

s {

WpHrl

S58

53;2:'-

^2S

§5352

^S^

eoiAoo

5gg

■3

COUNTIES.

g
3

o
H

Digitized by

Google

668

•mox

'p9ViO(I

•paMopiAi

•poiij«K

•eiauig

'p»)jod
-OH ?ox

'QJlOJOJ

'uvouamy

•pejoioo

o^lRAV

'aiioaiiUQ

^11

S28

22g

9S^S^

f:S^

®^«S

^S5

SS'd;^

8SS

2 !

3|i

S-3 ^

33 ±

Digitized by

Google

660

lAc^oo : C^SJC^ '.

Hi
P

c
c

Pi3

^"Sg| JgSgl 11 in

Mill slltSi tSllll ss&*Sg -gJlW

Ph^Bm^Pm OOOtz3R PJHtQSR ^^^•-s»-3 i-»tiJMi-3i-3

Digitized by

Google

^S^I55^

gr-co . CC3> .1-

661

:i-t« :i^ N : :jcci 'ffl**^

o,aQ'«4<ae9 Trn^i-^c^

ooc^cojeci :««o :t«

: i IS'' iJSSa

;S^ :«5«

eOf-C^r-i

^^^g :

e^cpe^-^ ■ *^^ •

>»»o ;ooo» ecQO :« I ri^O»eOJDC^

leies giigs i§®§i iigss siss^i 2§§2S isgsi §lsl

J::^ iS**

isSS

I l^sil iiisS §§i«M

f-l-<<«e<lr-»ri

i'^S :

:«i-^i«r-l

: : :

: :

r-iio :

:*o

I'^'M

I'*

:^c4 :

: « :

:« :

:i^

i-s^

:wCSI(Nr-»

: :^

"r-t

riCO :

'.t^

:<N^

^"^

irit- :

i-i ;

irH ;

:»;5

S§$IJ HisS§ ISSsS BESS§ s|l§§ s§«^« S§*iS 'e2§

sii.§ SsSia sS^SS SiSSa ^mm s§§«« ggggs

oOQOr;;jyeo

gs^gs isi^i ss§§s ssiss isgsg §isi

i§g|l S§33l §s?!2S S£Sa§ s^sSS »§&«»« fi

gssss

M ^f3?S-5 2g?5S5!c:i SSSsg i^§£35 ^ggJgg

:5rvi::?s:=5 S^-'SS 2:5?^253 ^^5?^^ SJoSSS*^ S^^^SS *^g?5S

•«* Oi P? IS ^

oc I— o e>i oo

r<P5 d»-^ r-< »*" ^ ^

ftt^r-i <o«oo>toeo

;=i2Fi«;-i<N

J2^2JSS S§<^8S ;:s^So

?;?]*s?5 ;253?SS!§ sg5SS?3 S£§3;:;5S s^;:;;^^^ '*s?g§

S^^^S Si3S53S§ "^Sg^g^lS ««5J::S'^ S^S&S *=^$?3g

g£Sggi8 555SgS SS3^:2e5 S'c^SSS^J SSSSS2 '^^2M SS85^ ^SgJJsS
S2gjr.|S SS^SSS V-^^=^85i SSS^S:^?; SS8^{^8 '^SSlS;: SSS^S ^^^^
-^S§5?! si'^SIJ:: S^SSS SSSSaS *§ISS« S^S§^ *8SS

S5Jg|?§

JgSS^gSs S?;SSS 2S^2S gc58SS ^S5gl2^ :2SJ::^^ gS55^5:5

00— ?<■<«««

S$||$

35^?;^^ ?5

?5CJ dri

gS^S:? S^g^^S 2SS8"*S fe^g^§5§J5

g?SaS?i SgJ'^t^ S^S^Si S^S;::^ 3S?§5^:S ?2S255§ J2Sg5;?

2:;:gg^ S3S?jj22&5 SSs^^J:; e?&S?3^ ISSS^SS 2;i:«Sj2 pg^^j:; •SSS

?|§^ ?i55;5c5^^ ;5&"'^t; $§5^S3S "^83558

ri-^i-lr-lOl

fcS§?3t§^ ^^SS

— 5 ®

5-^

»3»3*sa ssasa ^s^ooo &&o:&S, ££a«P5 (Soqoqmm oSmoqhh p»i>

niniti-7orl h\/

Cnno]e

662

I
El

'SJaq^oj^

•sjoq^tij

: :8 :

i'^S : ;2;^

r Jo ! §s« !^ 1 1

•woq^ow SSSS si§§ 1 1

•sj»q;iij I ^SSS iS^S

•g9I«UI9J

gggg glgg

•sai«K

1 2]

•moi

§lli ^

•■oi«K

?SS2!|

•joqraaoaQ J^^'SS SecSVJ S

•iaqni9A0>^ j "^"^eorn -^c^Sc^

•joqo^oo ooSrt^S Sfc^JftCM j ^

•dutif

•^«K

L*^-.

'__ J^co

H
O

ea tf OS <fi ee o^Xi

Digitized by

Google

663

CO 5^

*p9)J0d

-JOAQ PU13

•q^noAOia

•q^nox

■q^ai^

■q^q'ia

•q^uOAeg

•quis

'^mA

•q^noj

•pjfqx

■paooeg

•;bJ!J

•I«»ox

OQOO«OC4 aoc4-«r*c4 00 • •eoc4 aOf^c<i^eo c^dri

<DOkeOi-4rH cOiCOi^rH C>1C4

«ftf-4C4i-^ c^eoe>4e4r-i t-OJ

OC4 rHiM-^eOr-t rH>^COl-4i^

•O^^ i-^«Olft • ^C4i-«r-te«

^t^iO<-^^ -Hteoeo^Hco t»cflf^oo»r5 irtc^e^t^M i-^eocae^^^

'^o»oa»i^ ^^eo'^t^ c^iQoeoakt- o94ec»«-4 oom«^;oeo

C4 QOCOO^i

f^ooiooo csio»t>-km-- ejOGO^e^ tot»o»t^r-< oeoioaoi/

a^iAtDQP t^OlOrtt;^ S^'^'^ci^^ S'^S^S^"^ •«0OO»«O«O

?3P:^SS aiass^ 553:3SS sasSSt:; ^'SJ:;*S

^.S5!g58 §815^255; g2S!?S53^ 8^S5?§? ^12.^^^

gS?SS58 SS^S^SSS §g5i!S|5g?? ^I1$S3 A2S;g?2S

?22£SS§?2 S«^S5S ^SSSS? 3§S3!Sg STJ^SSSS?

