This action with respect to measles is taken because the disease is the cause of many needless deaths. During the past seven years over two hundred deaths have occurred from it in New Hampshire.

It is true that, on account of the disease being communicable in its early stages, measles is not so readily restricted as some other diseases, but by prompt isolation in all cases many children might be saved that otherwise will certainly fall victims to this too generally ignored disease.

SCARLET-FEVER.

During the past few years scarlet-fever has been very materially reduced in this state, and that chiefly, if not solely, by the enforcement of sanitary rules and regulations. Efforts in this direction alone have saved to the state many valuable lives-enough, if nothing else had been accomplished, to more than justify the expenditure of every dollar that has been used in the public health service of the state. Scarlet-fever is one of the most communicable dis eases with which health authorities have to deal; nevertheless it can be most effectually controlled and readily stamped out by prompt isolation and thorough disinfection. This fact we have endeavored constantly to impress upon the local boards of health and the public. Circulars relating to the prevention and restriction of this disease have been quite extensively distributed. Local boards are furnished with these circulars free of expense, and are urged to distribute them in localities where the disease is prevailing.

All that is necessary to protect a community when scarletfever appears, says the Iowa State Board of Health, is to isolate or separate the patient from all other persons except the physician and nurse, and destroy all the infection produced by the sick. In fact, public safety may be expressed in two words: isolation and disinfection. Hence it is good evidence if a second case appears, that isolation and disinfection have been neglected, and that the officers of a local board have not done their duty. Partial isolation and disinfection are of little value. The residence should be placed under strict regulations, be placarded to warn others against entrance; children of the family should be excluded from the schools,

and other children rigidly excluded from the sick children. The "walking case," one who may have had the disease in a mild form and goes about the community, is usually the source of an epidemic.

It may be assumed that to notify a family to disinfect premises after a case of scarlet-fever, is practically useless. It should be carefully done by an experienced person, or under the direct supervision of such a person. So many are the ways in which the virus of this disease may be retained and concealed, this point is of the utmost importance. The following letter is illustrative of some of the points above mentioned:

SOUTH NEWMARKET, N. H., June 5, 1893.

State Board of Health, Concord, N. H.:

GENTLEMEN: Enclosed find our report for May. We are glad to report that the scarlet-fever did not spread from the house where we had the last cases, notwithstanding it was situated in a crowded district, with many young children in the immediate vicinity. As none of the family had been out of town we suspected that there must have been some connection between the first family and the last before the danger of infection had entirely passed, and we at first suspected a dog might have been the carrier. But diligent inquiry brought out the fact that a child from the first family taken, after the recovery of the survivors and the fumigation of their house and burning of clothing, came to the street where the last family resided, and associated and played with the child first taken down, and who was taken at just about the average period of incubation thereafter.

This warned us that there was danger of communicating the disease to a susceptible subject for a long time after recovery; so after the full recovery of the three later cases-all the children of the family-and the fumigation of the house, we forbade the children going to school, or to meet and play with others, or to go near them. Happily the parents and the children seconded all our efforts to prevent the spread of the disease; besides, the danger of infection and of the disease has been greatly impressed upon the minds of the community by the stringent means that have been

made to suppress it, as well as by the distribution of the pamphlets you so considerately sent us.

We need a provision in the law, allowing the family, while confined to the house, a certain sum per diem, say the amount paid jurors-$2 per day--for their support while the father, the wageearner, is taken from his work. We are compelled by the statute to see that the family while isolated do not suffer for want of supplies. One of the families we isolated was poor, but proud; we were satisfied that they needed the help they would not ask for, but it required considerable tact to relieve them and not offend. A provision in the law such as we recommend above would relieve the board and the selectmen of much embarrassment, and would be an act of justice to the families isolated.

Respectfully yours,

GEO. E. FIFIELD, Secretary of Board of Health.

If every local board of health were as prompt, interested, and efficient as the South Newmarket board was in the instance reported, this disease would soon be eliminated. from the state. Unfortunately they are not, and for that reason scarlet-fever has been allowed to spread in some localities to an extent entirely uncalled for. It is not a difficult matter, ordinarily, to suppress this disease upon its first appearance in the community, and a board of health that fails to do so should be held responsible.

DISINFECTION.

There are two chief and all important factors in preventing the spread of certain communicable diseases-isolation and disinfection. The health officer is promptly notified upon the outbreak of the disease, the house immediately placarded, and the family isolated. Rules and regulations, sometimes inconvenient and even oppressive to the individual, are enforced, in order to protect the legitimate rights of others. The isolation is made effective and the disease soon runs its course. The fear of its spread is over; the surviving members of the family have fully recovered, and the restrictive measures imposed by the health officer seem no longer necessary. The first essential in preventing the spread of the disease has been faithfully performed; now comes the second, which is no less important, but which too frequently is a deceptive and useless farce. Disinfection, to be effectual, must be in accordance with what scientific investigations and carefully observed experiments have demonstrated to be necessary to the destruction of the germ or substance which produces the disease. Disinfection should always be performed by the health officer, or under his supervision. The State Board of Health furnishes every board of health in the state with explicit directions, as to how disinfection should be carried out. If fumigation is to be resorted to, a given amount of sulphur is required, according to the cubic space to be fumigated. A less amount leaves the result uncertain, or perhaps does not destroy a single germ of the disease. Likewise, all disinfecting solutions must possess a certain strength to be effectual. All of these points, and many more, should be understood by the health officer and conscientiously applied. Probably the lack of proper disin