its orders in this matter, the Secretary addressed a note to Attorney General Kirkpatrick requesting an official opinion. Such opinion was promptly given and sustained the power of the Board to the fullest possible extent. Such decisions having now been given in both the eastern and the western metropolis of the Commonwealth, there can be no reasonable doubt that a local board of health in any part of the State would be sustained in using force if necessary in the removal of an infected person to the hospital for infectious diseases. The act is simply that in the presence of an epidemic, sanitary law to be worth anything to the community must be as resolute and untrammeled as martial law. As has been said this outbreak is now apparently at an end, there being only a straggling case now and then; but the possibility of the survival of its germs in clothing or other fomites which have escaped the action of the public disinfector, makes the utmost vigilance necessary, if the advent of cold weather with its attendant deficient ventilation is not to stimulate them to renewed activity and subject the city to another period of anxiety.

At Horton City the disease was confined to a single case, and so efficient were the precautions taken by the Drs. Earley of Ridgway, that the inspector of the Board, Dr. Free, found nothing to do on his arrival but to sustain the action they had taken. The only case occurring at Pittsburgh was promptly sent to the hospital for infectious diseases by Superintendent of Public Health McKelvy, and failed to communicate the disease.

The Secretary desires here to acknowledge the vigilance and kindness of both Superintendent McKelvy and Health Officer Patterson, of Philadelphia, in notifying him of the existence of suspicious cases outside the limits of their respective cities. It will be seen then, that the event has fully justified the precautionary measures taken by the Secretary early in the year in warning all local boards of health of the necessity for taking unusual precautions against the introduction of small-pox, and in vaccinating the children in an otherwise unprotected extramural suburb of Philadelphia. The following is the advisory letter on the prevention of small-pox.

COMMONWEALTH OF PENNSYLVANIA, STATE BOARD OF HEAlth, EXECUTIVE OFFICE, 1532 PINE STREET., PHILADELPHIA, March 15, 1888.

To all Local Boards of Health and Borough Councils of Pennsyl

vania:

This Board has received official information since the first of the year of the existence of small-pox in nine States of the Union. Two outbreaks have occurred in this State. The State Board of Health of California, has declared it epidemic in that State. It is raging with great virulence in the neighboring Island of Cuba, where sanitary precautions appear to be extremely lax, and with which we are in

constant communication. It has prevailed extensively during all the past winter in portions of Great Britain.

In the neighboring State of Delaware cases exist, and several deaths have occurred as the result of the importation of infected rags. This Board, therefore, deems it its duty to urge upon all municipal and sanitary authorities the importance, first, of doing all in their power to promote vaccination in their respective communities; and, secondly, of keeping all new comers and returned travelers, and especially all immigrants, under observation for fourteen days after their arrival, in order that, should symptoms of this disease manifest themselves, steps may be taken to circumscribe and isolate the center of infection with the least possible delay.

By order of the Board.

BENJAMIN LEE, Secretary.

The third disease mentioned, typhoid fever, has prevailed to an unusual extent in the cities of Pittsburgh and Philadelphia. Both of these cities having efficient and experienced health bureaus, there was no occasion for interference on the part of this Board. But as both outbreaks were clearly due, to a considerable extent, to the character of the drinking water used, the responsibility of the Board for urging such State legislation as shall ensure the purity of the water supplies of cities and towns is thereby emphasized.

Your Committee on Water Supply has had assigned to it the duty of preparing a bill for presentation to the next Legislature, which shall in some measure remedy the present irresponsible modes of procedure of water companies. Complaints of citizens of Chestnut Hill led to an investigation of the prevalence of this affection in the State Hospital for the Insane at Norristown, the results of which exonerated the officers of that institution from the suspicion of any disregard of sanitary precautions, and made it evident that typhoid germs could not have reached the Schuylkill from there.