C4iniAl2> QO<-«'

s;?s?gs ;$S55P St^s^gg ??5j?5:s

S^s^S S^2§s|3 ggsgg §fc|^g S3SSS

i[|55g§ i§s^§ g^ss? mm^ ?5?iss

e J

£0

«npQn nncov oqoAQ Qi=)A;:;» ^u^fa;^^

Digitized by

Google

662

PE^S

•■i9M!|0W

iis: •'irl

•8i9q;iij

i :a: •

•BJoq>opi

■•^^S : X^

; ^^

•"9qi«j I 3§2S iS^S ^

•B9ima©j

•B9l«pf

1 ;-»• :

ec : ; :

rH i-^ ;

•* : . ;

*89i«inaj

gsas

•8ai«K

issH

t2
?!

*<5

inni

->dl«inaj

iSii iiii §

B^zB siS§

^' I

•jaqmaood

J:;'-as

2S«SS^

•i9qra9x\ox

^J'^g^tS

^^g^cS

•j9qoioo

S;::S8

Sf^'oS

U9qra9>(IaS

:?^s^

•^i«na«f

g5^§5a SS^:^ i

Digitized by

Google

5^
53

5*.

-JOAQ pa-B

•q^^uOAOis

•q^nox

■q^ni^

•q^qaig

•q^a9A»g

•qi»!S

•qv!j

•q^jnoj

•pjim

'pnooag

■*WIJ

iwjox

l-H

H
O

oooococ^ aoc4-<rr*c4 oo • •ooc^ ooi^e^^co cic4rH

fcOOt^ri «iAefli-H-< S<1M

iAi-4C4i-4 C^COClNr-i I-CI

»o»H r-ieooko • ^o»i-»i-«

■^tr»«'-*« "^fwcoi-^eo i-c«f^oo»o ioc^e«r-« f-«eoe<ic4F^

f-lgSOaoeo C^Oit^iOt^ <MOaOiOC9 COt<-Okt»i^ «OCOkC0OiA

?SJ3*^8 $;^S?2J; ??Pisa5;2l S^^iiia •««<^««

PSPISSJS S;?3SS^ 55ISISSS SSS^St; '"3^*3

^853858? §?S:igSS; f2S?S5S^ StiS^S? ^Sg^*:;

§^3^5? SS^?3S §ggc5«?? ^f^S'^^ ;^5oS?J2S

22g2S??S?2 S^SSS J^SSSS Sn?^SS sTJ^^aS^

gggfiS; 22qJJ5S$ S^^2" ?8i^§S| SSS5!g

S§§S§S §?5S?3'o §^SF2g gfc^SJo SSSSS

^gliS lsSi§ g^Sgs iSP§ siiS§

'o=s OS «,= o b ee oi.^ ^:z^E«« « 0) • s;:: ea;s e c s

<;-<nnn pqpqcoo oooAQ qqq,=)» scbiktb^pE.

664

n3
o

c
o
O

X
o

»
1

K
M

ft.
o

•pa^jod
-9H 10K

eoioa» j»H

rHCOeOrHp-*

eooo-* |w »-<

rHM •

^"SS-

WN<0 J»

•JOAQ pav
qVl9Mx

-♦eciMej 1

*H?sic^ :*H

ecHwran

ec^r-i

r» je<34rj

OOOOtOWSN

•q^a9A9ia

iCi-Hio©jeo

CONtO-H-*

CCW-^rHi-H

•ceo 11

««eog^

i-meo^f-i

•qiaex

r<r<eoaoio

-*»^<e-*eo

«-*«0"*c^ eosjcic^

s-^ss**

W-*^0Or^

•qi«!M

^e^aoOiO

lOrHt-Or-

ceeotoc^-* eo-^wi-^

0» 0)9^10

eo»oo-*co

•qiq«!a

oec^Mt-

eotoot^co

JSS^SS

^OOOC4

•q^uoAog

StiSSsS

s;5ass

J^0>-000 OljrH^j2

s^ssgs

s;sss2S

•qixis

gaS!5S3

J:;?J8§555

sa^Sri '-gHS'^s:

S?SS;2^

S^S?1S

•qwu

S5S^^

?5S55S^

22«2S ?5g?P|t;?]

s^ggs

8^55S

•qvinoj

SfeioS??

'^^:^Sdi

j::5'toAi!?? sSSicSS

^3S£g£5

»3So^S^

•pjiqx

So|f2SS

;$S8I^53

g'^i^SS? 5:gS5i

Sl^g-

§S5?25

•puooag

g|g|ie

SSrJSSS

|5|5S i^gs^s

• i§ii§

Sl^^^g

"»"!.i

iSSI§

gSggg

gSgl^iJ sgssg

217
166
568
1.280
129

ssgsgs

•l«>ox

gsggi §iliS ig|p

ISiSS

Oibaon

Grant

Oreene

Hamilton

Hancock

: ; : : B

u S C ^ S
ee a; A^ O 9

: -j i ; M

■ • is? :

^'^i yjy mil

H»H,'^^'-> H9j«jui-3j H^,-];^sa

: : : • :

xsa?KS

Digitized by

Google

o»

i-*e<»

• C^Vi^i^

»^ ;»^ ;e^

t-l-l •*»

-*«<o

r»eoi-i

ou;

»H

udf-i«Deo

••^

c«*cc^

Otr-i»9,-l :

P-IC4CI3^ j

r-^Nr-l

o» Jt-

• r^

•

•^'*'*rH

•^

CI 1

ec CO CO •-I'M

!«-*.-•«

•^ JM •

jcceo

^c«.^

j-^C^r-i

•oeoecco-*

cacoecoj"*

.-•«'* eoeo

0»C4e4 [

<DmC9

•H-^t*

rHi^

•^

Mseoioo)

iO»0«0«©«

r^eco»c^co

»0»oeoeoeo

CCiCiO

t^Mflft

«>

«»oog«

icveoecio

eOTj«i-oeo

■*oooo«o

'rHi-^

a-^*^'-

??*a5

(Ot*C>9>0

SSS*"

nfDOi'^9

t;SS?2'Q

•OgiOMQO

«.g««D«o

JgOOOOOCO

-S'^^J

l-Clt»iO

OioetQcao

*SSJ2§

;sag;53

ojffc-oeoo

gss?^u

"^SeSS

S.«^?2c3

S3^!!)S

iss'^?;s

:3§!sg5g:]^

2§5S5?18

sas^s

«sss

^'-^SSJ

SS9S

s^J'^ss

S3g3§3g3S

SSSS^

£235SaS

ssss;;9

'^H^S

^;:s^

sssss

Cflogecgjoo

;SSS{oS

?JSg55

?5je^S«

g:s£:;s«

S|^SE

5;:sss:j

sssss

$S3S:s;s

^ggfcS

g^SgicS

?355S5g5

sgi^s;?!

