of Staunton are hereby requested to invite one of the Government experts to visit Staunton at once and make diagnosis of the disease prevailing in a section of Staunton, and being treated as smallpox. In accordance with the above resolution, we, the board of health of the city of Staunton, Va., request that an expert in the matter of diagnosis of smallpox be sent to our city for the purpose of settling the question as to whether smallpox exists here. H. H. HENKEL, Board of Health. SUPERVISING SURGEON-GENERAL MARINE-HOSPITAL SERVICE, [Telegram.] Washington, D. C WASHINGTON, D. C., May 17, 1895. P. A. Surg. M. J. Rosenau, Marine-Hospital Service, leaves for Staunton 11 to-night. Has had large experience in smallpox hospitals in Antwerp during epidemic 1892 and 1893, and in detecting the disease among immigrants embarking for the United States. WALTER WYMAN, Supervising Surgeon-General Marine-Hospital Service. Dr. J. B. CATLETT, City Physician, Staunton, Va. Report on the smallpox outbreak at Staunton, Va. WASHINGTON, D. C., May 22, 1895. SIR: I have the honor to report the following observations in compliance with instructions to proceed to Staunton, Va., and decide upon the character of the epidemic disease prevailing in that locality. The disease is smallpox. The sudden onset with vomiting, the appearance of shotted papules on the fourth day, turning to umbilicated vesicles and finally pustules, and the characteristic pitting of some cases left no doubt as to the diagnosis. The epidemic is moderate in severity considering the large number of unvaccinated subjects the disease has found, the death rate to date being only 6.7 per cent—a total of 59 cases and 4 deaths. The origin of the outbreak is traced to a negro, Henry Johnson, who came to Staunton from Cincinnati about the middle of April. Johnson himself is a fugitive from justice, and can not be found, but his traveling companion gave me this account. They went together to Cincinnati in March to join the circus. While there Johnson lived in Griffin street, near the levee, and near a house quarantined with smallpox. He left Cincinnati about April 15 for Hinton, W. Va., where he stayed a few days before proceeding to Staunton. The day he left Hinton his face was covered with an eruption. At Staunton he lived with the poorest of the negro colony in a squalid portion of the town. Ten days after Johnson's arrival other cases appeared in the neighborhood. The disease spread until 52 cases broke out within an eighth of a mile of where Johnson lived. This infected district is a small triangular area, in a hollow, at the western end of town. It contains about thirty wooden hovels in which live some 250 negroes. There are four other foci, two in the town proper and two in the county, all clearly traceable to the infected district. Of the total of 59 cases only 3 have occurred among white people, and those 3 in a poverty-stricken family of 4 living in the same infected triangle. Vigorous measures have been instituted, which, if energetically carried out, will soon put an end to the epidemic. 5553-VOL I—24 The board of supervisors passed an ordinance making vaccination compulsory in the entire county, and directing the city physician, Dr. Catlett, to put the measure into effect. The city was divided into ten districts, and a physician given each district. with instructions to make a house-to-house inspection and vaccinate generally. Land was purchased just inside the city limits and a hospital and detention camp started for the sick and suspects, whither they will be moved as soon as possible. In the meantime each infected focus is guarded and carefully quarantined. In concluding this report I desire to cordially thank his honor, A. H. Fultz, mayor of the city, Dr. J. B. Catlett, city physician, and Dr. H. H. Henkel, of the board of health, for many courtesies shown me during my short visit. Respectfully, yours, M. J. ROSENAU, Passed Assistant Surgeon, Marine-Hospital Service. SMALLPOX AT EAGLE PASS, TEX., AMONG NEGRO COLONISTS RETURNING FROM MEXICO. July 30, 1895, word was received from the collector of customs at Eagle Pass, Tex., stating that a number of destitute negroes, returning colonists from Mexico, had arrived within the past few days, with a number of cases of smallpox among them; that the State authorities had them in quarantine; that more infected negroes were expected, and asking instructions. I replied, quoting the regulations and requesting to be kept informed. I wired also the State health officer of Texas, asking what measures were being taken, and received the same day a reply that the sick colonists were all isolated and receiving