We do not furnish vaccine virus, but we aim to keep constantly on hand a small supply of fresh virus, which will be sent immediately, if requested, for the purpose of Vaccinating persons who have been directly exposed to small-pox. We would suggest, in the vaccination of school children, that it would be well to make a registration of the virus used, giving, 1st, kind of virus used (humanized or bovine); 2d, when the bovine, by whom propagated; 3d, whether primary or secondary vaccination, and 4th, the results. This information would be of great value in arriving at the comparative value of different kinds of virus. We have prepared a pamphlet on "The Prevention and Restriction of Small-pox," and can send you copies for distribution if desired. Please inform us, at an early date, of the action you have taken in this matter, as we wish to know how far the public has been protected by vaccination. Very respectfully, By direction of the State Board of Health. C. O. PROBST, Secretary. To the Board of Education: State Board of Health, SECRETARY'S OFFICE, COLUMBUS, OHIO, January 21, 1889. GENTLEMEN: We desire to call your attention to the present dangers from smallpox in Ohio: At the present time we have cognizance of small-pox in five counties of the State. At Oberlin, a student at the Theological Seminary was taken with small-pox in mild form, and before the nature of the disease was recognized, he attended a lecture at which over twelve hundred students were present. At Ashtabula, a child was brought from Buffalo, New York, with small-pox, and children living in the house with the patient attended school for several days before this was known to the school or health authorities. Every precaution is now being taken to prevent further spread of the disease, but the time is one of danger, and we urgently request you to at once take measures for the protection of children entrusted to your charge. Vaccination and re-vaccination afford almost complete immunity from small-pox, and as the enforcement of this measure has been placed in your hands, we call upon you to adopt a rule requiring the vaccination of all children admitted to schools under your control. We ask your attention to the following provisions of the Revised Statutes of Ohio for enforcing vaccination of school-children. Section 3986 reads as follows: "The board of each district may make and enforce such rules and regulations to secure the vaccination of, and to prevent the spread of small-pox among, the pupils attending or eligible to attend the schools of the district, as in its opinion the safety and interest of the public require; and the boards of health and councils of municipal corporations, and the trustees of townships, shall, on application of the board of education of the district, provide at the public expense, without delay, the means of vaccination to such pupils as are not provided therewith by their parents or guardians." It is the opinion of this board that the present conditions in regard to small-pox in this and adjoining States call for the protection, by vaccination, of every pupil admitted to the public schools. Trusting this matter may receive the prompt attention its urgency demands, I am, Very respectfully, By direction of the State Board of Health. C. O. PROBST, Secretary. Reports received from boards of health, correspondents, and from the public press, indicate that the recommendations of the Board were followed in a large number of places with the consequent vaccination of thousands of unprotected children. A number of letters have been received from druggists and physicians asking whose vaccine virus should be used. I generally recommended Martin's, of Boston, Griffin's, of Fondu Lac, Alexander's, of Marietta, Pa., and Pettit's, of Chicago. Arrangements were made with Dr. A. M. Martin & Son, of Boston, to send us a small amount of fresh virus every two weeks, with the privilege of exchanging old stock for new. SMALL-POX AT CIRCLEVILLE. On January 26, a case of small-pox was reported at Circleville. I telegraphed the clerk of the board of health for full information, and received the following letter in reply: C. O. Probst, Columbus, O.: CIRCLEVILLE, OHIO, January 26, 1889. DEAR SIR: In reply to telegram would say, there were eight persons known to be exposed during incipiency of fever, all of whom have been vaccinated and re-vaccinated. The case is at the extreme edge of the city-in fact, last house on the street, and at least 100 yards from another house, forty or fifty yards from street, and is kept strictly guarded. The father, mother and two sisters of patient are the only parties allowed on the premises. Patient is doing well; house is placarded with yellow flag with words, "Small-pox," in large letters thereon. No new developments in either small-pox or scarlet-fever; will keep you fully advised in regard to each. Respectfully, S. B. EVANS, Secretary Board of Health. A letter of the same date from Dr. Jones, attending physician, informed me that the patient had stayed the night of the 20th in Cincinnati, name of his hotel not given. I at once informed Dr. Stanton, health officer of Cincinnati, of this fact. Dr. Stanton answered that the hotel would be found and room occupied by patient would be thoroughly disinfected. The attending physician, Dr. Jones, has furnished the following history of this case: C. O. Probst, Columbus, O.: CIRCLEVILLE, O., February 2, 1889. DEAR DOCTOR: Have been intending to write to you in regard to the case of varioloid which has been reported to you, but until now have not had the time. The following is a history of the case: Name, Frank Lynch; white; age, about thirty years. The 7th January patient was in Columbus, going there from Circleville. He remained all night and returned home on Tuesday, the 8th. He was here attending to his business-grocer-until the l5th, when he started for the South on a tour of inspection. The 16th he was taken with a chill, and was very ill, but managed to travel for several days. Getting no better from day to day, he started for home, arriving in Cincinnati on the morning of the 21st. He put up at the Palace Hotel, being so ill that he went to bed. Mr. John Heiser, of this place, his traveling companion, remained with him. On the afternoon of the 22d he started for Circleville, arriving here about 9:30 P. M. He went at once to his home, which is just at the edge of the town and some distance from other dwellings. I saw him about 11 A. M. of the 23d; temp., 102. There was an eruption similar to measles on legs and showing some on trunk, which first appeared during the night just past. There was no eruption on soft palate, or I would have pronounced it measles. Told patient would call again at three P. M. Told patient's father it was measles or varioloid. At 4 P. M. I went in consultation with my father, Dr. N. E. Jones; temp., 104 (I think); may have been 105°. Eruption was much more pronounced on trunk; had invaded arms and the face was