tended the sincere thanks of himself and people to the State Board for their action in their behalf. All railroads should continue their prohibition against Indians on their trains, and the government agent should keep a rigid rule against the Cornplanters visiting the New York reservations, and vice versa, which is respectfully submitted. ARTHUR A. WOODS, M. D.

ERIE, PA., October 15, 1888.

(g.) Instructions to Dr. J. L. Stewart in regard to Local Quarantine. EXECUTIVE OFFICE, PHILADELPHIA, October 23, 1888.

Dr. J. L. STEWART,

Medical Inspector:

DEAR SIR: Accept my thanks for your favor enclosing the report of Dr. S. L Woods of vaccination done at the Cornplanter Reservation. You say that you are not yet satisfied with the condition of things on the reservation. In view of this fact and of my desire to be certified as to the success of the vaccinations performed, I author ize you to send Dr. Woods again to satisfy himself on this point and get as full details as possible in regard to names, ages, previous vaccination, and any other point that may occur to either of you, provided, the expense shall not exceed ten dollars ($10), in addition to the fee already agreed upon. In reference to enforcing vaccination on the recalcitrant braves, I would say that as there is no law in this State making vaccination compulsory, our board can only employ force to effect it, when it considers it absolutely necessary to "check the progress of an epidemic." Such a condition cannot be said to exist at present on the reservation. Should the disease make its appearance there I feel that in view of the well known fatality of small-pox among people of that race and their extreme liability to infection, we should be justified in making a show of force at least. It is, of course, desirable, however, to effect our purpose by persuasion if possible.

The assistant secretary of the New York board writes me, in the absence of Dr. Balch, that Dr. F. C. Beals, of Salamanca, acting health officer of the Allegany Reservation, will be glad to confer with you as to steps necessary to be taken in concert for the protec tion of our border. You can communicate directly with him and ar range for a meeting at such time and place as may be mutually convenient, if, in your judgment, public safety requires it. I do not know whether Dr. Beals is empowered to act for any larger territory than the reservation or not. You can inquire of him. The assistant secretary says, "we do not apprehend any great extension of the contagion spreading from the Indian reservation. Happily it was taken hold of in time and with the coöperation of the Indian council thorough measures for vaccination have been inaugurated. We will keep you informed of any new developments."

One case existed on the 18th at the Cattaraugus and two at the Allegany Reservation. You inquire as to your power and duties should the contagion reach the State line. I would say, first, should the disease prevail to an alarming extent near the border or in large towns on lines of direct communication, it would be well to confer with the railroad authorities as to the expediency of establishing an inspection service at the station nearest within the line. Should the emergency warrant it I have no doubt Surgeon General Hamilton, of the Marine Hospital service, would coöperate with me and place physicians on duty for that purpose, and would probably allow me to name those at your suggestion. No one who was recently convales cent from either small-pox or varioloid should then be permitted to enter the State, and no one who could not produce a certificate or give satisfactory evidence of comparatively recent vaccination. Hav ing been inoculated in infancy or having had the disease many years. previously should not be a cause for dispensing with the requirement for vaccination. The inspector should be provided with pure, fresh bovine virus, and should be at all times prepared to vaccinate in transit.

Second. In quarantining a house or a village, first, a yellow flag should be displayed from every inspected house; secondly, all unnec essary visiting should be absolutely forbidden; thirdly, where it is necessary to enforce this, as will not often be the case, a constable is the proper officer to employ, but, fourthly, he should be employed by the director or overseers of the poor and at the expense of the county. My experience has been that in such emergencies both officers and people are only too glad to be instructed as to what steps to take for their self-protection; fifthly, a vaccine physician should be appointed if one does not already exist; if the county absolutely refuses through the poor officers to defray the expense for all who are uuable to pay for it themselves, the board will offer free vaccination, but it is a legitimate expense for the local authorities. In case of actual epidemic prevalence, the board will insist on vaccination. Wherever a local health organization of any kind exists, it is the policy of the board to give it all the aid in its power, and give it credit for all that it accomplishes.

If there is any point on which I have not been sufficiently explicit please let me know.

Yours, very truly

(h) Final Report of Drs. Stewart and Woods.

Benjamin Lee, M. D.,

ERIE, PA., November 9, 1888.

