Ofscarlet fever, the cases occurred in Parkersburg; mild; origin, imported. During the month of December there prevailed in various parts of the county numerous cases of gastro intestinal catarrh in both adults and children; in the neighborhood of Volcano took the form of cholera morbus and cholera infantum, readily amenable to treatment; think it due to atmospheric influences; Dr. McIlvaine, of New England, in this county, reports prevalence of same disease, and accompanied by icterus and a continuous fever, with temperature ranging as high as 103° Fahrenheit, and lasting from four to eight days.

The vacancies in the Local Board of Wood county, reported in my last report, have not been filled.

Respectfully submitted,

W. H. SHARP, M. D., Chairman Wood County Board of Health.

Volcano, W. Va., January 31st, 1883.

SPECIAL PAPERS.

SMALL-POX IN MERCER AND WYOMING COUNTIES.

BY HON. ISAIAH BEE, M. D.,

PRESIDENT LOCAL BOARD OF HEALTH OF MERCER COUNTY.

In the spring of 1883, small-pox made its appearance in the north-western portion of Mercer county and that part of Wyoming county lying adjacent thereto. Sometime in the month of April, 1883, without monition of danger from any contagious or infectious disease, the people of this county were startled by a rumor that small-pox had invaded a large territory of the western section of Mercer and also of that part of Wyoming adjoining Mercer. For a time the existence of small-pox was doubted, for the reason that the place of its reported invasion was more isolated than any other district either in this county or Wyoming. No person was known to have been exposed to the disease. The locality was essentially a farming and grazing section of country, and very few persons, if any, had been known to be away from home. The out-of-the-way locality, in connection with the stay-at-home habits of the people, gave confidence in contradicting the report of the presence of small-pox, or indeed of any other infectious or contagious disease. The scourged district is situated upon the Great Flat Top Mountain, a spur of the Apalachian chain, and at the altitude of about 3,000 feet above the ocean's level. Those who were the victims of this outbreak of small-pox were an easy-going, thrifty and industrious people, whose simple and correct habits of life usually characterize the manners in sparsely settled communities. With but few exceptions, those who were attacked occupied comfortable dwelling houses of the log-cabin order of architecture; and their diet was of substantial character, consisting of healthful meats, fruits and vegetables in abundance. All their lives, and the lives of their grand-parents, the people of the invaded district had been granted perfect immunity from small-pox or any other of the many contagious and infectious diseases which have destroyed so many of the human race in populous communities. In a word, this people had never been in the least concerned about small-pox, never dreaming even of the possibility

of its presence among them. Such being the fact, they were wholly unprepared to resist its rapid spread. On the contrary, their habit of visiting the sick, attendance at funerals, or a general turn-out of the whole community at any unusual event, was the cause of the rapid spread of the disease before its true character was made known.

I have made more prominent the description of the place and people, than, perhaps, might be at first thought necessary, in order that the reason of the rapid spread of the disease might be better understood, and in view of what follows, the incalculable merit of our law creating the State Board of Health, as well that the value of County Boards may be thoroughly appreciated, and especially the efforts of the members of the State Board of Health individually.

Various theories have been suggested with regard to the introduction of the disease into this and Wyoming counties. At first, it was believed to have been brought to Mercer county by a merchant who had been exposed to the disease on a trip to Charleston for goods; but this was some time in February, and the small-pox did not attack him or his family until April, and then his family and brother's family were attacked on the same day. While contagion must be admitted as a quality of small-pox, yet it is not less true, that for its existence and spread, it is sometimes dependent upon active epidemic influence. The following case will show how the disease sometimes mysteriously appears: A young man who had not, to his knowledge, or that of his family or friends, been in any way exposed to the disease, and who lived more than thirty miles from the infected region, was attacked by small-pox. It ran the usual course of the disease. The best medical aid that could be had was called-two physicians, who themselves had had small-pox, and another who was a nurse in a smallpox hospital during the war. All gave it as their concurrent opinion that he had confluent small-pox. He lingered fifteen or sixteen days and died. This was at a period when the disease was under control. Strict quarantine regulations had been established at all exposed points. All the roads leading from the Flat Top mountain were strictly guarded, and how this patient was exposed is, and will still remain, a mystery, unless it is to be accounted for on the hypothesis, that the contagion of small-pox is sometimes generated anew.

But that variola arises from a specific contagium, whatever may have been the cause of its first origin, is not doubted by the best informed authorities. That the contagium can be conveyed by fomites is proven by a case that occurred in the vicinity of Princeton last April. Anderson Via, living twenty-five miles from the infected region, visited the Flat Top Mountain with his son, before the small-pox alarm became prevalent, to buy a cow. He stopped at Eli Blankenship's, one of the families in which small-pox first started. The bed he and his son occupied for the night was one in which a girl had slept, who had been a nurse in the family of Wade Blankenship, who was one of the first victims of the disease. Fourteen days after his return home he took the small-pox, and in five days after, just when the eruption was appearing on his face and breast, died. The son escaped; but as soon as the nature of the disease was suspected, the son, wife and little adopted boy were promptly vaccinated, and all escaped the disease. Every precaution was taken to prevent infection by the

purification or destruction of all articles likely to serve as fomites, and after the family could be removed the house was burnt. The disease was, almost without exception, fatal to infants, and I am not aware that a pregnant woman who had small-pox escaped with her life.

