(navigation image)
Home American Libraries | Canadian Libraries | Universal Library | Community Texts | Project Gutenberg | Children's Library | Biodiversity Heritage Library | Additional Collections
Search: Advanced Search
Anonymous User (login or join us)
Upload
See other formats

Full text of "Annual Report"

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- 



n 



Digitized by VjOOQIC 



Digitized by VjOOQIC 



Digitized by VjOOQIC 



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 



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 



10 

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 



11 



1. 
1. 
1. 

3. 

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. 

1. 

1. 

1. 

5. 

1. 

1. 

1. 

1. 

1. 

5. 

1. 

1. 

1. 

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 



12 

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 



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 



17 

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 



18 

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 



19 

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 



20 



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 



21 

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 



22 



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 



23 

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 



24 

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 



26 

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 



27 

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 



28 

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 


5. 


No. 


C. 


No. 


7. 


No. 


8. 


No. 


9. 


No. 


10. 


No. 


11. 



30 

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 



31 

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 



32 

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 



33 

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 



34 

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 



35 

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 



36 

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 



37 

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 



38 

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 



39 

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 



40 

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 



41 

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 



42 

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 



43 

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 



44 

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 



45 

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 



46 

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 



47 

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 



49 

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 



51 

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 



52 



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 



ss 



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 



64 

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 



55 

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 



56 

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 



01 

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 



58 

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 



59 

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 



61 

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 



62 



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 



63 

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 



64 

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 



65 

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 



66 

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 



67 

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 



68 

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 



69 

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 



70 

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 



71 

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 



72 

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 



73 

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 



^4 

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 



76 

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 



77 

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 



78 

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 



80 

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 



81 

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 



82 

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 



83 

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 



84 

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 



85 

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 



86 

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 



87 

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 



88 

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 



89 

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 



90 

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 



91 

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 



93 



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 



94 

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 



95 

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 



96 



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 



98 

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 



Digitized by VjOOQIC 



ANNUAL STATISTICAL REPORT 

FOR THE YEAR 1901. 



Digitized by VjOOQIC 



Digitized by VjOOQIC 



125 



Eh 















I § 
•2 3 



e 


=q 


5" 


^' 


<»>c> 


^ 


^ 


^ 


53 


^ 


;^ 


^ 


^ 


S 


Q 


S 




,e 




io 





I 















ai 



o, 

< 



s 



I 



•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 



I 






. 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 






^1 



Digitized by 



Google 



12G 



.s 

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 







S 



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



n^eotooi ooc9t«'<«ieo «ogo 



<1 



I 



•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 



a 

•-5 



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



a 
5S 



'^S 



c^ 



=•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 



li 



A 

1:1 



■ SI.2 X.2 

.aS :^o .2a :«3 

-r^ ^ o ^ o o S 9 









.2 



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 



g- 



2S 



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 





^ 




ff 




*f« 




-« 




ff 




f^ 




i^ 




Q 




^ 




<W 




-< 








!^ 




«£. 




^ 




5^ 




O 








t-.* 








^ 




• S 




o 




o . 








CJ "^ 








- e 




?»>.'^ 








2 ^ 








fe « 

"^ ^ 


o 


cS 


o 


•§ fe 


1 


^0^ 


r-t 








(J 

ft 


2 -; 


^1 


<1 


¥S3 




K , 




^1 




a 




^1 




S'^^ 




CO 




:s 



o 



o 

.5^ 






«5^ 


3 




;g 


a 












§ 


er 


53« 




t^ 






:3 


eoc 








t*co 


%S^ 


rH 




??^ 


N 






B* sa 


tOfH 


«g^g 






MOO 


S28 


i 




g«>^^ 






■5- a* 


s 




cogeog c. 




eoeo 


S5S 






SSSS'^*' 




wejuo ON.-i» 




"S 


»• tH 




F4C9 


J85g 






0>t>CI99 »-• 


-§?- • 




S3 




'"g«S '^ 




■♦« 


^34 


1 




UJ« 


t* tH 


f-iMfH oeo 


?-• 




.g«« 






iftt* 


^S^ 






g**««> 




«& : •'" 


<o 




00|«2 


'^ 


•00 


85^ 


^4 




oo^c^^ ^ 


^gj^ goo 


SI 




«>J^« ^ 




s* 


«2^ 






«o^i-< « 


«a 


«o^ 


s 


^0|«3« ,-. 




-^s 


S2jf5 


s. 




t^^WOi C« 


i-g<N U5^ 


a 


^«gr^g - 




«*?2 


^s^ 


1^ 




s- 


«^ ■♦ 


g3S. 


»o 




;5 




«|-s .. 




