DEAR SIR:*

ILLINOIS STATE BOARD OF HEALTH,

OFFICE OF THE SECRETARY,

Springfield, January 16, 1882.

I have sent you, by express, an additional supply of Official Orders of this BOARD concerning the Vaccination of School-children, (S. B. H.-50A) and the Prevention of SmallPox, (S. B. H.-53.)

It is the duty of all good citizens to aid in the enforcement of these measures-intended not only to preserve the public health, but to avert interruption of business, loss of trade, closure of schools, and kindred evils, which an outbreak of small-pox always entails.

In your county the.

are, ex officio, the legal health authorities for all localities in the county where there are no regularly organized boards of health. You are respectfully requested to distribute copies of Order No. 53 to these officials, as well as to the regular board of health; and to give them such other information and assistance as you may be able.

It is hoped you will, also, aid the school authorities with reference to the enforcement of Order No. 50A.

Please read the Orders carefully, and write this office if you need any further information. Any suggestions will be gladly received, and inquiries promptly answered.

Very respectfully,

JOHN H. RAUCH, M. D., Secretary.

NOTE.-If additional copies of either Order are needed, state how many, and they will be at once forwarded.

Your Return of Vaccination Certificates is herewith returned for completion. The marked passages in the accompanying copy of Order No. 50, indicate what is necessary. You have until March 3, in which to perfect your Returns, so that there is no valid reason why all the data required in the Order should not be furnished. Please read the Order carefully, and insist upon a strict compliance with its requirements by all your pupils. This will save all concerned much future trouble and annoyance.

Teacher.

* Addressed to the County Clerks.

Respectfully,

JOHN H. RAUCH, M. D., Secretary.

.Co., Ill.

It remains now, before proceeding to a consideration of the results of the School-Vaccination Order, to formally recognize the share taken by the school authorities in this cffort of the BOARD to promote the welfare of the schools, by securing the protection of the scholars against a loathsome plague. In less than half a dozen instances was the BOARD compelled to exercise its legal authority in securing compliance with the Order. Every other means was exhausted before resorting to this; explanation, argument, appeal, personal visits by the Secretary, were all tried first, and, with the few exceptions noted, with ultimate success.

But all these measures would probably have proved inadequate, had not the BOARD been sustained by the school officials. Beginning with the office of the State Superintendent of Public Instruction, down to the teacher of the smallest district school, with hardly an exception, there was accorded to the BOARD a ready, earnest and intelligent support and co-operation. Here and there, a school director or trustee, or, perchance, a parent, manifested some opposition, inspired, usually, by prejudice, ignorance, and the fulminations of the anti-vaccinationists. But such recalcitrants usually found themselves in a hopeless minority, and, as a rule, soon yielded to the arguments and explanations offered, or to the example of the majority.

With very few exceptions, the County Superintendents took an active, personal interest in the work, often at their own individual expense, and always at a considerable outlay of time and labor. The following extract is fairly illustrative of the correspondence received from these officials:

"I think the Order of the STATE BOARD OF HEALTH, regarding the vaccination of school-children, should be made a part of the school law, and all directions for its execution and for its reports should be printed in the law, so that all can know their duties. Circulars are soon lost or worn out.

"There is no doubt that the Vaccination Order came just in time last winter to save our schools and county from a terrible plague."

School Boards, in like manner, gave efficient support, frequently passing supplementary orders of their own, embodying the substance of the STATE BOARD'S Order and enforcing it by their own authority.

Upon the School Teachers, themselves, however, devolved the most arduous and responsible share of the labor. The careful and intelligent inspection of certificates, and their accurate return to the office of the STATE BOARD, were duties requiring time, patience and an amount of interest in the public welfare which it was hardly to be expected would have been accorded so generally and so generously for it should be remembered that this work was done without recompense. The enormous mass of Returns preserved in the office of the STATE BOARD OF HEALTH, is a substantial testimonial to the intelligence and public spirit of the public-school teachers of Illinois.

*Hon. G. R. SHAWHAN, County Superintendent of Schools, Champaign county.

STATISTICAL RESULTS

OF THE

SCHOOL-VACCINATION ORDER.

Or the total number of enrolled scholars in Illinois in the fall of 1881, returns and other data in the office of the STATE BOARD OF HEALTH indicate that considerably less than one-half (45.34 per cent.) were protected against small-pox at the date when the Vaccination Order was issued, requiring children to present satisfactory evidence of proper and successful vaccination before being admitted to the public schools after January 1, 1882.