erythematous; eruption on legs beginning to have a shoty feel. On the 24th, patient was thickly broken out, and many places eruption confluent and angry in appearance. From this on to 27th, eruption gradually advanced. Some papules forming vesicles. Then the fever began to subside, the eruption to fade, and the whole thing stopped short. There are but few pustules, these small and on legs. The flag, with "Small-pox" upon it, has been taken down, but there is still a strict quarantine of the premises. The daily paper here has intimated that the case was not varoiloid, but chicken-pox, and the shop-keepers tell that a mistake in diagnosis was made. Our paper announced that the quarantine was over. There is no doubt about it in my mind that the patient was infected at Columbus. Very respectfully yours, HOWARD JONES. The patient was quarantined about four weeks, made a good recovery; no other cases occurring. The origin of the case was not learned, as there was no positive evidence in favor of the opinion that the disease had been contracted in Columbus. SMALL-POX AT ASHTABULA. On January 28, a telegram was received from Dr. Hopkins, health officer of Ashtabula, reporting a second case of small-pox there, and requesting me to come at once. I visited Ashtabula the following day, and secured from Dr. Hopkins the following history of the first case they had there: This patient was a child of Mr. D— a railroad engineer living in a ward of Ashtabula. Harbor, although included in the corpor Harbor, ation, is quite distinct from Ashtabula, being on the lake two miles distant, and having a population (mostly foreigners) of over 2,500. The child of Mr. D had been visiting with her aunt in Buffalo, N. Y., and returned to Harbor January 5th. She was taken sick the next day, but the true nature of the disease was not fully recognized before January 12th. Children from this family had attended public schools as late as January 15th. When the disease was pronounced small-pox, the mother, with three other children-the youngest but a few weeks' old-were taken up-stairs, the aunt acting as nurse of the small-pox patient. The child died January 23rd, not having been seen by the family after the nature of the disease was known. The father, who continued to run his engine, was not allowed to enter the house, which was guarded day and night. For a few days prior to the child's death, an old Finn woman. had been employed to help nurse. When the child died she wanted to leave, but the health authorities told her she must remain and have her clothing disinfected. That night she escaped, and although chased by the guard, was lost and not found until the following day. She had been hidden in an old tenement-house called "Castle-Garden," in which a number of families lived. She was taken back to the house from which she had escaped, and after a thorough disinfection of her person, and a complete change of clothing, was permitted to leave. January 27th, a second child of this family was taken sick with small-pox. After getting the above facts, Dr. Hopkins and I drove out to the house of this patient. We found Mrs. D., her sister and four children in one room up-stairs. The lower part of the house had been cleaned and disinfected, but not occupied since the first child's sickness and death. The patient, a little girl, presented a fairly well-marked case of varioloid, the history and appearance of the eruption, which was slight, corroborating this diagnosis. The patient, with the other members of the family, except the baby, had been vaccinated about two weeks prior to this time. The baby, on account of its age-it was but two weeks old when the others were vaccinated-was not vaccinated. I advised that this should be done at once, and while Dr. Hopkins prepared to do this, examined the child closely. I found two or three suspicious papules about the head and face, and a temperature a little over 100°. We agreed that it was probably another case of small-pox, which proved to be the case, as the baby died in four days from that time with hemorrhagic small-pox. The mother, on whom the former vaccination had had no effect, was re-vaccinated. A special meeting of the Board was called on the afternoon of my visit, and a detailed account was given of the measures taken to limit the spread of the disease. The Board was specially apprehensive of trouble coming from the escape and hiding of the Finn nurse. Vaccination of school-children had been pretty generally enforced. Those who might have been exposed in school by children from Mr. D.'s family, had passed the period of greatest danger. I advised the immediate vaccination of all the inmates of "Castle Garden," and as many of the foreign inhabitants of Harbor as possible. Also, that their pest-house, which was in bad condition, should be placed in shape to receive the first case that might occur. Directions were also given for the proper disinfection of the house, clothing, etc., after the death or recovery of the patients. The disease was successfully confined to this one family, no other cases Occurring. The following letters received from the health officer since my visit are of interest. It is possible that we were all mistaken in regard to the nature of the first eruption in the little girl mentioned in the doctor's letter. Possibly a case of delayed eruption, mentioned in Ziemsen's Cyclopedia of it was Medicine, volume II, page 375. C. O. Probst, M. D., Columbus, O.: ASHTABULA, O., February 4, 1889. DEAR DOCTOR: Your letter received Saturday, February 2. In reply, will say that the inmates of Castle Garden have been vaccinated, and yesterday I made a visit on all the Finns in that part of town, and found things all safe so far. The babe did have small-pox, and died yesterday, the 3d, at 5 A. M.; was buried in the evening, and all precautions taken that could be taken. We still keep the police watching the house. The little girl, whom we saw the day you were here, with the vesicles beginning to dry up on her face, developed on the second of the month quite a great many papules, and yesterday, the third, she was covered with well-formed vesicles, and plenty of them. C. O. Probst, M. D., Columbus, O.: ASHTABULA, O., February 12, 1889. DEAR DOCTOR: In reply to yours of the 6th, and also of the 9th, will say that the attending physician, Dr. Fricker, thinks that what you send will hardly cover the case. You will remember the character of the eruption when you and I saw her on Tuesday morning. Dr. F. saw her that afternoon, and not again till Thursday morning. He states that the mother then said: "Doctor, I am worried about the little girl; she was very sick last night, and did not let us sleep any; and what do you think of this rash on her face and neck?" The doctor then examined and found that there was a papular rash, and on Friday those papules were vesicles, and in every respect from that time on it followed out as typical a case of small-pox as could be found, the vesicles umbilicat |