«e4 


S5S 


i 




fe'^'^S «'"r3'^ 




^ 


lO 


^ :3g«»o ^ 


eo 1 


»o5© 


1 




SS 


s ss^gs 


JOC«T-lt» 




^5581* 




r-ie4C« 


ae 

Q 
95 


^ 


g 




o^eo 


<© g^ecg'* 







eo 




Jl:-«0»-i 






»-lN 


« 


s 




S* 


0» OOOkOiO 


•H 




©« 




:S^ 


?-• 






^4 


CM* 


i 




»•« 


^ ^^9:^ 






W4^ 




iSS"^ : 






C4 


-J 


1 




sa^a ssss- "'^ 


00 




:«55* : 






•* 


d 


1 






^S8S -^ 




-*« 






s 

c 

■ 

If 

1 

s 
< 




■ 
If 

1 


5 

c 

X 


c 

J 


1 


m 

1 


> 

s 


a 

i 

h 
t 

'S 


e 
£ 

i 

1 




a 

» 

s 

« 

1 




i 


■ 

2 

j 

• c 

1 

a 
> a 

1 


'i 

< 

s 

«e 

IS 


1 

t 

< 


j 

2: 


*4 

h 

If 

a; « 

II 

3 s 


■ 

I 

c 

■c 

c 

1 

"= 
E 

q 


t s 

•■! 

■ q 


1 


8 

j 


c 

1 


! 

C 
« 

e 

1 

i 


1 
1 

'S 

> • 
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- 



n3 



C 

o 



pq 



^2g§ 



S2§j 



52S 



U.CO 



C^QOOOi-^rH 



2^-" 



-S-^ 









c 

E 

.a o 



'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 



si 

^ 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 



S 



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 



^3 



■ 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 



5 



^5 



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 



T3 

.5 

a 
o 
O 






sse 






«« 




U3 




»-H-^ 


f-l«C 




2$ 


m 




ec 




0»^r-< 


j 




s^ 


^g 




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 






jo 


«DC^f-li-i 


00 «e 


s;"^ 


lONW* •* 


'♦fnm 


OOrHt- 


958 






•t> 


iAi-«»o • 




eo 


.S^ 


■«f-ie4eo eo 


•*^«o 


o»f-ioo 


S5!S 






•a» 


eoc9^ .»-i eo^ 


,5^ 


t- |»-no 




eoc^'O 


■<*« '-at 


S2S 






is 


'♦^eo 1 




•o 


COiO 


«o.-i |«o 


«■«* I"* 


"-S 


858 


— 




:- 


00 


eoN 


' ejo» 


*goo i-i«*»-*ioc« 


NOOrHO rHOO |«0 

1 


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 \ 




lO 


8a 




• :«a <'• 


^ l-H 




jeo 


•°5S 




















•«•• 


^c^ 


.-1 • |o» eo 


f-ICI 




eirHiO 


•d 

s 

is 


"* 




















?-• 


•oo» 




: jd o 


F4f~( 




r-trHCO 


00 




















01 


^;s 




•?-• 




lO j 




MfHrH 


(N 




















04 


•8 






»•»-•«■♦ 






jo» 


rH 








^ 










rH 


•« 




: > gr^OOC 




r- j« 


^ 


S^ : 


















cooo 


<& jr-iei ^Qoeo<«c4 


eocog 






> 

1 

.£ 
S 

1 

: 

a 
C 


1 

« 
5E 


J 

"pis 

lOQCC 


> 


i 

■•s 
1 

1 

OE 
1- 

■ 
■J 


D 

1 


1 


i 

a 

9 
S 

•Es 
=^ 
is 


1 « 

1 


1 


i 

5 


I 

X 

a 

'i 

1 

c 
a 

a 

« 

o 


1 

1 


1 

c 

• i 

e 

*s 

1 


'c 

1 

c 


• • Ci 

: : J 

■2° 

III 


.2 

1 

c 

M 


1 

*c 

1 

e 

a 
« 

s 
,c 
"> 

c 
c 



c 
e 

a 

u: 




c 

'2 

e 

1 

C 

"c 

Si 

« 

c 


■i 

.2 




1 

1 


GQC 





Digitized by 



Google 



13J 



s 



o 

O 



E-« 



5^ 



o 






s 



5Ȥ 






ft: 






•mox 



*p9)J0d 



•^opiiML 



•MiiOpij^ 



•pwjjiTK 



•lanig 



'pe^jod 



*a4iojoj 



avoiMmy 



•pejoioo 



•'niqii 



oiioaiinn 






85g 



2S8 



S3g^ 



1 



B. 



gSS-i gss|8 §s-|- -sssg ;3-«sp 



350.r^« ^ 



a- 



«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* 



'r 



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 • 

1555 S 



ooo-S 

« as ««« 

ooSg 
e'S'o-S 









•> «B h ^ 

522 J S 



Digitized by 



Google 



136 



c 

c 
o 
O 

I 

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^ : 


eo 




*« :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^=^ '=^ 


5 


<^' 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^ 






li 



1^ 

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 



PQ 



•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^^ 



ss 



ss 



lO e^io«-iio 



a «a 



: 0.2 ® 

•^ fl o 

* * £ fe-" 

-- a «— ® 

e8"" • © OQ 

I slot 



€8" 



&3 

9> 90 



oer2^ 



o o 



«s^- 



g**" 



"5 2 o © © a 

SSgagg 
PQOQwO 



c tD a> o 3 

.2 fc. © g o 

<'<PQOP 



:a 



,o On— • 

« ©"^ 
55-3 

oofe 






Si 
as 

II 

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^ 



s^ 



§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^ ^ — 






c 

. .'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 









r 



si 



•2 

Ho 






« 
S 
.« 

^ 



"5 



*«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 



la 

^ 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 


s 


•««rHlOO» 


