Secretary's Report. diseases of this kind were apparently of less frequent occurrence and of less severe type during the past year than during that preceding. SMALL POX. The first instance of the occurrence of this disease subsequent to the date of my last report, was at Marinette, where a case was reported by Dr. J. J. Sherman, November 20th, 1887. The patient was a man employed as a bridge builder by one of the railway companies in that vicinity, who had come to Marinette from Michigan. How or where he had been exposed to the Small Pox contagion did not clearly appear. Dr. Sherman's action was prompt and energetic; as soon as the character of the disease was discovered the patient was removed to the pest house, which the authorities at Marinette wisely have always in readiness for such an emergency. Vaccination was enforced, and all who had been exposed were kept under observation until it was certain that no further cases would develop. As a result of these judicious measures the disease was restricted to the single case. The next report of the appearance of Small Pox came from Lake Mills, the subject here being a child of six or seven years of age, who had never been away from home and had not, so far as could be ascertained, been exposed in any way. The disease ran a very mild course, and was confined to the one individual. The next locality to report the occurrence of Small Pox was the town of Liberty, Vernon county. The subject here was a young man who had been employed as a car driver in St. Louis, Mo. He left that city December 26, 1887, reaching Liberty, where his parents lived, January 1st, or thereabouts, and came down with well marked Variola very soon after his arrival. The case was not reported to or seen by the Health Officer until the characteristic eruption was well Secretary's Report. developed. In the mean time the members of the household had gone about as usual, though it does not appear that there had been much visiting of the patient. The Health Officer, Dr. DeLap, instituted a strict quarantine immediately on discovering the case, and as soon as practicable vaccinated all who were known to have been exposed, and reported the facts to this office. The original patient recovered in due course, but his mother died, the circumstances attendant on her death being described as follows: "She had been an invalid for six months prior to the appearance of Small Pox in the family, but had no fever; about twelve days after the eruption appeared on her son she had high fever and died within twenty-four hours, complaining of pain in her head and back. I judged that it was the primary fever of Variola which caused her death." A matter which deserves a word of mention in connection with this case was the fact that some of the residents were disposed to find fault with the health authorities of the town for what they wrongfully considered a too liberal expenditure for guards and attendants. The patient was somewhat a difficult subject to control, and it was therefore deemed needful to watch him closely lest he should effect his escape before complete recovery and disinfection, and on this circumstance the complaint referred to was based. The opinion of this office upon the matter was given in the following quotation from a letter to the Health Officer: "A libera] expenditure now for stamping out the disease is the best and truest economy, and the residents of the town might justly censure the health authorities if the subjects of Small Pox were dismissed before their persons have been submitted to disinfectant baths and their clothing thoroughly fumigated. We earnestly advise that no false notions of saving be allowed to stand in the way of securing the safety of the community. Now that you have the disease confined Secretary's Report. to known limits it will be the height of unwisdom if, for any reason whatever, you fail to stamp out all traces of it." A case of Small Pox was reported to this Board from Detroit, Mich., in March, the subject being a young man belonging to Green Bay, Wis., who was taken sick very soon after reaching Detroit, whither he had gone directly from home. No history of exposure in any way could be obtained by the health officer at Green Bay, who visited the patient's family and made special inquiry on two separate occasions. Though the disease was reported to have developed sooner than would have been expected except from exposure prior to his leaving Wisconsin no evidence of such exposure could be obtained. Racine was the next point at which Small Pox made its appearance. The health authorities were vigilant however, and the disease was confined to the house, and to the single individual in whom it originated. The cause of this outbreak was somewhat doubtful, but it was due to either a newly arrived immigrant from Denmark, or infected rags used in carpet weaving, which occupation was carried on in the household. The authorities at Racine are entitled to credit for the thoroughness with which measures of disinfection were carried out, every article on the premises having “been disinfected in one way or another, by burning, by sulphur and sulphurous acid gas fumigation, by boiling, by scrubbing with carbolized solutions, by kalsomining and by gereral renovation. Personal cleanliness had special attention." The next appearance of Small Pox was at Lake Mills, the patient being a young man who had been attending a business college in Milwaukee for some months during the winter and spring, and who came down with the disease shortly after his return home early in June. The facts as reported to this office were communicated to the health commissioner 2-B. H. Secretary's Report. of Milwaukee, who investigated and reported that he was "not aware of case of Variola in the city, and he believed that the disease must have been contracted elsewhere." The case ran a favorable course, and on July 3, Dr. Dodge, health officer of Lake Mills, reported that it had "entirely recovered, having been a very light attack," and that the premises had been thoroughly disinfected. No other cases developed from it. The history of Small Pox during the past year in Wisconsin may be summed up as follows: The disease has been introduced five times, and at four different places, namely, twice at Lake Mills, and once each at Liberty, Marinette and Racine. At Liberty there were probably two cases; at Lake Mills there was but one case at each time of the appearance of the disease, and but one case at Racine. In all there have been but six cases reported during the year. There have been one or two false alarms, based upon a similarity of names in one instance, and having no foundation in the remainder. This showing is an eminently good one, and the fact that the disease was confined in every instance to very narrow limits speaks well for the energy with which the local health authorities acted, and for the wisdom of their precautions. In view of the extended prevalence of Small Pox in other states, with some of which Wisconsin is in frequent communication, the history just given is showing cause for profound thankfulness. DIPHTHERIA. In my last report I noted that Diphtheria had made its appearance with considerable frequency and with a marked increase in the severity of its character within the months just preceding the date of that report. This increase continued through the entire winter of 1887-288, reports of the occurrence of the disease coming with frequency from Bay Secretary's Report. field, Calumet, Columbia, Dane, Dodge, Grant, Green Lake, Iowa, Monroe, Oconto, Outagamie, Pierce, Portage, Racine, Rock, Shawano, Vernon, Walworth, Waupaca, Waushara and Winnebago counties, though other parts of the state were also affected. The outbreak seemed to reach its height about the middle of January, from which time it declined rapidly. The disease appeared to be quite intractable in Dane county, being reported from several points in that section through the months of February and March. In the same months Barron, Clark, Fond du Lac, Grant, Jackson, La Crosse, LaFayette, Langlade, Outagamie, Racine, Richland, Sauk, Walworth and Wood counties were affected to a greater or less extent, and somewhat later reports of its occurrence were received from Manitowoc, Marinette and Vernon counties, but the type of the disease does not appear to have been severe at any point, nor could it be said that there was anything like an epidemic prevalence of it. Few reports of Diphtheritic outbreaks were received from any part of the state, during the months of April and May, or in the early part of June. About the middle of the last mentioned month and from that time until the end of the month, a number of such reports were received, a characteristic of nearly all being that the cases were few in number but virulent in type. The localities whence the reports came were widely separated from each other, being in Barron, Dane, Oconto, Outagamie, Racine and Waupaca counties. The authorities were generally on the alert however, and the disease was restricted in the majority of instances to the households in which it at first appeared. An outbreak of Diphtheria, very obscure in its origin, occurred in the townships of Hortonia and Liberty, Outagamie county, early in July, or possibly very late in June. The first cases were not reported promptly, and the disease spread to the city of New London, where cases made their |