curred in an employee of this family, and the fifth I found to exist in the person of the physician who had attended these four cases, and who now, on the seventh day of the eruption, was still calling it chickenpox. On the previous Sabbath, which was the fourth or fifth day of the eruption, he had attended church in the town and on the sixth day of the eruption attended a trial before a justice in the neighborhood and gave the disease to both the justice and the lawyer who tried the case. Invited by the principal of the school, I addressed the school children, with a number of parents who were quickly congregated, impressing the fact that the prevailing disease was not chickenpox but genuine smallpox. Learning that but about 5% of the 50 or more children congregated had ever been vaccinated, I impressed the importance of immediate vaccination and endeavored to disabuse the minds of those present, and through them the entire community, of the falsity of the reports in circulation as to the evil effects of vaccination. Vaccine points were immediately ordered and on the following day the county health officer vaccinated 95 children.

At this time about 20 cases of smallpox existed at Pinegrove, four miles west of Jacksonburg, nine of these in one house, and all well isolated and quarantined, and Dr. Fankhauser reported that the citizens were co-operating with him and Dr. A. E. McCuskey who had charge of the cases. Dr. Fankhauser, therefore, did not think it necessary for me to visit the town.

In this region, as along the main line of the B. & O. Railroad Co., there had been so many exposures before this disease was recognized as smallpox, that cases sprang up in many different points in the county, but the county health officer and the prosecuting attorney were very active in their efforts to stamp out the disease which was a very difficult task. These two officials kept a close watch on the situation, consulting daily and issuing orders of quarantine wherever they found it necessary. They also employed local inspectors and guards as the situation seemed to require, and in this way I have no doubt they did the very best that was possible with the existing situation, and so far as possible limited the spread of the disease.

I visited New Martinsville several times to hold consultations with these officials and tendered advice as it seemed to be needed.

As a sample of the work of this Board, and as a guide to other Boards as to the proper method of procedure, we here print the following action of the sanitary officials at New Martinsville.

New Martinsville, W. Va., December 22, 1913. At a joint meeting of the Local Board of Health of Wetzel County, West Virginia, and of the Local Board of Health of the Town of New Martinsville, West Virginia.

Present:

Dr. E. E. Fankhauser, County Health Officer;

Glen Snodgrass, Prosecuting Attorney of Wetzel County, W. Va.;

E. H. Yost, Mayor of the Town of New Martinsville, W. Va.;

Dr. F. E. Martin, City Health Officer of the Town of New Martinsville,

The meeting was called to order by E. H. Yost, Mayor, and as such a member of the Board of Health of said Town.

On motion it is ordered that Glen Snodgrass act as secretary of this meeting.

On motion it is ordered that Jehu Morris be employed to act as guard at the Baltimore & Ohio R. R. depot, in the Town of New Martinsville, for the purpose of detaining, until they are examined by the county or city health officer, any persons coming into or going out of the Town of New Martinsville, who are suspected of having smallpox or of having been exposed thereto; and that the Mayor of the Town of New Martinsville be requested to appoint said Jehu Morris a special police officer of said Town for the purpose of enabling him to more effectually perform his duties under this order.

The members of these two boards having been advised by the secretary of the State Board of Health of West Virginia to prevent all public meetings within the Town of New Martinsville until danger of the further spread of smallpox is passed, it is on motion ordered that from and including this date until the further order of these boards, or until the said State Board of Health of West Virginia may order otherwise, all public gatherings of any kind are hereby prohibited within the corporate limits of said Town of New Martinsville.

On motion is is ordered that from and including this date all persons within the Town of New Martinsville who are known by either the city health officers or the county health officers to have been exposed to smallpox, and who are liable, in the opinion of either of said officers, to spread contagion, be and they are hereby required to submit to vaccination by some reputable physician, upon being notified so to do by either of said health officers.