;:SS*^^ 


r«tp«t«o 


g3S*;S-» 


aot<-9Cuoo 




: :*''* 


ec ••-< : 


3 


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 


s 


■*»Heo«»-i 


JeoeoecM 


|c4rHpH 1 


<OOSeC'*rH 


»H«f Jeoeo 


^rHN 1 


S2^S 


0O«O»iO 


g 


«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 


t^ 


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 




Si 


: ': :^ : 


1^ I tr^fH 


rH j 1^ j 


^'^CC j j 




»-iC>< 1 • 


eooc JN 


■^-♦WOJ 


g 


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^ 
«' 






.r 



5J 






o 



:3 



*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 



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 



84 

5 

248 



420 
82 

167 

114 
90 

201 
52 

103 

81 

1 

204 
24 
Pi 
24 

124 

25 

67 

1 



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 



54 


2.1 


4,115 


163.5 


153 


6.0 


187 


7.4 


11 


.4 


1 


.0 


2 


.0 


00 


2.3 


79 


3.1 


24 


.9 


49 


1.9 



1.5 

16.6 

3.2 

6.6 

4.5 

3.5 

7.9 

2.0 

4.0 

3JJ 

.0 

8.1 

.9 

.4 

.9 

4.9 

.9 

2.6 

.0 



Digitized by 



Google 



145 



Deaths in Indiana Classified by the Bertillon System^Continued. 



c 
o 

li 

SB 


CAUSES OF DEATH. 


No. of 
Deaths 


Death 
Rate 


00 


II. DiSIASRS OF tHB NBRVOUS SYSTKM AHD OP THE 

Organs of Sbnsk. 
Ell r-nhjiliiis 


180 

553 

236 

32 

128 

1,264 

129 

986 

56 

78 

129 

38 

406 

63 

14 

183 


7.5 


61 


Siirj im' ihiTjinntis 


219 


61a 


Ej ' i ■ t'Mij \-- 1 'ftTebro spinal meningitis 


9.3 


6i 


Pr*pt;ri?''>i^'e locomotor ata^cia - 


1^ 


63 


0( \^i• r n i "►■■■i j(sq of the Spinal cord 


5.0 


64 


C<u] t;i' 1 r i 1 r]i and hemorrhage of brain 


50.2 


65 


Sc'tf ►■[! iun "f the brain 


5.1 


66 


Pa Ml [ Mr L- , 4 .a nae unspecified 


39.1 


67 


Gcrarriil I^EXI-JllvsiS 


2.2 


68 


OlluT fnnna uf insanity 


3.0 


69 


E^'i'i-i'sv , , i 


5.1 


70 


C<jm ^ ulf jf3nfl (not puerperal) ..* 


1.5 


71 


Ci'N '- iil^toiis of infants 


16.1 


72 


Trt^inii^ ♦, ■ 


2.5 


73 
74 


Ci I. ?< . 

Ot ' ■ 1 r, . .'I ui diseases 


.5 
7.2 


75 


D ■ ■ the eyes i 




76 


D : the ears 


10 

76 

125 

1,754 

161 

86 

31 

11 

4 

79 

1 

2 

61 

3 

377 

185 

480 

2,989 

41 

354 

127 
14 
156 

36 

41 

4 

56 

648 

1,776 

34 

395 

6 

203 

362 

6 


^ 


77 


III. DiSEASKS OF THE ClBClILATORY SYSTEM. 

Pericarditis ; 


3.0 


78 


Acute endocarditis 


4.9 


79 


Organic heart disease 


69.7 


80 


Angrina pectoris 


6.3 


81 


Diseases of the arteries, atheroma, aneurism, etc 


3.4 


82 


Embolism and thrombosis 


1.2 


83 


Diseases of the veins (varices, hemorrhoids, phlebitis) 


.4 


Si 


Diseases of the lymphatics, lymphangitis, etc 


.1 


85 


Hemorrhage 


3.1 


86 


Other diseases of the circulatory system 


.0 


87 


IV. Diseases of the Respiratory System. 
Diseases of the nasal fossae 


.0 


88 


Diseases of the larynx 


2.4 


89 


Diseases of the thyroid body 


.1 


90 


Acute bronchitis 


14.9 


91 


Chronic bronchitis 


7.3 


92 


Broncho pneumonia 


19.0 


93 


Pneumonia ... . 


118.7 


94 


Pleurisy 


1.6 


95 


Congestion of lungs, pulmonary apoplexy 


. 14 9 


96 
97 


Gangrene of the lung 

Asthma 


.2 
6.0 


98 


Pulmonary emphysema 


.5 


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 


.1 


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 


.2 


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 


.2 


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 


.8 


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 



1 

137 



142 

1,066 

55 

2 

146 



27 

8 

234 

58 



14 



1 

180 

1,175 
68 
4 

1,265 



112 
1 

48 
16 
52 
9 



.0 

5.4 



5.6 

42.3 

2.1 

.0 

. 5.8 



1.5 
.0 
.1 
.1 
.3 
1.0 
1.1 
.5 



2.7 

1.0 

.3 

9.2 

2.3 

.0 

.1 



2.6 
.6 
.6 
.9 



.6 

.3 
'"6 



7.1 



46.6 

2.7 

.1 



50.2 



4.4 
.0 

1.9 
.6 

2.0 
.3 



Digitized by 



Googre 



147 



Deaths in Indiana Classified by the Beiiillon System — Continued. 



