according to directions. Several charity cases have been treated at my own expense, as I find it almost impossible to get these patients to furnish the number of specimens of stool necessary to send to the State Laboratory to secure state aid.

During the year I visited some turpentine camps in Washington County in the interest of smallpox and vaccination, but no cases of the disease came under my supervision in Holmes County.

Malarial Fever.-I have treated several cases of malaria with quinine, and have insisted upon drainage and screening. Also insisted that ladies who would not have tin cans hauled off their premises, should punch a hole through bottom as soon as can was emptied. This appeal I made through the Holmes County Advertiser, our county newspaper, and I find some obeying the instructions. Typhoid Fever.-Have insisted upon screening and careful burning of excreta and using great hygienic care.

We have at present an epidemic of measles and whooping cough; with only one death, from measles, an infant three months old.

Only two cases of pellagra have come under my observation, with one death, a white female. The other case, a white female, is now in the asylum for the insane.

I have made official inspections of places in and around Bonifay and have given instructions as to remedies and abatements. My suggestions have been carried out slowly but in a satisfactory

manner.

I find the Florida Health Notes to be a good educational factor. They cause the public to talk of subjects beneficial to health, which they would not have known of except for the Notes.

Having been Agent of the Board during only a part of the year and having been inexperienced in such work, I have to hand in a report unsatisfactory to me, but a better report will be furnished next time.

JACKSON COUNTY

Theophilus West, M. D., Agent

The prevailing diseases of Jackson County during the year just closing have been largely of a malarial character, of the intermittent and re-mittent type, although these diseases for the period mentioned have been less prevalent than usual.

The general health conditions have been, perhaps, above the average, with the single exception of smallpox, which has been quite prevalent in some portions of the county during the entire year. Of smallpox I have had under my observation and management something over four hundred cases during the year, a majority of which, however, have been mild, there having been only one death registered among all the cases. There have been as many more cases, perhaps, under the observation and treatment of other physicians, and it is more than probable that there are and have been a number of unreported cases. The disease seems for the most part to have been confined to the negro race, as only a small percentage of the cases mentioned were among the whites. I have employed vaccination, isolation and all other means and remedies within my power to stamp out this loathsome disease, but owing to the general opposition to the application of these measures, especially among the negroes, it has been an exceedingly difficult task. More than three thousand persons according to my estimate, have been vaccinated in the county during the year, and it is my opinion that in from eighty to ninety per cent. of these cases the vaccination has been effective.

Something over two hundred cases of hookworm disease have been effectively and successfully treated during the year.

There has been quite a large number of cases of measles, both in the towns and rural districts, characterized, however, with few complications.

There has been a perceptible decrease in the number of cases of typhoid fever.

One case of scarlet fever and one of diphtheria occurred in the town of Marianna within the past two months. The origin of the infection could not in either case be determined.

Several cases of pellagra have occurred during the year both among the negroes and white people.

Very few cases of tuberculosis or pneumonia have occurred. The sanitary conditions of the various towns of the county are not entirely satisfactory. The streets and alleys need to be made more cleanly, The populace seem to be indifferent to the importance of sanitation, but with the enlightenment and awakening that will necessarily come from the propaganda of the Health Board, there will come, I confidently believe, better conditions, and incidentally better health.

JEFFERSON COUNTY

J. R. McEachern, M. D., Agent

(No Report)

LAFAYETTE COUNTY

C. A. O'Quinn, M. D., Agent
(No Report)

LAKE COUNTY

W. D. Bush, M. D., Agent

The health conditions of Lake County during the year 1911 have, as in previous years, been good. In the spring and summer some few cases of malarial fever and about one-half dozen cases of typhoid fever, occurred. During December quite a number of people have had acute colds, but no serious troubles such as pneumonia.

There were some cases of smallpox in the summer among the colored people of Leesburg and vicinity, but I want to state that every person who was successfully vaccinated did not contract the disease. Some of the cases were very severe and some quite mild-one family having smallpox so mild that there were simply a few pustules, with patients only slightly indisposed. All of the family would not be vaccinated, as the disease was so mild. However, the father contracted the disease and his case was quite severe. He lost much time from his work and often wished since that he had been vaccinated. Get vaccinated if you do not wish to have smallpox.