8g8|

sriss

0SSS

o»

SS^^SSS

ssssg

5S5i;gg«

logS^S

ggsga

^gsi

(d:;?^$

s2SS

as®§3 §ii§2

^mm

2sgE«

§5g§S

101
1.188

317
1.169

igii

S§li

.5S ^

^^^Sii ^^?SS ^^SSS 5^6.55 -s^g^" «<•:=■ tTiTis? t?6l>?

SZ^ThOOC P^P^friOiai O^P^nXK GOC£{CG00OQ OlQQGClHH l^»> ^'^>^ ^^^^

666

o
O

® ti.ti

i-i *^

•o|«mej

•oi«K

•0[«ai9j

•»i«w

•oivmoj

•ai«K

MH^opf

•J9q^«j

•J9H1UJ

•Joqi'J

•jaq^ow

•joqi«j

•joq^ojv

•wq^«j

•joqiopi

•jaq^vj

; ^

•joq^ow

8 I Jeq^^j

8 I -jeqjoj^

jT I joq^trj

H
K

• d eoiA

r-i»fr«i^9»

*'^£i'~'^^ «DeOiAC^iA t««D

^?IS

eO'«o»e4-« r-ccrH«Dio o>'*

COrHtDC<l*^ eOOJ

OJfiODiOOk r>C4

jt^^ocgto «<N^goo og

«oec • -t-eo

eov tA

r«oo ioc90i<er-«

00 -t- •'•

ooo «>i-S«;3

rH .r-frHC^

r-Iir-ocM ■^O'^c^o*

-JNt-OCM

ScS§?:2a a5:;?2J3?3 g?5S85?3 SSJoS^

SgS^S f^^^^g gSC^SS ;ii:7g8&

§283gfJ ??gSj3t2 8!a5?gS aKSSSS

S^iiS S«s8i gg^gS SsgSS
ilHS§ i^s^i gsgag

^iiif

^iS^S SSSr^S »3SSS S3SSSS

^S:|:fiS 8^^^$ S$S^S So^SSS^^

c^'^col.-'* -1«eoc>^^

ftCJ>««r-« i-eot* •'•

^£^t% oStss &s*5« S-»«--ifl

«:flaW3Q pq«ooo uo^ftQ Pfi<

ioqS

Digitized by

Google

0D(

•doOf-ieo t^ri-^t^ija r-ti-^ro^x'^i loeor-icotD •**««os<iN

eO«OQOOG<l

2S=^

■ C<I C^ M C>1

oeov^i^o cOfHt^soi-H i>cotoeoG^ o> --^cOfH r^otoeo

•-•■^OOOt- i^r^ .»Ot-*

• eOf-if-HC>a

I0e0f-^i-<<0 ■«'M^-^f5CC 'M<Mt--t-H.-i I-C10«C«5 »rt00i:00>

^o«o^«o

s^^

o«eOf-icc<D eiit-«o»»oi'- WMt-f-i»fl t-c^oec»c rtoo -b-

CX)OQ0 94t>-

OOgO

•i-i»-iO(M

•f-i • -O^

«DiOt>- -c-i i^ec«o>-^ t-H^

ec ec ^ooO"* '^'^^in

'^lOt-'-*-*

lOiaao -co ^t««oaQt« tnt^i--

•QO eC-^5<l«C»'^ tDO>t«<^

I-0«JJ««0

goo

j»fl

- ^^

too

;g:C>»^CN SCJ;5-*.0^ :MO

•«*«ag — 1-«

'^'fcCOJSiC

r-'TJ'*'^

g ''5^2*^ '«?§;s«* ?t'--2SS

r-« j

•^ : : : : c^"?*^ : : ; : ■

^ j j j

e^fi

pH j(Mi-lf-i CO^riiNN C^l«» JrH

»HtC-<1«0

r-t -OleO

'-'

'^ : : :^ : : : : : : :^

'^ : : :

•ooiooo eor^ooooi-H ao'^ir:eoc<i o»<oo»0»^- -^cccoiflrH i-H«otOb»oo ■^ooO"«i«i-4 toos-Mcoo

CJJCOiflrH rH«OtO{^00 -^OOO-^i-

SSg5S2 §5fe?3SS 252S'-8 SS^gJi:: ''^SSSS

*:$;S5SiS '^SSgS*^ SJ2"*"^S

'SSw^ Sf

Seoo»-*4f« rnS-^S «i^G»i->S S^c^iF-SS SiOf-^cceo

feSSeS ^S5ggB8 853SSS SSS?:?i SSSS85S J=SS8^ ?i{^SSS5 3335;2^5

sgs?2gi ifigsg |g5g§ g^gs^i SgggSo gligg

3S|«gS Sg^S?i

sss«§ is^ss sSii^g nmu^ sms ssisi sgsi§ ss^ss
3SS-- s^§s2 s§si^ §«iss^ m^m mm ssa§s ^s-s*^

Sirggg ^^;SS;:? SJSS^SJJ ?3|^JcS SSg^S ?r^53^S35 '^^"^i^ll

^Si^^ix

^^^

eoeoi^'«"oo lAcotooi— eowi^-^co oa'Mooc^c^ c<ia)e^oii-« co«ojp<»<D imim^icm rico • •'.—