§ 

II 


CAUSES OF DEATH. 


No. of 
Deaths 


Death 
Rate 

i(S?obo. 


ie2 


Gruf hing 


1 

16 

136 

1 

788 

165 

4 

90 
11 
33 
112 
717 
31 
66 
27 
47 
1 

194 
20 
360 


.0 


163 


Other methods 


^ 


164 


Fraetnrei 


5.4 


166 


DisIocatioDs 


.0 


166 


Other acoidental injaries 


31.8 


167 


Burning by fire 


6.5 


168 


Baming by corrosiTe substances . . . : 


.1 


160 


Sunstroke 


3.5 


170 


Freesing «. ; '. 


4 


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 


.0 


177 


XIV. Oaubis Ill-Dbfinrd. 
Dropsy 


7.7 


178 


Sudden death (not puerperal) 


.7 


179 


Causes not speciflea or ill-defined 


14.3 









Digitized by 



Google 



148 



Eh 



6 






?2 



^ 






a 



5? 



CO 






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 



H 



O 



5|1 5|i 3|1 i|l i|l 3|1 5|1 5|1 
a£ ^l£ ^i£ ^l£ 5l£ ^^pS hI£ ^t.£ 



a 



5 



-2 

a 

M 



i 



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 


©5555 


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 



3 



a 

S 



a 










(S p » 



Digitized by 



Google 



150 



a 



c 
O 

I 



H 

O 



JSS** Sa<5 SSSS ass SS^ !8a« 5aS5 ai*!3 J82?; 



i 


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 


9 

a 




r- jr- 


ass 


s;:'^ 


S^*- 


gojeo 


53SS 


S8S: 


ass 


I5SS 


99 


^^^ 


sss 


JS*"** 


S*"£3 


oeor> 


^^^ 


s$s 


ass 


asa 


1 


ga* 


8SS 


a<*s 


as::: 


cg«e- 


ass 


^!S);c 


sss 


asa 


:9 


as* 


5?sa 


feSS 


as*- 


ass 


sas 


S9S 


ass 


.$aa 


J9 


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 



e 

J 

s a 



Digitized by 



Google 



151 



s** iiS55 ass ssa aaa «s3a ^ca &s*- s3ss ass s^s ss'- 



ass 


feS« 


8S« 


RS* 


ass 


ass 


asa 


t^iOd 


ass 


ass 


ss^ 


s«^s 


«•* 


^^eo 


^(S;!: 


S8as 


ass 


ass 


ass 


aoeito 


i;s« 


ass 


ss-* 


a*-s 


as33 


S*"* 


SiSS 


$s«s 


ass 


ass 


ssas 


ss** 


aas 


ass 


s*s 


ass 


SiSS 


s*-s 


ass 


ass 


sss 


ass 


aas 


s^s 


as-* 


ass 


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 


ass 


ass 


s-^s 


a«s 


9sas 


ass 


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 


ass 


asa 


ss*> 


9S^ 


asa 


•ot-op 


ass 


as« 


S5SS 


ss*^ 


^aa 


^sa 


sss 


5ISS 


S*"* 


tosa 


5?sa 


CPOOOD 


ass 


ass 


9SiS 


sssa 


^sa 


tcSS 


aas 


^aa 


s**- 


ass 


asa 


ass 


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| 



a 






o 



3 



(» 
^ 



Digitized by 



Google 



150 



a 



c 
O 







I :3 



SS** Sa<5 8SS ass S3^ !88« 5^3 35*!S RS5; 



► 

is 


r>coOk 


$SIS 


ass 


jDr-o* 


j5flo« 


sss 


saa 


5553 


a*-s 


1 


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 



•-a 


t- jt- 


a2?2 


ss-^ 


s***^ 


C40>eo 


sss 


9SI^ 


ass 


RSS 


96 


53S;3 


cssa 


s**** 


s^a 


S«^ 


S5J:; 