the atten tion that humanity and sanitation required. The following day, July 31, another dispatch was received from the collector reporting additional arrivals, and stating there was danger of the negroes stampeding and escaping to the interior. Passed Assistant Surgeon Magruder, at Galveston, was ordered to proceed to Eagle Pass, without delay, to offer aid to the authorities, to wire a report on the situation, and to insist on the enforcement of the regulations. July 31 I wired the State health officer again, conveying the substance of the telegram received from the collector of customs at Eagle Pass, and informing him that any assistance required would be rendered. In reply to this I received a letter on August 4, that the State could and would use all necessary precautions to protect the people, but asking assistance. The State health officer himself visited Eagle Pass, and all possible assistance was rendered him and his subordinates by authorizing certain purchases to be made through the collector of customs, and by the professional advice of Passed Assistant Surgeon Magruder. It soon became evident that the State health authorities were unable to meet the demands of the situ ation, and after representation from myself of the precautions that must necessarily be enforced, and upon my suggestion, the State health officer turned over the whole matter to the Marine-Hospital Service. The Bureau assumed charge August 11, and supplies, in addition to those which had been furnished through the collector of customs, were imme The board of supervisors passed an ordinance making vaccination compulsory in the entire county, and directing the city physician, Dr. Catlett, to put the measure into effect. The city was divided into ten districts, and a physician given each district, with instructions to make a house-to-house inspection and vaccinate generally. Land was purchased just inside the city limits and a hospital and detention camp started for the sick and suspects, whither they will be moved as soon as possible. In the meantime each infected focus is guarded and carefully quarantined. In concluding this report I desire to cordially thank his honor, A. H. Fultz, mayor of the city, Dr. J. B. Catlett, city physician, and Dr. H. H. Henkel, of the board of health, for many courtesies shown me during my short visit. Respectfully, yours, M. J. ROSENAU, Passed Assistant Surgeon, Marine-Hospital Service. SMALLPOX AT EAGLE PASS, TEX., AMONG NEGRO COLONISTS RETURNING FROM MEXICO. July 30, 1895, word was received from the collector of customs at Eagle Pass, Tex., stating that a number of destitute negroes, returning colonists from Mexico, had arrived within the past few days, with a number of cases of smallpox among them; that the State authorities had them in quarantine; that more infected negroes were expected, and asking instructions. I replied, quoting the regulations and requesting to be kept informed. I wired also the State health officer of Texas, asking what measures were being taken, and received the same day a reply that the sick colonists were all isolated and receiving the attention that humanity and sanitation required. The following day, July 31, another dispatch was received from the collector reporting additional arrivals, and stating there was danger of the negroes stampeding and escaping to the interior. Passed Assistant Surgeon Magruder, at Galveston, was ordered to proceed to Eagle Pass, without delay, to offer aid to the authorities, to wire a report on the situation, and to insist on the enforcement of the regulations. July 31 I wired the State health officer again, conveying the substance of the telegram received from the collector of customs at Eagle Pass, and informing him that any assistance required would be rendered. In reply to this I received a letter on August 4, that the State could and would use all necessary precautions to protect the people, but asking assistance. The State health officer himself visited Eagle Pass, and all possible assistance was rendered him and his subordinates by authorizing certain purchases to be made through the collector of customs, and by the professional advice of Passed Assistant Surgeon Magruder. It soon became evident that the State health authorities were unable to meet the demands of the situ ation, and after representation from myself of the precautions that must necessarily be enforced, and upon my suggestion, the State health offi cer turned over the whole matter to the Marine-Hospital Service. The Bureau assumed charge August 11, and supplies, in addition to those which had been furnished through the collector of customs, were imme |