'.So

§^ 9-S

3 5 fl

6G8

a
o
O

55^

*9i«in9j

••i«w

*oi«ia3j

•9I»W

^aO«r-liA C^aOO«»-irH «•♦

tc-i •CQ c4-«<4<-<r^ eotAso

eocor-i-*iO -lOtAc^ ; we*e« ; ; ^ -lo^eo ;<&iac4

r-l 00 00 94 to

i-i ■* . .«« ■9<-^<e

^^^

^ eof-i j'^d iS'^^Ij

i^vH-^c^ f-iei-^M'* <D ••^o»r- .oo^

-9i«m9j

•9i«H

-*■* -w f-tio-^N^ f-ito'*^'* eO"*r-ieot^ .co«ooo

•jaqioj^

•J9q^«j

•jioq?»i

•jaq;«j

« (OC43ifiN^ C40C9 -r^ aCCO

§: SS'

00 0» t-OOr-iJOCfl <0«0Q

•J9q^opi

•Joq^Bj

•jaq^ow

•jaqi»j

•Jdqjoyj

•J9q;Tjj

•jaqjoj^

•J9q?iij

•49q^oyj

•a9q;«j

^"-^

CO -ot!

S-a

*ss te;;5i

-^a^^i

g3g55jS2a 2?3S5«^S «^fc5*** SSSSS '^SSS

eio5;^s ajsit^g sjssas 53c5?3$5? *S3^

S^S^S ®Sg^^ ^gi^S§8 jj3S2S

2g§SS SS|5Sg ^g|gt8 g*22SS SgSg

SSSSg f^'Ss^l 5SS«* i§"SS sggl

|ggS?g 5:g§5:ig Sgitpn §|Sg2 5|S§

S?SSSg ^Sg^S S?S<f5S; SSZJSS *35g

00050 »-•?-<

^30 oo -«<9^e<ic^eo co^ •eoao

;s^

5 o

i^ -B-J 1S|1J :i^sl| IISII III

p*eL,5L^ai CL*pL,a5pc;?^ ccaQcnaico coaoxiHH t2.^»

Digitized by

Google

C<l«

(OCDC4 94

•0 ■N.H C0«0-* ;

T-iMe«Jeo iftj*«rti-«

*«-C<IC<J^ t"*l-^

f-HC^co ooec'*'*

e«c4 e^'^aoeo

gjH WWWrH

■CJ

tjg ^cnco^

'ft

r-l C^ jt-H .

r-i •

OCO«Ol- Oi-«o»ec

^^ ^2;s?S

S5S?;a ssrtss

S^^S S||S

^^^n §g|s

s^"^i=§ ms

g^2l

5S5S

MCSI-*W tfiiMWJO

-5

e
e

a
I

« 4

"Sic

670

"•^

•(?o

•
1

•l«»0X

i^Ssa

^SS2

^§§55

§§Si§

;89i>iJa

NiA.-^p- 1

f:; i^Sg

«oo-*«

5^^^o»

-smoojf)

lOeC |r-lpH

t; '.SS

CiO^ 1

5 :- :'-

1 >

1 -<

■soioojo

Sg^'^S

^^^

00^i^«?0

»-.'J"*8^«0

^gJOIC"?!-;

::5«

^gj^sr-

-Zi2^S

■gapug

SSgsi issai §iS^i 2§i§§

-Btnooj

0 gi§S| |8g§§ giljgg Si|S§

q
o

I pwojoo '

is§§§ i^^'S§«f n^%m M§m

•aoqmoooa i H^^^ ^^SSg JS^JSSS S^$-?;

'jdqmoAOX

?3S2s^?5 ?j::as^ g?S52«5? s^ss3«

•aoqo^DO S5SS*^S S'^SgSS 2SSS^S5 SS3g25?

•aaqoie^dos ; S^Sg^'-g ?3"^«53q: ^S^S2 SSSS3

'IBuBny

SSSaS ?5JSS:3:|:

np ! J::^S^i:: ''^^^^ISS ^5:;;rS« 2S25;

•Xjnf

•ounf

S?:5*§1 ^"235 aSJ2S§3 SSF?"*?!

•XBJV

SS^'^'S 2*^285! f^S'^an '=*5;5;Si

•ludy 2S^8*S 55^32^ 2!2gi^5::a 25:;^$a

■qoj«)\[

-^vnjqe^

-.<j«nu«x*

S5c^**= 51«2S;S 82^22:3 52835-^55

:3:??J:;522 S«2^g I5§5*22 =^a5;5Si

^:^^^^ §5«c1fc5S3 5??8^§i:: 2;5S*^8

-c=5S^ oSSS^ --2;$» <«-S^5S
<<aa30Q wtto^o ooooa ftaOQpq

Digitized by

Google

amm mmn B%m^ M^mn isisi mm^ s^^^i ^^"^bs

eo»o \r^-it> j^« \ • jc^c^fc : "^ : :S ; :*>::: •'^ jco«n

« :^ : j i-^ ig

eoio \ \^ : :2 : : i'^'^S : ^ i i*^*^ i* '' i*^ *" i*^??"^

-* :^ : :«^- :g

• • • • ' ^ • ■ ' . • .

e*oca^ : i^"**^'^ JNooeo ^o^t^oi ^c^ j'^g g iSS'' i£

jHi-icoi--i cc»o • I •

nms% mnnu ^^m^ ^m^n ^mm mm i^^^^ ^^'£^

§ii§§ §iii§ 22i5§s aSSSS §liS§ g§i§3 «i§SS si'SS

•as

«ooo eo -r-ifl

C0?-lrH»O?C <0

s§

aig§g is§g§ ssggi is^^s siiii g^ip agiig ^g'^gs

^^SSS

as$E^«i

s;s^fc;5

s»-2i;5^

^SSSSJo

;!:s)s3gg?