8SS 


asts 


asa 


A 


855* 


s;s:s 


a**s 


»ss 


««oe- 


8JSS 


^S8^ 


9SSS 


asa 


s 


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< 



5 

a 

9 



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* 


as* 


ass 


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 


ass 


s*-;3 


ass 


ass 


sss 


ass 


aas 


S^S 


aa-^ 


ass 


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 


aw 


ass 


s«s 


a*s 


aas 


ass 


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 


ass 


asa 


ss* 


$s^ 


asa 


•otocc 


ass 


as* 


ass 


as** 


5siaa 


^sa 


ass 


5sa 


s»-* 


^^a 


5sa 


«Daoao 


atis 


aw 


9&;S 


«8a 


^aa 


tcSS 


as^s 


!;aa 


j©o»»* 


ass 


asa 


ass 


ass 



■ ••00 ••■ ••■ ..to ••■ ..00 •>■> ,••• ••■ ..OQ .•« 

••• ••• ..« . . 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 



S 






s 

•-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* 



I 



il 



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 



o 



ssaa asj:: sss gsus saso fe^a ss^; ssss ^ss 



1 


K 






ac 


X 














j 






I 






J 













^^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 « 



S 






J3 j 



4 
73 



5 



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« 


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; ^ 



o 






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 



D 

<^ 

c 
c 
O 

f 

w 



n 





as 



4 






l-H 

H 

o 



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£ 



a 

s 



I 



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 



s 



CO 



P 



Digitized by 



Google 






o 
O 

I 

< 



O 

JZ5 







156 

S!«:8 85S?^ •^^ f!S* gSS fc^S «as SflS 



*i^5 85SS "^^^ ass «S* SgaS 5SaS 8*S 



1 


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 


i 


S^SS 


s»-* 


CO 00 


joi^oo 


ass 


sas 


SJ;::^ 


^JJO* 


1 

-< 


365:5? 


asis 


a»'*ic 


SS'-^ 


fc5?a;s 


S^S3 


000 94 

eo»^r-« 


s*s 


S3 


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 



5 



Digitized by 



Google 



157 






P. 



^=" m 



**s II 



ass 1^ 






Mjr^oc g« 



»"' ill 



JS*S §1 



8S- SJ 



ass §g 



n 



3|i |i 

o * K ,* © 






^ 



Digitized by 



Google 



o 

a 
*-» 
a 
o 

I 

w 
< 



5: 



a 



?5 












'r. 



SSg 



ss« 



CO 

» 
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 


;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« 


eo 


M1-41--1 


jgt-oo 


tONco 


C^i-li-l 


•oeooi 


eoi-HDi 


C^rsrs 


i-H |»-4 


©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* 



*2 



1 



s 



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 


SM 


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 



3 



5 



i 

5 



I 

a 












1 ^ 



Digitized by 



Google 



160 



o 
I 

w 

PC 



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 

1 


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 

1 


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 



'■ 


I 


"Z 


9 


s 

"3 


^ 


w 




^ 




go 

c 

"5 






— 


-: ? 




— 


5 


a 
"3 


: ■ * 




•■ 


« 



>5 



O 



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 


iM 


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 

a 



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 


sm 


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«^^ 


CO 


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 



QQ 






O 



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 


rH 


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^ 


©40^ j 



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 


eo 


eo 


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 


'-' 


rH 


^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» 


e^ 


•Mi-ti-^ 




^rH : 


«^l-« 


'" 


'" 


»eoco 


eOfHC4 


rH jrH 


lOCvjeo 


tM .»-i 


rl jrH 


cc 


CO 


«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 


Ol 


-^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 



3 

w 

1 






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 






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 



5 

o 



9 

04 










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 



S5 


a 


•■ 


Jg 


& 


j 


OQ 


GQ 


U) 



3 






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^® 



S5 



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 



« 
^ 



8 



Digitized by 



Google 



I6i 



as?s 


It 




a»<oe« 


is 


o 

2 


OKoeo 


i^ 


1 


cj^r- 


21 


1 


»*^«o 


ii 


!- 


df-i-H 


11 


>2 


00 "^Tf 


ii 




• 


IE 


"♦f-I« 


ii 


5 


r>e«iO 


§1 


5. 


t--*co 


§1 


5 

-J 1 


eO^N 


si 


i 



to>a \ 


IS 


oa 

S 1 


i : i 2H 


^ 1 


»-ll-H • 


§§ 


5 


<o«eo 


§g 


i 1 


toiAOl 


ig 


! 1 


ssa 




5? 1 
GO 



3|S IS 

o • • * • 



^ 



Digitized by VjOOQIC 



168 



P3 

Eh 






a 



a> 


iT 




o 


c 


>' 


■-C 


• O 


c 


H 


1 


« 


1 




G^l 


1 ^• 




1 ^ 


.J 


^ 



e 

CO 






CO 









HK 



•MopiAl 



•JftMOpij^ 



•P9UJ«W 



•»I«ais 



HX 



'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£ 



CO 

H 
H 

o 






•2 

o 

ce 



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 


ps 


§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 


nm 


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 


^m 


ii§ 


SSI 


m 


'*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 















oc 






K 




■s 


















9 






J 






J 












an 



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^&^ 



4 



Digitized by 



Google 



170 



c 
o 
O 

I 



Total 
Males 
and 
Fe- 
males. 


iS§ 


!§§ 


gis 


sss 


§§s 


Si§ 


eii 


iS5 


§S§ 


UN 


?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 

1 


S^S 


SSS2 


gg'^ 


^S??3 


aS^;}: 


Sffg 


S§2 


ggs 


gStt 


•oi»uig 


|$So 


ss§ 


gse 


8SS 


stgis? 


SB! 


iii 


§=2 


ggss 


ax 

1 


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 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^ 



4 



a 
2 

5? 