Yellow fever has been three times brought to the capes of the Delaware during the past summer, but through the vigilance of Surgeon Orr, of United States Marine Hospital Service, has not passed the United States Quarantine Station at the Breakwater.

Our sympathy with sufferers of a stricken sister State has, therefore, happily for us been born of the fellowship of brotherhood and humanity alone, and not of misery. But in passing, the conviction must be expressed—and it is that of all those who have given the subject thoughtful attention-that if Florida had possessed a State Board of Health, this terrible ordeal might have been to a great degree, if not entirely, escaped.

The last report closed with an allusion to the "absence of any law in this State for circumscribing and stamping out the epizootic disease known as glanders or farcy." That the allusion was called for is evidenced by the fact of the occurrence during the past spring and sum

mer of a considerable outbreak of this incurable, infectious, and in man, agonizing disease, in Monroe county. The attention of the Secretary was called to it by the following letter:

STROUDSBURG, MONROE Co., PA., June 7, 1888. Dr. BENJ. LEE, Secretary State Board of Health, 313 S. Fifteenth street, Philadelphia, Pa.:

DEAR SIR: I enclose reports of the State Veterinary Surgeon, F. Bridge and Prof. Huidekoper of the University of Pennsylvania, from which you will see that glanders is prevalent in this county; some of the owners whose horses were examined refused to kill them, and the same difficulty would be met throughout the county. There are undoubtedly a large number of cases in the county at present and if vigorous methods are not used, the disease will be wide spread.

I am informed that your Board can kill all infected horses on the ground that the disease is one which is dangerous to human life. If such is the case, I will endeavor to have the State Veterinary pay another visit here and examine all suspected cases in the county, and if a State officer could come with him and kill all condemned horses at once, the disease could probably be stamped out. Awaiting the favor of your reply,

I remain, yours truly,

ROBT. J. VASSEUR.

The report of Prof. Rush. S. Huidekoper, consulting State Veterinarian, expressed the conviction as the result of his inspection that "an extensive and dangerous epizootic of glanders-farcy" prevailed · among the animals of that region, and closed with the following recommendation: "There is at present no specific law in Pennsylvania in reference to glanders. I understand that the only means by which it can be reached is through the Board of Health, who have such animals destroyed as a matter of protection to man. I would advise you to report the extensive existence of this disease in your county to the Board of Health and request their official investigation." Under the circumstances there seemed to be but one course open, to order an inspection by Dr. McIntire, medical inspector for the district, and to authorize him to kill any and every animal for which the State Veterinarian would give a written certificate that it was infected with the disease in question. Communication was at the same time had with Mr. Secretary Edge, of the State Board of Agriculture, his Excellency, Governor Beaver, and the Honorable the Attorney General of the State, in regard to provision by the State for compensating owners of such diseased animals for their loss when killed by order of a State officer. At the last meeting of this Board, Secretary Edge was invited to be present and favor the Board with his views upon the subject, which he kindly did. As a result, a resolution was passed declaring

"That this Board would take action in reference to the suppression of diseases of domestic animals communicable to man only in conjunction with the Board of Agriculture, and would always be ready to cooperate with said board in its efforts for this purpose, and also in the endeavor to secure appropriate legislation touching the subject."

It is earnestly to be hoped that the next Legislature will not adjourn without supplying this manifest deficiency on the statute book, and conferring the appropriate power upon the Board of Agriculture. Agreeably to an arrangement with Secretary Edge, Dr. Engelman, the President of this Board, Medical Inspector McIntire and the Secretary met the Secretary of the Board of Agriculture and State Veterinarian Bridge, at Stroudsburg, Monroe county. The owners of the condemned animals and other citizens interested were called in and a conference was held, with the result of establishing a basis for compensation of owners for said animals, if killed. The owners all expressed themselves satisfied to take certificates from the Secretary of the Board of Agriculture, and the matter was thus satisfactorily adjusted. On the day following, the Secretary accompanied the State Veterinarian to Shawnee and other points, and was present at the killing of three infected horses and one mule. Post mortem examinations were made by Dr. Bridge, verifying the diagnoses in the case of the horses. The animals were all buried where they fell, at a distance from the habitations of either men or beasts.