Within sixty days thereafter, that is, before the last of February, 1882, nearly ninety-three per cent. (92.92) of all those in attendance. in the State at large, had presented this evidence; and of the remaining fraction, 1.2 per cent. had presented evidence of protection. by previous attack of small-pox, or of apparent insusceptibility by repeated unsuccessful vaccination. So that the ratio of protected school-children was more than doubled within a few weeks-increased from 45 per cent. to 94 per cent. of all those in attendance.

These figures, indeed, understate the work accomplished in this brief period; since they do not include over twenty per cent. of revaccinations performed after December 1, 1881. As more than twothirds of these revaccinations proved successful-thus demonstrating the renewed susceptibility of that number this proportion (20.88x .678-14.15) should be deducted from the 45.34 per cent. classified as protected by vaccination before the date of the Order. This would then show that, on the one hand, 68.81 per cent., or more than two-thirds of the entire public school population of Illinois, was susceptible to small-pox on the 1st of December, 1881; and that, on the other hand, there was less than 6 per cent. of unprotected and susceptible remaining among those actually in attendance on the 1st of March, 1882. In other words, that, the vaccinal protection of 450,000 public-school children, in round numbers, had been secured within sixty days.

The foregoing proportions are based upon the returns of 304,586 individual scholars, whose names, ages, sexes and vaccinal history were forwarded to the STATE BOARD in the following form:

ILLINOIS STATE BOARD OF HEALTH.-FORM No. 52.

RETURN OF VACCINATION CERTIFICATES.

1. From the Principal of the common school at Alpha, in District Number 1, Township Number 13, Range Number 1 W. of the third principal meridian, in the county of Woodford, State of Illinois.

2. From the Principal of the......

county of...............

..school, in the city of..

State of Illinois.

EXPLANATIONS.

1. In country schools, use the first heading; in city schools, use the second heading. The principal of a graded school may make out the RETURN for the whole school. Use the common designations of the schools in towns or cities, as Dearborn, Third Ward, Front street, etc.

2. For convenience of tabulating in the Secretary's office, it is desired that the names of all girls be given consecutively, and follow with the boys' names-instead of mingling masculine and feminine names indiscriminately.

3. Names of months may be indicated by figures, thus: December 31, 1881, may be written 12 | 31 | '81; January 1, 1882, may be written 11 | '82.

4. Designate the kind of Virus used by a cross (X) in the proper column-"B." for bovine, "H." for humanized.

5. Designate the character of the scar, in the columns "Result," by a cross (X) under the appropriate initial-T. for "typical," M. for "modifled," B. for "bad." Write the word Failure across these three columns where that is the result.

6. This RETURN should be completed and mailed to the Secretary's office promptly at the end of the second month of the school year, or as soon thereafter as practicable.

Supplemental Returns (on this Form) must be made at the end of each term, embracing all new pupils, and the perfected records of those previously returned imperfectly.See Circular No. 112, S. B. H., September 20, 1882.

7. Additional blanks of this form may be obtained by addressing the Secretary STATE BOARD OF HEALTH, Springfield.

§ "Not safe to vaccinate; erysipelatous diathesis."-Dr. Simpson.

Twice with bovine; once with humanized. Both failures.

**No result. Developmental change not yet taken place."-Dr. Greene.

I CERTIFY that the foregoing is a correct abstract of the data contained in the Certificates of Vaccination presented by the scholars in attendance at this school during the month of Fet ruary, 1882; that the names given correspond with those on the register and schedule of this school for said month; and that no scholar has been admitted, or is now in attendance, who has not complied with the current order of the ILLINOIS STATE BOARD OF HEALTH relative to the vaccination of school children.

+ Has been revaccinated twice before without result. * Has had small-pox.

JOHN S. HART, Principal.

§"Not safe to vaccinate; erysipelatous diathesis."-Dr. Simpson.

These fifty names and their corresponding records are taken at random from the Returns of fifteen schools in five different counties, simply to illustrate the materiel which forms the basis of the Tables which follow. For obvious reasons the localities and other means of identification of the individuals are more or less disguised; but each entry is a literal transcript from the teacher's Return on file in the office of the BOARD.

Over 11,000 of these Returns (11,720), averaging about 26 names each, were received and examined, the faulty and incomplete returned for correction, and in June, 1882, the work of tabulation was begun.

With the limited clerical force at the disposal of the BOARD, and the pressure of other duties frequently causing the work to be suspended for long intervals, the progress of the tabulation was unavoidably slow. In many respects the work was novel, and much of it required the exercise of technical knowledge, which compelled constant supervision.*

* Some idea may be formed of the merely clerical labor involved, by considering that over two million different items are embraced in these Returns, each of which items required examination, and subsequently entered into the composition of the appended Tables.