3 



Digitized by 



Google 



170 



o 
O 

I 



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 


^m 


*uMoas[Uf^ 


w Jm 


(Mf-ii-i 


lowco 


N-M '• 


^ i^ 


oeooi 


»<oec 


0^— 


-*C^N 


j -MAO 

1 


« 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 




K 


J 






J 






i 




X 


— 




• c 




•J 




« 


it 




« 






«i 



I H55&M 



>5 



: 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^** 



S' 



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 


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 


im 


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 



a 



a 

3 



Digitized by 



Google 






a 
o 
O 

I 

< 






H'X 



•MopiM 



•joiiopiM 



'pOIJUBJ^ 



•oiauig 



•HX 



'IL819J0J 



'atiouamy 



•pajoioo 



•»^TqAi 



'aMoa^afi 



•19A0 

pa« 


06 


S2g 


S28 


esff 






H 
5^. 



O 



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 



SB 






5 5 



OS 

a 



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 


JC 


JC 


^ |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 : 


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 






a 






o 



Digitized by 



Google 



174 






HX 



•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 



HN 



gsg SSS l§i S«- iS§ §§1 gB gS2 S^s 



eoootc 


ss-*- 


?::S'- 


o»eoco 


aoioeo 


04 oc^ 


OiO-^ 


«094<« 


00 


eo 


S is 


^ ifS 


5S :^ 


S :£J 


§§ :^ 


55 :« 


^ :g^ 


55 :53 


22 


to 



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 






»• 




^ 


i 


1 


> 







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 


"a 




s 


-3 


rs 


a 




>^ 





"ei 


^ 




C 

"5 




S 






« 


a 

"3 


^ 


S 


13 ^ 


BQ 


"3 






« 

"5 




« 




^ 


« 


•3 



HSSb hSS) 



^ -I 



CC OQ CO CQ 



Digitized by 



Google 



176 






HK 



•MOpiM 



'jdj&opi^W 



'paijjn]^ 



•©laaig 



HN 



•U819J0J 






o 



'avoiJdiny 



•paaoioo 



•»^!qA\ 






== ,1- 



uaAO 
pa«06 

S2g 



,1 ^ 


2g 


1, 


se 



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 -^ 



c3 



Google 



Digitized by 



>8i 






177 



m 



A 



ss 



&!;$ 



r-ao 



i:$S 






II 



B I 









??3 



-^ :^ e?3g 



8SS g| 






12~Bd. of Haalth. 



Digitized by VjOOQIC 



178 



< 









t^ 



f^ 



^ 






o 
5 



"< '\ 



IS 


•fiwq^opi 


•SJ9q;«j 


H 

13 

< 

< 


a 

be 

£ 

"i 

© 
s 


•pjaqjoj^ 


•Bjoq^wj 


•saomoK 


•sJoq^Bj 


OS 

o 
o 


o 

6 


•B9itini3j 


•sai^K 


6 


■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 



O 






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 



e 



^fotufV 



'SdLvmnj 






o 
O 



<1 



< 



*MI*W 



g 



'|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 









"2 






CO 

Is 

CO fe 









0:1 



c 

ft:; 

"3 



I 



H 



'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 



cs 


•^ 


f-HOO 


«ojo«oioec 


©««f-H 


« 


«0«O0«CJ 


:« 


N 1 eo 


sgi~ 


eQi«« 


««" 


»-• «i^r- 


(M--< 






r-iW 


cookc^n-^ 


CO 


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<£> 




00 


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 



OQ 

H 
H 

O 



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 



^ 

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 






O 

I 









^ 






<;j CO 
O 

0^ 



i 












op 



J 5< — 



Oh 






H 



*9|«aiaj 



•oi«W 



*9i«taaj 



•3I«W 



*3[V1IIVj 



■s[i«K 



'jsnidjf 



UiiqiB^I 



^£g u^Hlnj 



I 



85^1 'ien*^^ 



'^'^H1«W 



•joq^«j 



Si 


•Jeqiow 


3 

s 


•jaq»«J 


§ 


•jaqiojv 


S 


•jaqiBj 


^ 


•jaq^OK 


3 

8 


•wqi«J 


8 

9 


•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 


oo 


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>«« 


1M 


sas«s 


^^SS5 


*SS5gS 


:^«c.tao gj{55-o»:o 






ll-l 




• j • !»-< 








: i*^*^ 




:«-t : :« 


09 




eqi^ 


r-iOQ 


PH 


COrlCO 


r^ 


|cO«r-f 


i-H 


t-QO 


rtriC^ 1 


r-«i-l JMCO 


«o j 1 1 1 : 












ic 


'" : 


N '• 'l-* 


i i*^ i i 


j-^oooBao 


J^O 


o> 


too* 


■«f 


SS 


«c» 


25 ^^'^^ 


CO 


«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 






O 

o 

I 



52 

copq 



O O 



gSSB 



■diBinoj 



•»i«w 



•j9qiOK 



•jaqjuj 



•jaq^«j 



•aaqiBj 



s 

o 



o 

i 



•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| 



o 



•«q,o„ ssssg fegg??! ssgsss iiaag as?a 



•49q;opf 



•jeqi«j 



P 

O 



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 


i 








1 






N(M o |t- : 


3 






aON N jr^ j 


S 


• 


C4C4 1 t- ;<e"^ 


1 


(Mr-lt« j t-rHtO-* 


S 


g^iC>^<«< to ;»OW 


«o 

=5. 