On motion it is ordered that the city health officer be and he is hereby empowered, when in his opinion it is necessary so to do on account of the prevalence of smallpox, to establish quarantine at any house or at any premises within said Town of New Martinsville, either by oral proclamation, or by written or printed notices posted thereat; and that thereafter all persons who may be within said quarantined premises at the time the same are so quarantined shall remain therein until said quarantine is raised; and no other persons, other than the physician in charge or the city or county health officer, shall thereafter enter said premises unless he remain therein until said quarantine is raised; and no persons, other than the physician in charge or the city or county health officer, shall thereafter enter said premises unless he remain therein until said quarantine is duly raised. Meeting adjourned.

Dec. 29, 1913.

At a meeting of the local Board of Health of Wetzel County, West Virginia, held in the town of New Martinsville, W. Va., Dec. 29, 1913. Present-Dr. E. E. Fankhauser, county health officer; Glen Snodgrass, prosecuting attorney of Wetzel County, West Virginia.

It appearing to the board that Mr.

of

and his family, have frequently been exposed to smallpox and that

circulating among the citizens of the community in which they live, thereby endangering the health of said citizens, quarantine is hereby declared upon the residence of said Mr. and upon

him and each member of his household; and it is hereby ordered that Frank Trader, constable, forthwith post a copy of this order on the front door of the residence of said Mr. and serve

a copy thereof on said Mr.

in person; and it is further ordered that the said Frank Trader, constable, employ some person to guard said residence and confine therein the said Mr.

and each member of his household until said quarantine is duly raised. And what the said Frank Trader, constable, does pursuant to this order, he shall forthwith report in writing to the county health officer. Meeting adjourned.

County Health Officer.

Prosecuting Attorney of Wetzel County, W. Va. In addition to orders such as the above, the schools in the districts where the disease prevailed were closed, and where they were left open an order was issued excluding all unvaccinated children The Board of Health was so active in its efforts for the protection of the people that I thought it proper to send the following letter under date of January 9th, 1914:

"Board of Health of Wetzel County,
Gentlemen:

I' desire to congratulate you on your activity in efforts to limit the spread of small-pox in the county. By your wise and prompt action in issuing quarantine orders against families in which suspected cases exist, in closing the schools in badly infected localities, and in allowing no unvaccinated children to enter any school, you are pursuing a wise policy, limiting the spread of the disease, saving great trouble to families, as well as much expense to the county. Your orders thus far meet with my entire approval, and I urge that the order forbidding children unvaccinated to enter the public schools be continued in force until your county is free from small-pox. In no other way can you safeguard the health of the community.

With thanks for your efforts in behalf of the public, and assuring you of my hearty support, I remain,

Sincerely yours,

S. L. JEPSON,

Secretary State Board of Health."

The disease spread from Wetzel to Tyler county and by request of the county health officer of Tyler county, Dr. M. M. Reppard, I visited that county on January 12th, and again on the 20th. On the former of these occasions a public meeting had been announced at which I gave an address on public health problems. On the second visit I made three addresses to the school children of the town on small-pox and vaccination. I found one doctor in the county still calling the prevailing disease "chicken-pox" and I failed

county I had the following communication inserted in the Wetzel and Tyler county papers:

VACCINATION vs. SMALL-POX.

To the Editor:

A recent visit to Wetzel and Tyler counties has revealed an amount of prejudice against vaccination that is simply astounding. Nearly all of this can be traced to the most amazing falsehoods that I found in circulation in the rural district. One re

port was, that forty persons had recently come to Wheeling to have their arms amputated on account of the bad results of vaccination. Few people, I hope, credited this absurd report, for it is a reflection on one's intelligence for a moment to heed such nonsense. As a practitioner of medicine in Wheeling for over forty years, and a physician to one of the hospitals for twenty years, I can truthfully say that I have not seen nor heard of any worse result from a vaccination that a very sore arm, and where the arm is exceptionally sore it is not due to the vac cination, but to the poisoning that is permitted to occur at the point of vaccination by want of care and cleanliness in its management. There is no reason for the existence of small-pox. It is the one disease that can be banished from the world, did everybody resort to vaccination. Hear the Vermont Board of Health on this subject:

"We still have small-pox with us. There is no prospect that the mild form of this disease now prevailing will be arrested in the near future. Its very mildness is a serious obstacle to its suppression. We all know that there is only one effective preventive of small-pox, namely general vaccination. The disease can not exist in a well vaccinated community * * * It is the same loathsome disfiguring disease as of yore. It demoralizes the social and business interests of the community. Quarantine and disinfection are bungling and costly methods of dealing with it, and worst of all, in the absence of general vaccination are not effective. Several progressive states have abandoned quarantine in this disease and thrown the burden of its suppression on the public. The people are told in plain language that vaccination alone will prevent small-pox, and if they wish to avoid the disease they must be vaccinated. It is worthy of serious consideration, if the responsibility for this burden ought not to be placed where it rightly belongs, namely, on those who refuse vaccination, rather than on the general public who will have to pay the bills. Since vaccination is almost a perfect protective against the disease, it is absolutely inexcusable for any person to have it, and especially to spread it throughout a community, thus entailing great expense alike upon the vaccinated and the unvaccinated."

Allow me to urge that the activity of the county boards of health be continued, that every child in the county within five miles of a case of small-pox be required to be vaccinated before entering school, and that this order stand until the county is free from the disease. If parents will prefer to deny to their children the advantages of the schools, rather than to save themselves from small-pox by a simple scratch of the arm, they should be allowed the privilege of doing so, but they should not be allowed by neglecting vaccination, to run the risk of contracting the disease and spreading it in the schools. S. L. JEPSON. M. D.

Soon after the appearance of small-pox in the western part of the state the following bulletin on small-pox control was printed and widely distributed to health officials and others:

Small-pox Control.

For the past few months this disease has prevailed in so many parts of the state that it seems necessary to emphasize the importance of its early diagnosis and prompt sanitary control. The disease éxists in an extremely mild form, and has too often been mistaken for chicken-pox. We here venture two statements that are so nearly true that in the interest of the public health they should be taken as self-evident. I-When two or more physicians differ as to the diagnosis between chicken-pox and small-pox, the disease is small-pox. 2. Chicken-pox is a disease essentially of childhood, and when an eruptive disease resembling it occurs in an adult, it should be taken as smallpox, and controlled as such. If these two statements be accepted as true, there will be little trouble in controlling the spread of small-pox that now prevails in this state.

How Control Small-pox.

1. When called to a case of this disease isolate the patient in a room as free from furniture as possible.

2. At once vaccinate every member of the household.

3. Secure the names of every person who has been in any way exposed to the patient, search them out and vaccinate immediately, keeping them under observation for 16 days, and seeing them daily for the last six days of this period.

4. But one person should be admitted to the room of any patient, and that person should not be allowed to come in contact with any others:

5. If several cases occur in a community, by far the safest and most economical measure to stamp out the disease is, to put all in one building, if such can be found. In this way we avoid the infection of a number of houses with their contents, and the necessary destruction of much property that cannot be disinfected, such as pillows, etc. We also avoid the great expense entailed by having to support at public expense a number of quarantined families.

6. After the death or recovery of the patient securely close every crack and crevice in the room, and moisten the room with steam and fumigate with formaldehyde or sulphur. (a) place a metallic bucket in a tub of hot water in the middle of the room, put into the bucket not less than 10 ozs of powdered permangnate of potassium and pour onto this 20 ozs of formalin; (b) or crush 6 lbs. of stick sulphur, put in bucket as above, add a little alcohol and set fire to it. In either case close the door, stop from the outside all cracks and leave the room closed for 12 hours. Then open all doors and windows and have all woodwork and furniture in the room cleaned