There has ever been a wide-spread prejudice existing in this and surrounding counties against vaccination-indeed to the extent of absolute refusal upon the part of many of the citizens to allow themselves or children to be vaccinated, owing to the fact that many years ago impure virus being used, the memory of which was still fresh in their minds, several parties were seriously injured by vaccination, it being followed by erysipelas in its worst form. They even dreaded (many of them) small-pox less than vaccination; but of perhaps, more than 4,000 persons, of all ages and conditions, who were vaccinated in this and adjoining counties, there was not a single instance of any bad result. I mean, persons who were vaccinated during and subsequent to the prevalence of the disease here. Had the citizens of the late infected region been vaccinated prior to exposure, results show that the mortality would have been very small. Not one person died who was vaccinated early enough for the vaccine virus to have full effect before the patient was attacked by small-pox, and in a large number of cases susceptibility to small-pox seemed to be almost, or entirely lost; but in what time the human system will entirely lose its susceptibility to the small-pox infection after vaccination, or when re-vaccination for protection becomes absolutely necessary, this epidemic failed to disclose. One man, now almost sixty years of age, who was vaccinated thirty years ago, only had a very light attack of varioloid, and at no time was compelled to take his bed or keep his room, but seemed to be as thoroughly protected as if his vaccination had been of recent date. As soon as the authorities became aware of the presence of small-pox in this county and Wyoming prompt measures were taken to arrest the spread of the disease, and to provide for those within the quarantined section. No one was allowed to leave home, or at least pass the cordon of guards. Nurses, physicians, medicines and provisions were furnished by the county authorities to secure immunity from its spread. All the cats were directed to be killed, and the dogs to be either killed or confined, for the reason that in many instances it became necessary to separate the members of families that had been exposed to small-pox and place them in out-houses, when they would have been in danger of infection through the agency of these animals.

After quarantine was established, not a case of small-pox occurred outside of the quarantine limits.

The following are the names of the heads of families who had the disease in this and Wyoming counties, viz:

Elias Burton.

John Burton.

Henderson Burton.

Eli H. Blankenship.

Council K. Walker.

John N. Cook.

John H. Bailey.

MERCER.

Crockett Blankenship.
Wade Blankenship.

Boyd Cook.

Sally Bailey.

Samuel J. Bailey.

Johnson K. Lilly.

Anderson Via.

A. C. Godfrey.

Jane Shrewsberry.

Sylvanus Bailey.

Leander Bailey.

A. P. Bailey.

Harrison Bailey.

WYOMING.

Eli White.

John Belcher.
George Burton.

Joseph Murphy.
Anderson Murphy.

There were, out of these families, nineteen deaths in each county, and the aggregate number attacked in the two counties with the disease was one hundred and twenty-five.

It is impossible to give the ages, names or sex of those who died, for the reason that Dr. B. P. Gooch, who was the attending physician, is now and has been for several months, so ill as not to be able to assist in making this report.

The money cost to the two counties, because of the small-pox visitation amounted to about FIVE THOUSAND DOLLARS, and but for the fortunate aid and power of the State Board of Health law, the whole southern portion of the State would have been the scene of confusion, great suffering, and many deaths.

The superiority of humanized virus over bovine, as to certainty of action and protective infiuence, was well shown. The humanized virus was more certain to act speedily, and for that reason was much more valuable, particularly in cases in which it was necessary to place the patient under the influence of the vaccine virus for the purpose of preventing small-pox or modifying or averting the severe form of the disease.

It is of importance that all exposed persons should be promptly vaccinated with pure humanized virus.

A gentleman recently told me that his son-in-law, living on the Flat Top Mountain during the small-pox epidemic last spring, knowing that he had been exposed to the infection, had himself and whole family vaccinated; on the same day he was stricken down with small-pox, which was on Friday; after this he remained with his own and his father-in-law's family till Monday, when he was isolated from all the rest of the family excepting his wife, but only by being removed to another room in the same house. Then he was waited on by his wife until he recovered. His being vaccinated seemed to have little or no effect on him, but neither his wife nor any other member of the family had small-pox. Vaccination seemed to have had a most salutary effect on this whole family. It was a large one of twelve or more persons of all ages ranging from one year to sixty. All were exposed in every way to the disease, yet on the same day that they were exposed all of them were vaccinated with humanized virus, taken from the arm of a healthy child; as he expressed it, "It took well on all of us." After this the wife stayed, ate and slept in the room with her husband till he recovered, and did not have small-pox, neither did any of her father's family, all of whom remained in the same house with the sick man. Other instances showing the wonderful protective influence of vaccination can be cited, as well as the great value of humanized virus over bovine virus.