««S5 ^'^^'^ 
















s 


1^ 


(Nil inr-l 




g 


« 










3 


0^00940 ^e>4C>-«^ 


1 


S'^'^S^ S53S^ 


1 


Sg5S3S5! ?:5I5S 


1 


S5gS2 g^S® 


5 


SS2?2 IggS 




g^ss i§ss 


gg|& g||g 


1 


gJ=8S S^SSSI 


1 

■^ 


o 


CO \ CO'* 


©» 


s 


1 

il 


1 
^ 




1 


•5 


3 

2 


1 





Digitized by 



Google 



190 









"I 



5^ 









s 

^ 






H 









•sapuQ 



'smoojo 










o 


S 
c 

0) 


•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 


|« : 


^ 


la 


leot- \ 




^ :{g 




fH • 


•^ 


«^ : .S? 


r^ :r 


C^r-« 


i : i i^ i 


l«f^ 


C^ 


CO 


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 




5 


: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;: 


sasǤ 


^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 



0^ 



o 
O 









*80pUg 



'smoojo 



'sapug 



'Bcaooj{) 



08 



•sapug 



euoojf) 



S 

o 



p9ao[oo 



•onRAV 



H 

o 



•oea 



•^8W 



lutfy 



•J»W 



•q»j 



•u«f 



Saglg BfegCS 8§SS 



^m 



^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 



g 






I 



^ .CJ 



g^si gss§ 



8<»^8 . «»S):!I 



as»^ S3ass 



^^S:::^ SI2SS9 



R^ssa ;3S*a 



t 



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 



a 



»5 



Si 






CO 



1^ 



-■5 

ill 



s 



•iopua 



^e^-^r-iio riu 



O 



o 



S 



s 

s 

§ 



3 
^ 



5 

8 



a 



'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> 



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 









sa 



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 

Q 






o 



SggSS g§§S9 s§Se§ $SS§g H%% 



-I 



■WPHS 



8 

9 



s 





■•V00J9 



8' 

I 






8 



8 



S 

s 

9 



4 

a 

8 



8 
S 
8 



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 



i 



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-* • • • 


g 




00 


J J J«N : i : ; 


a 




S3 


j . : j c4*i4C4C4 


a 


^ I jr-i 


^eoiHW 


s 


M • ••© 


-*r-IOO« 




^ : ':^ 


iO(NiOiO 


1! 


C4C^00««< 


rococo 00 


g 


s-^a^ 


00iOO>»C 


S 


51^55* 


gt-flOt- 


1 


§8SSS 


5?S?3S 


E 


5SSS 


S5I855 


1 


g§2s 


gSgis^ 


1 


gS§8 


gS§5 


s 


SS^SSg 


«?2§85g 


1 


jlj«'»0> 


aO'«<"Meo 


s 



a 

a 

|£-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 


85 


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 






Co 

O 

o 






^ 

Q 
o 














r 


























I 


1 




























% 


L 




























i 


r 




























4 


r 




























5-10 




























I0-/5 




1 


























15-Zo 


_M 














20-XS 






2S-30 


■ 






30-35 


1 










35-¥o 


■ 














^0-^S 


J 


















fS-50 


1 




















50 is 


1 






















55-60 


■ 























60-65 


1 






















65 70 


■ 






















70-75 


■ 
























75-90 


1 


























80-90 


J 




























9ot 


■ 




























unk\»>i^ 




1 




























c 
o 



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 

do 

CO 
^0 

%o 



■ 


■ 




■ 


■ 


■ 


■ 


■■ 


■ 


■ 


■ 


■ 


■i 


■ 




■ 


■ 


■ 


■ 


■1 


■ 


■ 


■ 


■ 






■ 




■ 




■ 


■1 


■ 


■ 


■ 


■ 




■ 


■ 


■ 


■ 




■ 


■■ 


■ 




■ 


■ 


■1 


■ 


■ 


■■ 


■ 




H 


■■ 


■ 


H 




■' 


■ 


^ 


— 1 




■ 




■ 


■ 


■ 


■ 




■ 


^ 






■ 


■ 


H| 


■ 


^1 




■ 


■ 


■^^ 


■ 


■ 




■ 


■. 


■ 


■ 


















■ 
■ 


■ 



HOO 



ioo 



200 



JOG 

80 
Co 

40 



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. 



§ 









4^ 



^ 



c 




J 
1 

s 

H 

6-10 

iW Jo 
^d5 

csyo 
70-70' 
75'do 

80-90 



J 


_ J 
















W^ 


















\ 




















■ 
































! 


■■ 


















r 














■ 








■ 










J 














_l 














_ J 
















^ _J 
















■■ 




















r 
















■■ 
















J 
















1 




















1 






















■ 






















n 























^ $ 












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 



O 



O 

I 
% 

3 





-■!■ 


■HII 


1 1 


■ 






1 




Jll 


mil 


1 


I 






1 




III 


mil 


1 








1 






-<|i 


mil 


1 








1 




Jll 


mil 














II 














Jll 






1 










1 














ji 


■ 


1 






111 


in 


11 


1 


1 








—I II 


III 


n 


1 


■ 






■I 


III 


I 


1 


1 






— 




II 


III 


1 


■ 


1 






__J 


H 


Hi 


■ 


I 


■ 








II 




■ 


■ 










II 


n 


1 


1 










n 


11 


1 


1 












II 


1 


II 








J 


II 


; 1 


■i 


I 


II 






1 


J 


II 


im 


II 


1 


II 






1 


1 


■1 


IMI 


II 


1 


11 






I 



V ^ c*. *^ ^ 
^ O « Ci o 



ft 

c 

DIAGRAM V. 