Secretary of Board of Health of Pennsylvania:

DEAR DOCTOR: I enclose you report of Dr. A. A. Woods in regard to vaccinations of the Cornplanter Indians on reservations in Warren county, Pennsylvania. I have the pleasure to report to you that there is not now a known case of small-pox anywhere within forty miles of our State line. The last cases were near Vandalin, New York, are now recovered, and, I believe, all the infectious places have been properly disinfected. What might have resulted in a general spread of the dread disease was happily averted. The result certainly justifies the small expense involved. Fraternally yours,

J. L. STEWART, M. D.,

Medical Inspector Lake District.

REPORT TO BOARD OF HEALTH OF STATE OF PENNSYLVANIA IN THE MAT TER OF QUARANTINE AND VACCINATION OF CORNPLANTER INDIANS, WARREN COUNTY, PA.

Second Visit, November 1st, 1888.

Since I accompanied Dr. J. L. Stewart on his visit to Cornplanter Reservation, October 12 and 13, he requested me to again visit said reservation and investigate the effect of the vaccinations there made at that time.

I, therefore, visited Cornplanter, November 1st, 1888, by same route as before, and being kindly given a pass from Erie to Warren and return by the Pennsylvania railroad officials, I found that the Indian with whom points had been left, with instructions how to use them, on our first visit, had vaccinated four Indians not present on October 13, three others refusing to submit. I found the reservation clear and free of any variola and that the two cases, four miles above, over the New York State line, were dead. Out of fifty-six Indians vaccinated on October 13, the failures were: children, 5; adults 3; total 8. I re-vaccinated of these, children, 4; adults, 2; total 6. The roll of Indians vaccinated on this reservation stands as follows: children, 23; women, 17; men, 16; total 56. Less the two in whom it failed to work and who could not be seen to re vaccinate them, makes 54, to which add vaccinated by Indian after October 13, 4gives, total 58. In addition to which, as will be seen by report of visit of October 12 and 13, there were seven Indians having recent inoculations, giving in all of protected Indians on Cornplanter Reservation, 65 of all ages.

In addition to above it was reported to me that at least two of their people had had variola in previous years. The number unprotected, 3. It is utterly impossible to transcribe the names of these people without giving an extra day to learning names, etc. Officials and men of the N. N. Y. and P. R. R., and also of the P. R. R., were advised to keep Indians away from their lines and stations for two weeks longer and the chief, Marsh Pierce, was given the same instructions. Arrangements are made with a reliable white man living near the reservation for prompt intelligence of any change in the situation. ARTHUR A. WOODS, M. D.

Sworn and subscribed before me at Erie, Pennsylvania, this 8th day of November, A. D. 1888. A. A. FREEMAN [SEAL], Notary Public.

APPENDIX E.

REPORTS OF CONFERENCES AND CON-
VENTIONS.

1. Report of Delegates to the Pure Flood Convention held at Washington, January 19 and 20, 1888. David Engelman, M. D., Benjamin Lee, M. D.

2. Report of Delegates to the Fifth National Conference of State Boards of Health. David Engleman, M. D., Benjamin Lee, M. D

3. Proceedings of the Fifth National Conference of State Boards of Health.

4. Proceedings of the State Sanitary Convention held at Lewisburg, May 17 and 18, 1888.

I. REPORT OF DELEGATES TO THE PURE FOOD CONVENTION HELD AT WASHINGTON, JANUARY 19 AND 20, 1888.

The undersigned beg leave respectfully to represent that they attended the session of the Pure Food Convention, held at Washington, as delegates from this board. Drs. Engelman, Lee and Edwards were appointed delegates. Drs. Engelman and Lee attended. Notwithstanding much factious opposition a bill was finally adopted for presentation to Congress, to regulate the importation of articles of food and their manufacture in the territories and reservations of the United States, which, if adopted, will necessarily be productive of great good. The bill and report of proceedings are appended.

DAVID ENGELMAN,
BENJAMIN LEE.

(a.) Invitation.

BENJAMIN LEE, M. D.,

Secretary State Board of Health:

DEAR SIR: I have the honor to transmit here with proceedings of the National Pure Food Convention held last winter in Washington, and the call for another one to be held in Washington, January 19 next, to which your organization is invited to send delegates.

The movement for a national adulteration act began several years ago when Prof. Charles F. Chandler, of New York; Dr. John S.