^glSJoS

5SS*?3J2

ecMCttOiec

S3;S55?1

SS8gS«5

SSS5^S

85?8Sg

^^^§^

S8SSS

oeg >g

JS^^^S

3SSSS3SS

;3SioSS

SSfeSS

S$l5;253

ssasgs

SIQS55S

00>f-iNC;^

sgsssa;

ssasis

jQ'-s;^^

S?3S8S

S5§§8«S

ss^ssg^

^fcssja

^t-®ojo

S5JI5S5:;

Ol-HQOW'XI

990 04000

:S885::a

^sgs«»

*-Sg1^g3

^^-'^¥,

tOtf^^^iO

sgsss

;s:s;2:s^

?J*Sg^

sasss

«8SSS

^s-^sg^

S23S2

ssg^^ss

S'^SSSSl

SStlcSS

ss^s^;:^

t5SS§§3

^53^as

OOCJ'^^M

OfiC^CCCC

J2S53SS

Ot't'gjft

^ojogr-

aSJ^^S

^sgs^s

*55;2;2S

(00^^<OQc

ssri2!sa 5:3s?sas g5ss;5S :2^as;5 s^as^ ^S5S|^ ;ss;2a^

«-';^??«;3 52385885 S'-SgJS; S^^S^tHS SSS5SS ?2SS5gS 335532^

QOOCC^«£>QO

o» 55*^55^

2S2;2: SS^SSS t;'«S8S S^SSISS §3I5S«S n:^iB^^

ssSSS gSSSSsS SS^?2S5 SSaS^ ^^^^^ ^SIS^25 "SSSS ;2S'''^???i

•5a

4-S

fcSfeijx; o^scam wasKa ^^^^^ ^«wjj ^^sj^s sssss »!z;o5

670

•I«JOX

mms i'^SSs SsSSa ggisS$

■w

•3^

'89pijg
•smoojo

'sopug
*8mooj9

• «oo^c« ^.'-"-""•^

-sapug

*8inooj9

I §

I paaoioo

'jaquiouoQ

OiNCiicir-

52 ??3g8

i-HOr* QOi-iiCCC?0 -««-*C^O

HOr* QOi-iiC

00 e<5-*t-iflt- t-iC^3»!N

5* §?"&'

C^3»!Mg

SSg^i i^Sai iiS^g 2§ii§

gigsi iSBIg §iS§§ Silii

iB§la i'=sig isS§§ iSiiS

asssss si"ssg sssasj sss-a

•wquioAOK Sf2SS?3 ?3S55§^ g?§?S«5? 55SSS3S*

uaqo^oo : SiSSSS'^S S^S^S 5IS555?a ^55-3353

•laqmoidos ' SSSJ^^S ^S'^^c^S^^ g5SSS2 SS«2S

nenanv -^^^'"''^ S^^^SI?? 55S2SS 83SS5

.^inf I 525gs^^ '-«»-=J5g? «J:;r:2gi 222^*S5

•oanf ! 3SS~§1 S-'SSSiS? ^^^7^^ SS??'^??

x»w

a^^^^ 2*«S8^ S8*^S3;2 *525;2S§

■Ijjdv

SS8=^§? S^t5S^ §??5*-5:;a 252^5^

■qoj«W

s^??*''^ jj^^sss ss;2:2s s?ss'"55

•^wnjqaj

;253t;22 S«S55^ K8*SS *S5;::S1

•XjBnunf ■ ^s^^iJ:; S5«S^S3 ^^i=.^^ s;5S*g

-5^:3 2^ 5SSS^ ^'^S-S i55«

<<jaapQ« Mfpoc^u oooOP QpQftM

Digitized by

Google

m^m nmm ^m

COUi |i-i"««

-a : :

(N<Mg

ecio 1 -'&

i® i i

— §

«0N«O j

joeow 1

• |o

c<»oca'^ •

g^(N«

[ciOL

§g§si

22S|:

§ggii gii^i ssiii

'-S^

wc^tr^fooo CO 't^u:

•SS5'

SSSSS iS§g8 22gi:

'S^S3S 8$S53a SSS^fc;

2?32*S ?5S353SI} SSS

Sg^S'-S SSS8S SSfe^!

?4S5s?:?5 ssasis S'-aS!

855:S552'5 ^^^?^.

DuQOC-<rt<

58 ;^^z^

gssss SSSJISS s^sss

S?iS*5 52SRSS

SifiSSfrJ gJS??58S ?JS?JS

«^';5?.-S ?S3;S8$5

<^sss;5 S2«s;3 {:;'«;2S

*?5SSS g35;3S5S S2S2

Digitized by

Google

672

•vnoi

gSsiS SSS'S S|g6s sgsis sgsg

o
O

'sopug

*Baiooj{)

'SOpUQ

'soioojo

o»eo 'Od irt-^i-i

' sop US

§§§ss s§g

'SOIOOJf)

§§i§§ BSg

•pojoioo

f-«rHeo*H -^^ "^fe*

S;S8

g S|g82 igsga S2sg

g ai^ss ggsgs sfsg

••l!'Jj»

§§alS 0Si2§ ^§1^2 igsiS SSSS

'joqmoooQ

^5:;S3S53 ^SgSlSU *>5325SS K^*S38 S2Sc5^

'joqmoAO^

§325?5sa

S2?3aiSS

ssa*s

g§?^S?S

«^ogj

•jaqo^oQ

8S5::5::53

S?5gl2SI

0.00^,^55

SS^JSS

«i23§

•jeqnia^ddg

§5S^SS

^-^ISSiSS

^ojgt^r^

?cSS^S

ca^o.^

■^snSny

g?ss;3a

eoQO-^tDQO '*:?;fc:0>C5 'fiX'^Sa''* c«^j«

r-tr-tr^ C^<

6*S ss*

^«J«^

•Xinf

ssass ^^^;i^ ^ss-^ss f:g5*g3j2 ^S'^s

•oanf

J38SSS

J^-^FJSIS

««g5i^^i

583^5555

-^s^s

•^«w

;452ss;s

;:sg?3*

ifc^^as

-*$»f2

•IH<IV

S53SSS

;s«=»ac:s

'"?J5:^:S

^5=::as

COjJ«g

•qo«w

?3SSJSS

«.^j^c.g

io«t^ioco

sass5=

^S;:^

•Xi«njqoj

SS?3«S

•ssas

..gjg«,o»

eS55*-sa

^SSS

'ii«na«f

1SSSS •S8S'=

S55«S 5S28J: "S'*?

