August 15th I was directed to proceed to Panama City, Washington County, to investigate smallpox reported from several points along St. Andrews Bay. Met the State Health Officer and Assistant State Health Officer, (Dr. Byrd), at Panama City, and was accompanied by Dr. Byrd in this investigation. The situation was gone over thoroughly and was left in the hands of the local physicians. Returned to Carrabelle on the steamer Tarpon, in company with the State Health Officer and his Assistant, Dr. Byrd.

Was directed to proceed from Carrabelle to Tallahassee, to investigate the typhoid fever in that town. Found upon investigation two cases widely separated, and reports of several other cases. The source of infection of these cases could not be attributed to any pollution of water or milk supplies. It was decided that flies had played an important part in the distribution of the discase, and screening of outhouses was advised, and the matter referred to the City Sanitary Inspector. A visit was made to the city works for the disposal of sewage, in company with Mr. Perkins, the sanitary engineer. Nothing but praise can be given Mr. Perkins upon his efficient management of the septic tanks, and it was gratifying to learn, through him, that a visit from the constructing engineer had brough forth the statement that the septic tanks at Tallahassee were among the most efficient that he had constructed. After this investigation I returned to Jacksonville.

On August 28th, I was directed to proceed to Pablo Beach, Duval County, to investigate the sanitary conditions of the town. In company with the marshal, I made a tour of inspection and furnished a full report, with drawings, to the office to be later passed over to the town council of Pablo Beach.

On September 9th, I was directed to proceed to Citra, Marion County, to investigate a case of smallpox reported from that town. In company with the local physician the case was seen and found to be well defined, discreet in type. Vaccination was urged, but refused. Upon my return to Jacksonville, I was rendered hors de combat by a mild attack of typhoid fever.

September 30th. It was thought best at this time that your Assistant should change headquarters from Jacksonville to Tallahassee, which was done.

November 11th, I was directed to proceed to Marianna, Jackson County, to investigate a number of cases of smallpox reported by Dr. West, County Health Officer. In company with Dr. West

some of the cases were visited, and smallpox found, discreet in type. A full report of the smallpox situation in Jackson County will, no doubt, be presented by Dr. West. It does not seem amiss. at this time, to thank Dr. West for his kind and courteous treatment to me on my visit to Marianna.

In compliance with your request of November 20th, to investigate the hookworm situation among the negroes of this county, and to clear up, if possible, the part played by the negro as a disseminator of hookworm infection, a temporary laboratory for the microscopic examination of specimens was thought of, also a dispensary for the free treatment of hookworm disease.

An interview was obtained with Mr. Edward Eppes, Superintendent of Public Instruction of Leon County, and the subject was gone over carefully with him. At Mr. Eppes' suggestion an interview was obtained from the County Commissioners of Leon County, and a room in the Court House was placed at my disposal, available at the end of the December term of court.

In company with Dr. Eppes, I visited a number of schools, both white and colored. Specimen outfits were distributed and specific instructions were given to the teachers, and where possible, also to the parents, for the collection and return of same to me at Tallahassee. It was found at the time to be impossible to obtain specimens of blood, for estimating the hæmoglobin index, the slightest suggestion of any surgical procedure being met with almost a condition of panic. During these trips numbers of individual families were visited and specimen outfits distributed.

In many instances the
The microscopic result

The results, so far as return of specimens is concerned, were not as gratifying as might have been. specimen bottles were returned empty. proved the existence of hookworm disease in the negro but to a lesser extent than in the white. It is too early at this time, to come to any definite conclusions, but it is hoped that in the coming vear. sufficient specimens may be obtained, and the question of the negro as a disseminator of hookworm infection solved.

In several instances when visiting schools, I found the teachers had a good understanding of the subject of hookworm disease: for illustration: on my visit to Rose I found both teachers, both white and colored, had been in attendance at the Florida State College for Women and the Florida Agricultural and Normal School, and that both had heard, and from their knowledge,

must necessarily have been appreciative listeners, to lectures on hookworm disease delivered by Assistant State Health Officers, Drs. Byrd and Young.

The work ended for the year on the closing of the schools for the Christmas holidays, but it is hoped that the campaign for the eradication of hookworm disease may be taken up the coming year.