The manifest insufficiency of the appointment of most of the quarantine stations along the coast, taken in connection with the presence. of small pox and the threatening of cholera, produced a feeling of inSecurity among sanitarians at the west, which found expression at the conference of State boards of health, in Cincinnati, in May last, at which the President and Secretary of the Board attended as delegates. The discussion of the subject was opened by your Secretary in a paper entitled, "Should the National Government assume control of Quarantine at all Ports of Entry?" Before the "Section on State Medicine" of the American Medical Association, he introduced the same question in a paper under the caption, "Should not the National Government defend our Ports against the National Enemy, Contagious Disease?" The discussion thus elicited resulted in the passage of resolutions by both bodies urging upon Congress the importance of making appropriations for furnishing properly equipped quarantines at all unprotected points, and in the appointment by the conference of State boards of a committee to inspect the quarantine establishments of the Atlantic and Pacific coasts.

To a sub committee, consisting of the President of the State Board of Health of Ohio, Dr. John D. Jones, and your Secretary. was assigned the middle Atlantic district, extending from New York to Wilming ton, North Carolina, and including the stations at New York, Philadelphia, the Delaware Break water, Baltimore, Norfolk, Cape Charles 2 BOARD OF HEALTH.

and Wilmington, North Carolina. The committee started on its tour of observatian June 12, and occupied ten days. The following is its report on the quarantine establishment of this State; that is, the establishment for which the State makes the laws and the city of Philadelphia furnishes the money.

Philadelphia. The "Lazaretto." or Quarantine Station of Philadelphia was inspected Thursday, June 14, in company with Dr. William H. Ford, president of the board of health of Philadelphia, and the health officer of the city, Mr. Joseph C. Patterson. The buildings through which we were conducted by Mr. Robert Carns, the steward, remain as at the time of the previous inspection. The fine old hospitals have ample accommodations for sixty patients and there is bedding on hand for forty. But no steps have yet been taken to utilize the United States warehouse as an observation depot. The only water supply is from hand pumps in wells. There are no water closets, or sewers, simply old privy vaults. There is no adequate provision for unloading an infected cargo. The disinfecting chamber is a small wooden building about ten feet by twelve, in which sulphur fumigation is practiced. There is no apparatus for disinfection by steam. Immediately in front of the station is a wide marsh, into which the establishment drains, and although it is, affirmed that malaria does not exist here, it is manifest that the filling in of this spot, with the erection of a secure bulk-head, preferably of stone, and covering the whole with an impervious coating of asphalt, together with the introduction of a proper system of sewerage, would greatly increase both the salubrity and the commodiousness of the institution. By the courtesy of Dr. Brusstar, the lazaretto physician, and Mr. Newhard, quarantine master, we accompanied those gentlemen on the hospital tug "Visitor," a swift and staunch boat, on official visit to two vessels, the brig George E. Dale from Port de Paix, Hayti, and the ship Lansdowne from London. The plan adopted here of having two officials, one medical, to examine the passengers and crew, the other non-medical, to examine the vessels, bilge and cargo, appears to your committee judicious and calculated to diminish the delay to commerce to a

minimum.

All the executive officers connected with the quarantine service of this port are appointed by the Governor of the State, and their salaries are fixed by legislative acts, although the city is called upon to pay them. They are a health officer, a lazaretto physician, a port physician and a quarantine master. The steward derives his appointment from the city board of health There seems to be an occasional conflict of authority resulting from this arrangement. Telegraphic communication with the city was opened apparently on the day of our visit, but even more essential than this is direct communication by wire with the maritime exchange at Thurlow, eight miles further down, where early intelligence of the approach of vessels.