So-r

P^PL4Ck4P^PM p«04pC4pCpq QOCOOQCfiCO QQQQOQHH P»f>

Digitized by

Google

o
O

•mox

■sopug

'stnoojo

'SOpiJQ

'8 moo JO

•gepjjg

'smoojo

•pojoioo

•»»!«lAi

'loqnieoOQ

*joqtnaA02{

672

igteg sgs^ii sgsE

•S :8

52 .<=>(M lO^rl

siisi Bm

is§§§ B§i

'S" :S

i-l«D<N •l"

HooiM 2;fi i^^

S««

8oS»

g -igsg igfegs

S2g2

S -igss gg&8S si|g

ggggg gfcgss s§|ScS igsgg sssg

S5::SSS5 *S§?2S: ®S5I5SJS g|«g«?^8

3;S;2:^ aSSSS Sc38~S g?3*^2 '^SjSS

•joqo^oo

'joqind)(Ieg

'^snflny

•Xitif

•oanf

•^«w

•ludy

•qoj«H

'Xjivnjqoj

'iJivnnvf

asj:;^53 S?5232g| ^^g'^a SS**5:S *|2S§

§3e5*s8 •-?;s5;2:;2 ^as*-*- s^ssas "^j?*^

?5SSSc3 ««SSS ^S^*?5 SS**a'« ^'^^'S

•oeo£co>^ t-aoo»i-ie^ oo«i|>Atoec CSS*^S3*^ ^t^'^iS

SJS^aiS £;^533;3 "^sa'-s J$;2:'*siJ:; ^?f*8

SS8S*® «^SS::5'® SsS'^SS '"9^^

^S:SS5S2

«3?2«s;5 '^SS^S -*J55:;'«S S5JSSE5 ^$;5«

ojogjco-5 wgwas ^g^wo* ss'^sa ^ssa

g^ssss -sas

SS-Si

3cS«a 5;s2gj; «sg^3t

SO'T

^ 9

it.S& :3|»- aaill l-sllS §|"ici
s feral! -slSiS Ill5l "Sills -Sw

P^AiO-tf^P^ puP^ffiPQOQ COtBCOOOtC cococqHH &>»

Digitized by VjOO^IC

674

8
g

S
S

•Mpua

-smooif)

•■•piia

'emooiQ

'Bopug

*iinooj£)

•Bopua

'8010010

•Bepug

'BOXOOJf)

•Bopug

■Bmoojif)

•BOpUS

smoojio

•Bepiaa

•6inooj{)

'Bdpug;

■BinoojQ

P
o

§g§§§ §^S§I §§SgS i^gSi gsggs

'^S

'^e

Jt*i^ 0»tCf^

r-«p-l 04 '04

i-i e4e>4rHt-<eo

<« 'OrHrH rHMrHi^f-l C4-«'^e409

00 •<«<r-«eO'«t« C4r-4i-4CO^ tHiOOOOtO

i-irN-^iO

<4<^«o -co tH •ccc*«o c4«oeoei)c9 coc9<d«-i<d oie^e^oi?!

^8^*"-

•«^«o»

•Hor^Noo

««ao«3

eooowi-td

-•ss^*

i^^COOOr.

^OkOOt^OO

-^••Si^S

*'S'-"='^

*g3!9

t"- eo^c4«

o-«'t«a» eoa»Q»<DiA cojeteox

iAo-«'t«a» eoi

8SS*

Sfe8«-S a«;S5?S? §?8SS8 SS58S5SJ Sg?aSS

S8g^S9 :$^S^:gse ggi^SS^ $!3:S^3S F33SSS

SSS^a ssscgs gg^ss gggag ssgfHg

3i2^i S^3§i SS^Sg §2g3§ «5rS

i^SSt^ S;:38£S S;SStt^ S8@Slf3 SS^SS^

«ooeo •«-< ooe4<o<«a> M'^^oco ao^akio« eo»*«D '^

mil 55i iiiii iiiil iitli

^<pqmS ««5o5 Soofift aSftpa i^hS^ni^

Digitized by

Google

676

§SiS§ ^ggtsi §g&§3 sgSg g^SB iSSS

•apHa

iSS : l^iSH^

« '-*.— i«aa • :««-.

-•moojf)

1^3 : ••^53 i

t« • : lO j eo« 1

: i-^^a « : :—

•wpua

i i i i i*^

i : :

•o

-tmooif)

»H

f^ jfH

; r^ > I

: : M : :«-■

•wpHg

•fHfi^ : : : :

• '^4 ^4 ! I

tH 94 j 1

i i *^ i * *

'•moojo

•e«fH If-4 1 ji

^ Jet «# • jfioo 1^ j(

!0 jtH |tH r4tH^^ I

•89pua

tH09oo ::•-•••

F-iP^et «M JM 1 1 ic*w^ cit-i |r^ i-ie« t •

*tmooj{)

|ior- je4 ciiO'^tAio t^eoevt-ieo |o»co<o mi-imm oieoeo I

s
i

••epug

tHMto |e4 tHioe4«'« FHe4f-4M»M» |io |<

'Bmoojf)

«Oiog jio C4r.<«e«« aoe^fii^gio v^fi^^ '^

iA<« «Oaoeoeo

•seppa

««j3 jr- «^gco« g^;:!;c««>« cgwg- ««r-« tg«.o^

Q
^

'•mooif)

^»s :« ^js?3^* joS^s?*^ «s*8 ;2!^*^ a:3-^«

•S9PHa

*^aa is «85S^S5 sfcasa ««a 85«^sa s«sss

'smooif)

a»« :« *a5Sg8 |«S$a »-583 5SSa S!9S^3

si
g

wpua

8§g j« aggSX 5g58|lf2 8§S| |5^g gS§§

•Bmoojf)

8SS is ;s3gs§ §si5§5 ggggg sss§ g§ss

•wppa

92S :S8 ^S^SSiSS SSS^S <»g9§ 8SS96 S^^S

'smooif)

co«og jio uafr<.<^e<ieo ao<«co-<#^ iS^£; o»eo<eo coa»vH-«i

0M<

Randolph

Ripi«y

Rush

Beott

Shelby

ill

Tipton

Union

Vftndorbnrgh

Vermillion

111

yii

Digitized by VjOO^IC

676

d
o

BSSit

218^2

gags aggg i»S£

, gsss

•■•ppa

is2

:«^53-*

: :^. ^^v^*^ i^d8 *^ :e>«»H

-•aio<»{>

:«e

fr*

jto < eo«

:-*^8 « i j*^

•wpug

•f-4

•tOIOOif)

