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charged were seen. Both the acute cases are in isolated locations away from the path of travel. The disease seems to be well managed, and I therefore see no occasion for a quarantine against the town. Exercising the authority vested in me as Secretary of the State Board of Health, I therefore direct that the quarantine be lifted and public notice be given of this fact.”

(Signed) S. L. JEPSON, Sec'y, State Board of Health.

The conditions at Hundred were greatly exaggerated, and erroneous reports were spread to different parts of the county both as to the extent of the disease and as to the character of its management, the people being led to believe that no proper control was exercised by the health authorities. Here are samples of letters that reached me, which indicate the excited state of the people in neighboring communities:

"Earnshaw, W. Va., July 15, 1913. Dear Sir:

The people of this vicinity desire to call on you for protection from the unnecessary exposure to small-pox. It is still raging at Hundred and the people of that place are running at large and going around over the country anywhere their business calls them. There are a number of teamsters from that place that are hauling through here regularly. Our village here is not incorporated. Therefore, we cannot keep them out. So we appeal to you to come to our relief. We cannot have church or anything of that kind here for fear of some one coming and bringing small-pox into our midst. Hundred is about six miles from this place. Please let me know whether there is anything we can do in the matter or not, and what you can do for us. Yours very truly."

To this letter the following reply was sent:

My Dear Sir:

Your letter as to small-pox at Hundred is received. You are misinformed as to the disease which you say is “still raging at Hundred.” On a recent visit I found one acute case and one about well in that town. I learn that two cases now exist in the family of the first and last referred to. The thing for you to do is, to push vaccination vigorously. After this you need have no fears. The State Board of Health will not sanction any quarantine, since you have a perfect preventive of small-pox in vaccination.

Respectfully yours,

· (Signed) S. L. JEPSON, Sec’y.”

The following is an extract from a letter from Burton, a town two miles east of Hundred:

“Burton, W. Va., July 19th, 1914. Dr. S. L. Jepson, Secretary, Dear Sir:

Your certainly have a misconception of the small-pox epidemic in Hundred, and also of the extremely negligent way in which the health officer of that town is acting. One man was permitted sons recovered from the disease are permitted to run about, while in no case have we heard of any house or clothing being disinfected. What we wish to know is, is there any way in which we can compel all persons of the infected town from going out of it. There is no use for us to appeal to the local health officer, and unless we can secure aid from your board, we will, of necessity, ask the governor of the state. There are quite a number of new cases and some, from authentic reports, are very bad. For information as to the true state of the disease we advise, seek it elsewhere than in the town.

Yours truly,

(Signed by several citizens.)”

On receiving the above letter I at once wrote the following communication to the Mayor of Hundred:

“Wheeling, W. Va., July 19, 1913.
Hon. J. E. Martin,
Mayor of Hundred, West Virginia,
My Dear Sir:-

As promised you, I on July 17th, wrote to the Mayor and Health Officer of Littleton, directing that the quarantine established against Hundred be at once raised. The reason for this was your report by telephone of the small-pox condition now existing in your town, and my personal observation there during my recent visit. That I may be safely guided I desire that you write me fully and exactly the present condition as to small-pox. Give me the number of cases, their stage of development, whether you practice disinfection after the cases are discharged, and whether or not it is diligently practised. I have been informed that the proprietor of a meat store, “was permitted to remain in his store for three days after the eruption of small-pox appeared on his person.” Is this true? If so, some one has neglected his duty. Your health officer cannot be too diligent in pressing vaccination, and he must see that proper cleaning and disinfection are attended to before turning any patients out among the people.

Hoping that I may have a very early and full reply to his note, I remain respectfully yours,

S. L. JEPSON, Sec’y.”

The order raising the quarantine of Littleton against the Town of Hundred referred to in the above letter, is here given:

Wheeling, W. Va., July 18th, 1913.
Mayor Schultz,
Dr. W. H. Lemley, Health Officer,
Gentlemen:-

I learn that you have quarantined against the town of Hundred. Having recently visited that town and made a full investigation of the small-pox situation, I am satisfied that the conditions existing will not warrant your action. I have late information that the local situation is far from dangerous and, therefore, exercising the authority given to me by the law, I hereby direct that the quarantine be lifted, and public notice be given of this order. The situation in your community when I visited your town was very much worse than that now existing in Hundred, and yet I could not have sanctioned a quarantine against Littleton.

I urge a very free vaccination of your community. If this will be glad to hear from you as to your own exact condition. Sincerely yours,

S. L. JEPSON, Secretary State Board of Health."

It may be here remarked that no reply has ever been received to the above communication.

The letter written to the Mayor of Hundred on July 19th, brought replies from both the Mayor and Health Officer of that town. From these extracts are here given:

"Hundred, W. Va., July 21st, 1913. Dr. S. L. Jepson,

Wheeling, W. Va.
Dear Doctor:-

In reply to your letter of the 19th inst., I beg to say, that at the present time we have five cases of smallpox here, two at Mr. Ross's residence, two at Mr. J. H. Taylor's residence where they already had the disease, and one at E. L. Hinegardner's residence, the last being the only new case. Mr. Hinegartner is the meat dealer referred to in your letter and his eruption appeared Sunday morning, July 13th. As soon as the case was reported to the Health Officer the house was immediately quarantined. The report that the eruption in this case had appeared two or three days before Mr. H. left his place of business is false like many others in circulation. :* * * His place of business was thoroughly fumigated and his entire family put under strict quarantine. All those who had been exposed in his place of business were vaccinated or quarantined.

