BULLETIN OF THE VERMONT STATE BOARD OF HEALTH. Volume II. No. 3. Issued Quarterly at Brattleboro, Vermont. The Bulletin is published quarterly by the State Board of IMPORTANT NOTICE TO HEALTH OFFICERS. The failure of a large number of Health Officers to make their biennial reports to the Secretary of the State Board as required by the statute (see Section 4685, Vermont Statutes) is a matter of very serious importance. These reports are important and valuable only as they are complete. The State Board certainly expects these local officials to comply with the plain provisions of the law. Many Health Officers have made reports for only one year of the biennial term and many have made no report as yet. They should have been made in January last, and for the years 1900 and 1901. Health Officers are not required, as some have done, to report births and deaths, but only "the sanitary condition and public health of their towns." These reports should deal with infectious diseases prevalent during the biennial period, the sanitary conditions of schoolhouses and other public buildings, and of the streets, alleys and surroundings of buildings both public and private. All Health Officers will please take note of the provisions of the statute, and if they have not already done so, immediately make a report to this office. These reports should be embodied in the biennial report of this office and should be made at once. By Order of the State Board of Health, HENRY D. HOLTON, SECRETARY. PROPHYLAXIS IN INFECTIOUS DISEASES. BY JOHN H. MCCOLLOM, M. D., BOSTON. Fifty years ago the science of preventive medicine was unknown; the duty of the physician comprised the treatment of disease, not its eradication. In no department of medical science have the advancements been so marked and the advantage to the public so great as in the management of infectious diseases. To the science of bacteriology combined with clinical experience are we indebted for all that has been accomplished in this direction. The germ theory of disease is not new, but it has been elaborated and placed on a sure foundation by means of bacteriology. More than two hundred years ago Leeuwenhoek laid the foundation for all that has since been accomplished. Leeuwenhoek was a linen draper by trade, but he learned the art of lens grinding and carried it to such perfection that he was able to see objects which, from his description as published in a paper presented to the Royal Society of London in 1683, leaves little room for doubt that these bodies which he calls animalcula were the bacteria of the present day. Pleneiz, a physician of Vienna in 1762, was a firm believer in the germ theory of disease. He claimed that the material of infection was a living substance, and explained in this way the variation of time in the incubation of different infectious diseases. This physician also advanced the theory that there was a special germ for each infectious disease, the truth of which theory has been shown by the light of our present knowledge on this subject. It was not, however, until the last half of the last century that a number of important discoveries established the true relation of the lower organisms to infectious diseases. The oil immersion lens, the Abbé condenser and solid culture media were the most important advances in the science of bacteriology and have made it the basis of all important investigations in preventive medicine. While it is true that the germ of certain of the infectious diseases has not been discovered-namely that of smallpox, scarlet fever and measles-it is also true that the etiology of diphtheria, typhoid fever, cholera, consumption, anthrax and hog cholera has been made clear. If we know the cause of a disease we are thus enabled not only to make an early diagnosis, but also to adopt reliable measures for isolation and disinfection. There can be no better illustration of the aid that bacteriology has been to preventive medicine than the history of the epidemics of cholera that have visited this country. In 1832 the disease crossed the ocean for the first time and entered this country by way of Grosse Island, the quarantine station for Quebec. From April 28, 1832, to June 3, 1832, there arrived at Grosse Island four cholera infected ships, namely, the ship Constantia from Limerick, Ireland, which arrived April 28, 1832, the ship Robert from Cork, arriving May 14, the Elizabeth from Dublin, arriving May 28, and the brig Carrick from Dublin, which arrived June 3. The importation of the disease by the immigrants on these ships was the origin of an epidemic that extended to Quebec, to Montreal, up the St. Lawrence and along Lake Ontario, down Lake Champlain to Albany and New York. From New York cholera extended to Newport, Boston, Newark, N. J., Philadelphia, Baltimore, Charleston, S. C., and Washington, D. C., during the months of July and August. This epidemic spread from Chicago and St. Louis down to New Orleans. At the end of the year 1832 the United States was free from cholera. The next epidemic occurred in 1848 and 1849. On November 9, 1848, the ship New York sailed from Havre with a clean bill of health for New York, but when she was some sixteen days out cholera appeared among the steerage passengers. On her arrival at New York the ship was quarantined and the disease did not extend to New York City. In very great contrast to the history of this ship is that of the Swanton which left Havre on October 31, 1848, bound for New Orleans. Cholera appeared after she was twenty-seven days at sea. The arrival of the cholera cases on the Swanton was the source of an epidemic that cost the city of New Orleans two thousand five hundred lives. This epidemic of 1848 at New Orleans 'extended to St. Louis and Chicago. The most severe epidemic of cholera that Boston has ever had was in 1849 when there were about seven hundred cases and six hundred and eleven deaths. A hospital was established at that time on Fort Hill; the first patient was received June 29 and the last patient was discharged on the 15th of November. In 1854 there was a second epidemic of cholera in Boston. The number of deaths from this disease was two hundred and eighteen. Although there is no published account of this epidemic the fact that it caused considerable anxiety is evident from the report of the consulting physicians to the mayor and aldermen of the city of Boston. In the history of this epidemic it is interesting to note that the Glenmanna came to Quebec from Liverpool June 15, having had forty-five deaths from cholera during the passage. The disease extended to Niagara Falls, Buffalo, Detroit and west of the Niagara river; but whether it came to Boston from Canada, or New York, or New Orleans is a matter of doubt. The epidemic of 1866 in Boston was probably due to the arrival of the Virginia at New York from Liverpool with one thousand and twenty-nine steerage passengers, having lost thirty-eight from cholera during the passage, and having forty-six ill with the disease on her arrival. From this time until November 28, 1866, six ships arrived at New York more or less infected with cholera. In Boston there were thirty-seven cases reported during the year, of which eighteen died. The first case occurred on April 5 and the last case on November 16. From 1866 at various times to 1873 cholera was prevalent in Europe. The disease did not visit Boston during this time, although epidemics of greater or less severity prevailed through the western and southern portions of the country. The disease found its entrance to this country in 1873 through New Orleans, probably by way of Hamburg or Bremen. The epidemic of 1883 and 1884 in India, France, Italy and Spain did not |