•^

r4 • • r4 »

M j J»H

•wpHa

•1

»4r4 •

f-4 1-4

• Jp-* »^ •

t-* • • •

'•moojo

•

MtH |iH 1

i-H

M ^

jr^eo 1^

eo jfH Ji-4 f-4tHt-i 1

•Bopug

^c^eo j

r-i

tHi-^M eoesi JM I • jnph e>ii-4 \w^ t^c* •

*tmooi{)

Ar- je^ dio^tAio r-eoMtHM |o»eQ«o MtHMM oiooco j

•••pua

f-^Mto |e4 r4iOM«D'« iM84pHie« |*0

•Bmooif)

oudO |io e4r-^e9«o ooe^i^eio '^£1'^^ ^

•••pug

->*a jt- «;33eo-» S;S.«oo« cgcog- g<Mt«« jgo.*^

*gaiooi{)

^»S ;« ^ISS*-* loS*-t;* «S«8 s-*** ad*«

•Mpug

•as ja «8;s^a sfcasa ««s S5«ga 88ss

-Bmoojf)

S188 :^ •»88S8 gSSSSi ^^8^ 9SSS9 8988

i
8

•wpua

8gg i« S^gg8^ §g8|l^ 8gS| i^^g ggis

*Bmooi{)

8SS jS sgssi §2i5§5 sgsg S8S§ SIS2S

•wppa

9:SS i8 ^SSa;8 SSS^S <»§!5;8 S888 S&!98

'gmoojf)

eo«og^ jkO lor-'^eieo oo'^eO'^^ jeoco»» o»eo«eo «eo»»H^

,11

•1

1
1

ifi ill

III ill

Ji
11

III

Digitized by ^

Google —

Digitized by

Google

INDEX.

Page

Application for Permits to Discharge Waste Into Streams-
American Strawboard Co., Kokomo 41

West Muncie Strawboard Co., Yorktown 41

American Tin Plate Co., at Elwood, Gas City, Anderson, and

Atlanta 42

Albany Paper Co., Albany 42

Muncie Pulp Co., Muncie 42

Consumers' Paper Co., Muncie 42

Alexandria-
Account of Smallpox 62

American Tinplate Plant at Elwood—

Report of Inspection of 52

American Tin Plate Plant at Atlanta-
Report of Inspection of 52

American Strawbbard Company's Plant at Kokomo—

Reiwrt of Inspection of 53

Sanitary Water Analyses 55

Permits Issued 57

Anderson-
Account of Inspection of Tin Plate Plant 61

Complaint Against Anderson Strawboard Company 86

Investigate Stream Pollution 408

Lecture on Tulierculosis and Its Prevention 436

In Regard to Stream Pollution 515

Atlanta-
Account of Inspection of Tin Plate Mills 61

American Wire and Steel Co.. Anderson 86

Report of Inspection of 87

Aurora-
Account Smallpox 92

Allen County Medical Society 440

Albion-
Account of Smallpox 521

Board-
Members of 3

Board MeeUngs- 11K)1—

Special Meeting 15

First Quarter 16

Second Quarter 20

Special Meeting 48

Special Meeting 50

Third Quarter 60

Fourth Quarter 79

(677)

678

Board Meetings— 1902— Page

First Quarter 406

Special Meeting 421

Second Quarter 431

Special Meeting 443

Special Meeting 445

Third Quarter 446

Fourth Quarter 513

Bulletin and Statistics 41

Bedford-
Account Teachers' Institute 412

BatesvlUe—

Account of Smallpox 437

Brookville—

Account of Smallpox 516

Bills to be Presented to Next Legislature 525

Laboratory Bill 1 525

Quarantine Bill 527

CrawfordsvIUe—

Account of Municipal Management of Slaughter House 17

Account Smallpox 432

Columbus-
Inspect Schoolhouses 20

Nuisance at , 23

Account of Smallpox 65

Crothersville—

Report of Nuisance at 26

Clay City Schoolhouse 45

Sanitary Survey 46

Condemnation of 67

Report of Inspection of Schoolhouse 110

Connersville—

Account of Smallpox 62

Colfax—

Account of Smallpox 64

Cataract-
Account Unsanitary Schoolhouse 91

Conference Indiana Health Officers— 1901—

Address by President 291

Progiam 293

Subjects for Discussion. 293

Education and Training of Health Officers 294

Second Session 306

Contagion Among School Children 305

Discussion 317

Conference of Indiana Health Officers— 1902 543

First Session— Topic 1. Smallpox 543

Topic 2. How Dealt With 549

Topic 3. What to Expect in Future 559

Digitized by VjOOQIC

Conference of Indiana Health Officers— 1902— Ck)ntfnned. Page.

Topic 4. Duties of State in Regard to Smallpox 562

Resolutions 671

Second Session r 574

Topic 5. How Proceed to Secure Aid 577

Topic 6. How to Manage Physicians 579

Diagnosis of Smallpox 582

Topic 8. How Mildness of Smallpox Explained 591

Report of Committee on Resolutions 592

Topic 9. What Are Complications of Smallpox 593

Topic 10. How Many Physicians Could Be Induced to Take Pre-
cautions Against Carrying Smallpox 595

Letter from Kentucky Board of Health 598

Adjournment 599

Carmel—

Account Farmers' Institute 435

Columbus, Ohio-
Meeting of State Board of Health and Superintendents of Schools 447