O 



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 







■ 


■ 


■ 


■ 


■ 






■ 




■ 








■ 


■ 


■ 


■ 






■ 




■ 








■ 


■ 


■ 


■ 






■ 




■ 








■ 


■ 


■ 








n 




!■«»■■■ 








■ 


■ 


■ 
















■ 


■ 


■ 






~ ■ 








■ 


■ 


■ 












■ 


■ 


■ 












■ 


■ 


■ 












■ 


■ 


■ 










■ 




■ 


■ 


■ 






■ 


■ 


■ 


■ 


■ 






■ 


■ 


■ 

1 


■ 


■ 



2.09 



fOO 

80 

60 

^0 



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 



IS 



So 



i5 

15 

10 
5 

























































■ 


















■ 


















■ 


















■ 


















■ 


















■ 


















■ 








J 










■ 








1 






1 


-j 


■ 














■ 








































1 i 














1 


















■ 














II 










1 


1 

1 




1 

Jl 


Jl 


■ 




1 
1 
1 
! 

1 


1 
1 

1 



* ^ 

? Ai *\ ^ 



/OO 



7S 



SO 



29 

20 

/S 

/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 








1 








^ 

o 























/ 




pi 




















'J. 


1 




















3 






















L^i 


1 


I 


I 


I 


1 


c 


/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 



2W 



/oo 

75 
So 
Air 

















































































































1 






















































































H 






































































































































































H 


















































1 








































■ 


H 






B 



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 



























































1 




H 




II 


* 


I 




I 




I 




I 




■■ 




H 


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' 






•^^ '»^ " 



a 



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 

50 

25 



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. 



O; 



% 









o 



0| 









0» 

o 
o 





7 

2 

3 

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* 











































J 




























J 

■ 


■ 




























■ 






























1 




























1 


■ 


























































1 




























J 




























J 




























J 
























































1 






























1 































































































































J 
























J 
























JB 


■ 


■ 


■ 
























■■ 


■ 


■ 


■ 































o 



DIAGRAM XII. 



§ 

O 












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. 



^^' 




fe 


& 










1 
















1 





■ 


^^^^1 




























I 


■ 






































1 


Pr 


















' 




















3 


1 
















"1 






















^ 






































5-JO 












• 




























/0-/5 








































it-20 








































20-2& 








































2S'S0 


r 




































30-35 






































2S''/0 


































— 


'm^ 




1 






























%-SO 


r 


































SO'SS 




■. 
































5S-C0 


Wt 






























— , 


W-€5 




r 




























iS'70 




1 




















70-75 




^P^^PP^ 


B 


1 










7$'80 


MMH^tm 


r 






— 


80^0 




■■■■HHHHHI 


90* 


r 


































Uttkn^wn 








































SJ 


9 < 


t\ 


§5 


? 


I 


)IA( 


5RA 


* 

i 
M 1 


ilV 








i 


3 








8 



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 



Digitized by VjOOQIC 



ABRIDGED ANNUAL REPORTS 



COUNTY HEALTH OFFICERS 



CONCERNINQ 



SANITARY CONDITIONS AND HEALTH 



IN THEIR RESPECTIVE COUNTIES. 



19OI 



(237) 

Digitized by VjOOQIC 



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 
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 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, 
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 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 



OP 



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. 

t 

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 



Digitized by VjOOQIC 



PROCEEDINGS AND REPORT 



OP THE 



STATE BOARD OF HEALTH 



For the Year 1902. 



Digitized by VjOOQIC 



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. 


4( 


31. 


(( 


31. 


« 


31. 


June 5. 


tt 


16. 


(( 


16. 


July 


1. 


«( 


1. 


i* 


1. 


4t 


1. 


(« 


1. 


" 


11. 


(( 


11. 


ti 


11. 


I* 


11. 


(4 


11. 


44 


11. 


44 


11. 


<« 


11. 


44 


11. 


*4 


11. 


44 


11. 


44 


11. 


<t 


11. 


44 


11. 


44 


11. 


44 


11. 


44 


11. 


44 


11. 


Aug 


. 1. 


«t 


1. 


44 


1. 


44 


1. 


44 


1. 


Sept 2. 


44 


2. 


44 


2. 


44 


2. 


44 


2. 


(4 


2. 


Oct 


1. 


44 


1. 


44 


1. 


44 


1. 


44 


10. 


44 


10. 


44 


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. 


<i 


10. 


« 


10. 


*t 


10. 


(( 


10. 


(1 


10. 


t< 


10. 


it 


10. 


i< 


10. 


4( 


10. 


it 


10. 


ft 


10. 


*i 


24. 


t( 


24. 


(( 


24. 


(i 


24. 


« 


24. 


(< 


31. 


t« 


31. 


<( 


31. 


« 


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 



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 



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 1