The offer of the room in the Court House was considered, but owing to the uncertainty as regards the length of time possible for occupancy, it was thought best not to remove headquarters until something definite could be obtained. The character of the microscopic work makes it impossible for me to continue in my present headquarters, Dr. Moor's private office, and a formal request is hereby made for the privilege of obtaining a room suitable for a temporary laboratory and dispensary.

Respectfully submitted,

ERNEST W. DIGGETT,
Assistant State Health Officer.

REPORT OF DR. H. P. NEWMAN

BARTOW, FLORIDA, January 1st, 1912.

Dr. Joseph Y. Porter, State Health Officer, Jacksonville, Fla. Dear Doctor: I beg to hand you herewith my annual report for the year 1911.

January 1st. Detailed by wire to Alachua, Alachua county, reported smallpox. Investigation showed the disease present in the town of Alachua, the vicinity of Haynesworth and among construction crews of the Atlantic Coast Line Railroad camp cars stationed at Haynesworth for the holidays. Quite a number of cases had already developed. All of the people in the vicinity of Haynesworth and quite a number in the town of Alachua were vaccinated.

January 18th. A case of smallpox developed in Alachua county near Santa Fe. Case was isolated and contacts vaccinated; the threatened epidemic ending without further event.

January 20th. Smallpox was reported in Atlantic Coast Line Railroad construction cars at Archer, Alachua county. On investigation about one-half of the crew was found to be infected with variola. Cars were sidetracked, cases isolated and the healthy laborers vaccinated. Both white and colored schools and 200 citizens of Archer and vicinity were vaccinated.

A case of variola at this time developed at Meredith, Levy county, which was isolated, contacts and white school vaccinated. I wish to thank Dr. Rice of Archer for courtesies and co-operation extended the State Board of Health and myself.

Returned to my home at Bartow on February 15th.

February 22nd. Detailed to Fort Myers, Lee County. Investigation revealed two cases of smallpox that had been isolated and were being guarded by the city of Fort Myers. Instructions were given the Mayor as to our methods of control and our policy governing all such occurrences.

February 24th. Ordered to Boca Grande, Lee County. Investigation showed two well developed cases of smallpox on Boca Grande Island; both cases had been isolated and the majority of the citizens vaccinated by the local physician and myself. Returned to Bartow February 26th.

February 26th, to July 1st. Continual smallpox work in Polk and DeSoto Counties. The disease was prevalent in Polk County at Bartow, Fort Meade, Winter Haven, Mulberry, mining dis

tricts and eastern Polk County. In DeSoto County at Jane Jay, Tighlman, Bowling Green, Gardner, Limestone, Fort Green, and DeSoto County Jail at Arcadia. During the period between March Ist, and July 1st, about 200 cases of variola were isolated and treated; approximately 5,000 people were vaccinated in the two counties, 4,000 in Polk County, of which one half were in the city of Bartow. At Fort Meade, Polk County, I experienced difficulty in vaccinating. A small per cent. of the whites were vaccinated but very few negroes, the result being that Fort Meade had more cases of variola than any point in the two counties, regardless of the isolation of cases in a temporary hospital erected by the town council and over which I had supervision.

March 20th. I was detailed to Starke, Bradford County, reported smallpox.. Found one case of smallpox under the care of Dr. Freeman, who had the patient isolated and contacts vaccinated.

March 21st. Inspected Seaboard Air Line Railway construction cars at Maxville, Duval County, and found "all hands" either recovering from or suffering with variola. These cars were ordered sidetracked and detained. Five patients were taken to the Duval County Isolation Hospital.

March 24th. Returned to Bartow, Polk County, to resume vaccination and smallpox work in the county.

June 12th. Investigation of typhoid fever at Mulberry, Polk County, was made, showing the house fly to be the common carrier and absence of screens to residences and living quarters. My report at that time covers in full my findings. About June 20th I also investigated a typhoid epidemic at Chubb, Polk County, my report at that time covering the matter fully.

July 9th. Detailed to Morriston, Levy County, reported smallpox; failed to locate any cases at Morriston or Montbrook, but found one case near Juliette, Marion County, which was isolated.

August 6th. Detailed to Wauchula, DeSoto County, to investigate reported typhoid fever. Investigation failed to reveal any cases of typhoid. Literature covering the prevention of the disease was distributed.

August 22nd. Detailed by wire to Hawthorne, Alachua County, reported smallpox. Investigation showed three cases near Rochelle which were isolated and houses placarded. A few contacts were vaccinated.