Clark's Hill-
Account of Smallpox 450

Circular Sent to County Health Officers 491

Complaint of Mill Dam at Mill Grove 518

Danville-
Account of Inspection of School Children 18

Account of Smallpox 96

Decatur—

Account of Smallpox 66

Decatur County—

Schoolhouse. Condemnation 71

Daleville—

Account Conference With Farmers , , 93

Diagrams Showing Deaths From All Causes 202

Pulmonary Tuberculosis, by Ages 204

Pulmonary Tuberculosis, by Months 206

Other Forms of Tuberculosis, by Ages 207

Typhoid Fever, by Ages 209

Typhoid Fever, by Months 210

Diphtheria and Croup, by Months 211

Diphtheria and Croup, by Ages 212

Infantile Diarrhoea, by Months 213

Diarrhoeal Diseases, by Ages : 214

Pneumonia, by Months 216

Pneumonia, by Ages 217

Influenza, by Months 218

Influenza, by Ages 219

Dental Law 226

Disinterment and Removal of Buried Remains 525

Daviess County-
Report on Smallpox Conditions 481

Special Meeting of City Board 482

680

Page

Exhibit "A" 44

Barl Park-
Account of Smallpox 62

Elkhart—

Account of Smallpox 80

Elwood—

Account of Inspection of Tin Plate Mills 02

Evansvllle—

Report of Committee on State Medicine 450

Progress in Sanitary Science 452

School Sanitation 453

Health of the State. 453

Smallpox 454

Tuberculosis 455

Typhoid Fever 456

Diphtheria 456

Miscellaneous 456

Financial Statement— 1901 9

Financial Statement— 1902 398

Fowler-
Account of Inspection of School, Jail and Court House 19

Account of Smallpox 523

Fountaintown—

Account of Smallpox 63

Fortville—

Account of Smallpox 434

Qreensburg—

Inspect New Schoolhouse 21

Delivered Lectures on Public Hygiene 437

Account Smallpox 456

Greentown—

Account Smallpox 61

Greenfield-
Account Summons to Court 60

Gas City-
Concerning Tin Plate Mill 80

Inspection of 81

Greencastle—

Investigate Smallpox 437

Gaston—

Account Diagnosis of Smallpox 448

Greene County-
Report of Smallpox Conditions 483

Health Order , 120

Digitized by VjOOQIC

682

Lynn— Page

Inspection of Schoolhouse 90

Dedication of New Schoolhouse 62S

Lebanon-
Account of Inspection of Water Supply flO

Address to Knights of Pythias 435

Letts Corner-
Account of Ck>ndemned Schoolhouse 90

Lovett—

• Account Dedication of Sanitary Schoolhouse 100

Laboratory Bill 227

Lafayette-
Meeting Farmers' Institute 406

Settle Diagnosis of Smallpox 410

Account of Smallpox 431

Account of Smallpox 432

Account of Smallpox 478

Letters in Regard to Meeting of Boards of Health to Consider Small-
pox Epidemic 438

Letter from Kentucky Board of Health 443

Louisville-
Account Meeting With Kentucky State Board of Health 457

Letter from Governor Durbin , 473

Letter to Governor Durbin 486

Lettw to Dr. W. N. Wishard 488

Letter to Dr. J. H. Forrest 488

Letter to Dr. J. N. McCormack 487

Letter to Governor Durbin A 490

Letter to (Jovemor Durbin 607

Letters Sent to County Health Officers 504

Minutes and Transactions of Board of Health— 1901 13

Minutes and Transactions of Board of Health— 1902 405

Michigan City—

Accoupt of Eruptive Disease at State Prison 22

Epidemic of Winter Cholera 421

Resolutions From 426

Meeting of Citizens 427

Muncle—

Account Inspection Pulp Co.*s Plant 60

Investigate Stream Pollution 408

Meeting Delaware County Medical Society 413

Marlon County S'choolhouses Nos. 8 and 10—

Report of Sanitary Survey of No. 10 82

Report of Sanitary Survey of No. 8 83

Condemnation of No. 10. . . ." 84

Condemnation of No. 8 84

Marion County Medical Society 441

Mortality Statistics 201

Marion-
Address to Teachers of Public Schools 461

Digitized by VjOOQIC

684

Reports of County Health Officers— CJontlnued— Page.

Clinton County 245

Crawford County 345

Daviess County 246

Dearborn County ^ 246

Decatur County 247

Dekalb County 248

Delaware County 249

Dubois County 249

Elkhart County 250

Fayette County 250

Floyd County 251

Fountain County 252

Franklin County 252

Fulton County 252

(Jlbson County 253

Grant County 253

Greene County 254

Hamilton County 255

Hancock County 255

Harrison County 256

Hendricks County 256

Henry County 257

Howard County 257

Huntington County 258

Jackson County 258

Jasper County 259

Jay County. 259

Jefferson County 260

Jennings County .• 260

Johnson County 260

Knox County 261

Kosciusko County 262

Lagrange County '. 262

Lake County 263

I^porte County 263

Madison Co«nty 264

Marion County 265

Marshall County 266

Martin County 266

Miami County 267

Monroe County 268

Montgomery County 268

Morgan County 268

Noble County 269

Ohio County 270

Orange County 270

Owen County 271

Parke County 272

Perry County 273

Digitized by VjOOQIC

686

Page

Reports from Dr. Ferguson on Smallpox 402

Dearborn County 402

Ohio CJounty 492

Switzerland County 492

Clark County 493

Floyd County 498

Jefferson County 494

Franklin County 494

Adams County 496

Reports of Dr. Nelson Brayton on Smallpox-
South Bend 496

Brazil ^ 497

Greene County 499

SulUvan 500

Cases of Smallpox 501

Columbia City 502

Dekalb County 502

Whitley County 503

Claypool 503

Report from 524

Resolutions Sent to County Health Officers '. . 505

fik)uth Bend-
Account of Smallpox 63

Smallpox at Efcist Chicago 34

Smallpox at Crawfordsville 414

Shelbyville—

Account of Smallpox 63

Inspect Diphtheria 409

Account of Smallpox 436

Stockwell—

Account of Smallpox 64

Stream Pollution-
Delegation of Farmers to Confer in Regard to 119

Sickness— Monthly Statements 7 231

Smallpox-
Special Action in Regard to 121

Cases Reported 220

Monthly Statements 228

Request for Aid from Epidemic Fund 417

Official Ch-cular 418

State Medicine 222

Salem—

Address to Farmers' Club 434

St. Paul-
Conference in Regard to Sanitary Conditions 447

Sullivan-
Account of Smallpox 449

Spencer County-
Report In Regard to Smallpox 480

Account of Teachers* Institute 520

Digitized by VjQO^lg

Digitized by VjOOQIC

/Google

Digitized by VjOOQIC

Internet Archive Audio

Featured

Top

Images

Featured

Top

Software

Featured

Top

Books

Featured

Top

Video

Featured

Top

Mobile Apps

Browser Extensions

Archive-It Subscription

Save Page Now

Full text of "Annual report"

See other formats