Yours very truly,

J. E. Martin, Mayor."

From the Health Officer:--

“Hundred, W. Va., July 20th, 1913. Dr. S. L. Jepson,

Wheeling, W. Va.
Dear Sir:-

Dr. J. E. Martin, Mayor of Hundred, has just handed mo your letter of July 19th. I beg to report that the conditions are much as they were when you were here and it looks as if the spread of the disease was stopped, as we have but one newly infected house since then. Two new cases have occurred in the family of Mr. Taylor in which there had been a previous case. Two cases also exist in the family of Mr. Ross which you visited. * * * * The case of Mr. Hinegardner, referred to in the letter of Mayor Martin, was reported to me 15 minutes after the doctor saw him, and I had him quarantined in less than half an hour after he was first seen by his physician, and I also had every one who was exposed in his store vaccinated except two, and they were quarantined.

In regard to disinfection and fumigation will say, that I have all convalescent patients take a bichloride bath, change all clothing and then have their houses and all clothing thoroughly fumigated. I do not raise the quarantine until desquamation is complete. I have even kept the patients in longer than you advised, to keep the people from talking, but it seems as if they think I should keep them in for weeks after they are in

for quarantining too stringently and by others for not being
stringent enough, but we are trying to act in accordance with
law and as the best practice demands.

Respectfully yours,
F. M. Kearns, M. D., Health Officer.

Under date of July 22nd, 1913, I received a letter from his Excellency Governor H. D. Hatfield, enclosing a sensational communication from a citizen of Burton in regard to the smallpox situation at Hundred. The governor suggested that I visit the town of Hundred, “and see whether the people are properly protected against the spread of smallpox.” To this letter the following reply was sent:

“Wheeling, W. Va., July 23rd, 1913. Hon. H. D. Hatfield,

Charleston, W. Va.
My dear Governor:-

Your letter with enclosures received. I have kept in close touch by telephone and letters with the smallpox situation at Hundred. I have official reports, written at my request, from both the Mayor, who is a very intelligent man, and from the Health Officer, assuring me that there are but three infected families in the town. Two of these have each two cases and the families had been already infected by former cases. The other is the family of the meat dealer (one case) referred to in the letter which you have received. Of this case the Mayor says; ‘As soon as this case was reported to the health officer, the house was immediately quarantined. The report that the eruption in this case had appeared two or three days before Mr. H., left his place of business is false like many others in circulation. *** * His place of business was thoroughly fumigated and his entire family put under strict quarantine. All those who had been exposed in his place of business were vaccinated or quarantined.'.

Some of these exaggerated reports have reached me, and are simply evidence of the panic apt to arise in small communities when smallpox prevails. The people of Littleton have complained to me of the situation at Hundred, when the fact is, that on my visit I found the situation at Littleton much worse than at Hundred. I have refused to permit a general quarantine against Hundred when so simple and certain a preventive as vaccination is at hand. This I have written to several communities. No sanitarian would now advocate a quarantine against a town where smallpox exists, unless, possibly, the grossest carelessness prevailed. While the Hundred outbreak was not, in its inception, controlled at it might have been, yet I found that on the whole the cases were well managed.

I have been prevented from making a second visit by very serious illness in my family. Conditions are now improved, however, and I expect to go out tomorrow and will report my findings on my return.

My refusal to quarantine against Hundred is perhaps the cause of the letters sent to you.

Very sincerely,

To the above a reply was received from Governor Hatfield who writes under date of July 24th, 1913. I quote as follows:

“ * * * * I think you are quite right relative to quarantine. It is quite expensive to quarantine a community. I think vaccination is a better plan to adopt. If the people in this section where smallpox is epidemic are properly vaccinated the suppression of this contagious disease is absolutely guaranteed and assured. With my very best wishes, believe me, sincerely yours,

H. D. Hatfield, Governor.

I made another visit to Hundred on July 24th and reported to the governor as follows:

“Wheeling, W. Va., July 24th, 1913. Hon. H. D. Hatfield,

Charleston, W. Va.
My Dear Governor:-

This morning I made a visit to Hundred, went with the Health Officer to see the smallpox patients, except one family, too far away, and with this family communicated by telephone. The facts are as follows:-Ross family, already infected, has two cases, one nearly well; Taylor family, already infected, has two cases, one almost well; Booth family, already infected, has one recent case, very mild; Hinegardner family, not before infected, has one case, Mr. H., who will be dismissed on the 28th inst. Total families infected 4, total cases 6. Mr. Hinegardner is the meat dealer who was said to have an eruption three days in his store, selling meat all this time. He emphatically denies to me the charge and says he was quarantined promptly, just as soon as reported to the health officer by his physician. All the other families are shut in but no guards are employed. This seems not to be necessary, as every man and woman in the community is a self-constituted guard; and there seems to be no disposition for any of the quarantined families to disobey orders.

Hundred is blessed with a Board of Health much above the average. It is composed of a dentist (the Mayor), a bank cashier, a carpenter-shut in by family infection-a lawyer (Hon. J. F. Throckmorton, whom you known) and the Health Officer. I am satisfied that all are trying to do their duty and that the reports that are in circulation are grossly exaggerated. My opinion is that the epidemic will soon be ended and that no further outside interference will be necessary, but I will continue to interest myself in the situation and render such service as seems necessary. The epidemic has continued so long because of the very mildness of the cases, and because it was at first taken to be varicella. What is most needed just now is, to properly inform the neighboring people as to the true situation, and thus quiet their fears which are so nearly groundless. With this view I shall give notice of my findings to the newspapers here.

Sincerely yours,

S. L. Jepson, Secretary.

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