Since the citizens have been using screens and mosquito netting. the prevalence of malarial fever has greatly diminished.

Flies and mosquitoes are dangerous to humanity. The State Board of Health through the monthly bulletin, has done a great deal of good in instructing the people in regard to these dangers-the fly as a carrier of typhoid, and mosquitoes in the transmission

of malaria.

Hookworm Disease.-You will see on the streets no doubt, a few palefaced children. You suspect them of having hookworm disease, and if you go to the school house and examine the children thoroughly, about thirty or forty per cent. will be found to have anaemia and other symptoms of the disease. When Dr. Young

of the State Board of Health, was in Lake County, making an inspection, I went with him through the Leesburg High School, and must say I was quite surprised to find so many suspects. Am glad to know that the principal and the teachers are taking quite an interest in the treatment of these children for hookworm disease, and will assist all they can, with the children's parents and the physicians and the State Board of Health, in eradicating the disease.

There have been a few cases of scarlet fever which were very mild. We are using every precaution and do not think the disease will spread.

Tuberculosis. I am glad to say that this disease does not seem to be on the increase in Leesburg nor its vicinity; in fact, there is a great deal less of it than in previous years. The natives are not 3ɔ subject to the disease and the number of consumptives coming from other states to this section is small. The disease appears to be on the decrease or the sanatoria for such may be increasing for the treatment of that class of patients. While Leesburg and the neighborhood does not solicit consumptives, the doors of the hotels and boarding houses are open to them. Lake County, being in the center of the state, and as a rule, high and dry, asthmatics and persons suffering with pulmonary troubles are much benefited, providing they are not in the last stages of consumption when they come here. There are quite a number of people living in Leesburg and vicinity that came here years ago with consumption, and they are now in good health. My advice to those looking for health, is outdoor life and pure fresh air.

No cases of diphtheria, whooping cough, dengue or hydrophobia have been reported.

During May and June there were a few cases of measles, all making good recoveries.

Since my last year's report I do not believe that pellagra has been on the increase; in fact, I have no new cases to report, while those with the disease are physically in about the same condition. Have not seen any cases of anterior poliomyelitis nor have any been reported to me.

This county has not had a regular medical inspection of the different schools, but this is an important matter and provision should be made for it. While we have good teachers and good school trustees and a good school board, they need a medical inspection in the schools at least twice during each term. Patrons

of schools will not call in their family physician until the child is sick. The State Board of Health with its County Health Agents, is trying to prevent disease, and by these regular inspections we would find out whether or not the physical condition of the child or student is up to the standard; whether puny, anemic or undeveloped according to age; the condition of the eyes; whether lids are granular and inflamed; defects in hearing could be detected in those children often supposed by the teachers to be dull or inattentive; the speech, articulation and breathing should be considered, for the child may have catarrh or a polypus may need removing; the child may have consumption and may drink out of or use the same glass or cup used by other pupils. In addition, there should be an inspection of the school water supplies, condition of toilets, heating and lighting systems, play grounds and yards, for these are all most important.

The town of Leesburg uses the open bucket system of sewage disposal; the toilets are cleaned once a week, with phenol freely used after each cleaning. Some of the hotels use wells and cesspools in connection with water closets, which in my opinion is dangerous and should be regularly inspected.

The Leesburg water supply is from very deep driven wells, the water being forced into a large tank, and is supplied the town through iron pipes-a regular water system; most of the inhabitants, in fact all, except those on the outskirts or in the suburbs, use this water supply. The country people use open wells, springs and lake water, which is all very good except in the low lands where surface water is used, the water in some cases being only a few feet from the surface. This is not good and should not be used for drinking purposes.

LEE COUNTY

A. P. Hunter, M. D., Agent

(No Report)

LEON COUNTY

F. Clifton Moor, M. D., Agent

During the early months of the year 1911 smallpox was the only communicable disease occurring in anything like an epidemic form, and Leon County was the battleground for a period of about