subnormal and often remained so for days. We recorded some of 96.5°. The usual rate was about 97° to 97.5°.

The nervous symptoms in all cases were very pronounced. Aside from those mentioned, there appeared in a majority of cases as a complication a severe neuritis. Herpes labialis, and the various hyperaesthesias and paraesthesias were common. Herpes zoster occurred in one case. The mental depression seemed to be far out of proportion to the local symptoms.

Respiratory symptoms were usually absent. A few cases presented symptoms of slight pharyngitis, which subsided promptly on application of an antiseptic gargle. The lungs and bronchial tubes were entirely clear in all cases which I examined, with the exception of two children, one and three years of age, respectively, where I found a few fine, moist rales.

A variety of symptoms involving the skin were present in this epidemic. There was itching over the whole surface of the body, followed by either diffuse redness or circumscribed elevated patches. Where the latter were present part of the swelling subsided in three or four days, leaving a small, shot-like eruption of blue-red color. I saw the last-named eruption in five cases.

Another symptom, which for some time made diagnosis a little doubtful, was extensive exfoliation. While not present in every case, it was very profuse where it did appear. The character of this exfoliation was variable; the epidermis separating either in very fine scales or large flakes. A constant symptom was jaundice without the presence of claycolored stools, a fact which makes it appear that it was of hematogenous origin.

Considering the fact that Dr. Marshall claimed to have found plasmodium malariae in the blood of these patients, I examined fresh, as well as stained preparations, in every case which developed during my stay at Young America. The blood presented a very unusual appearance. The variation in size of the red corpuscles was the greatest I have ever had occasion to observe in any specimen of fresh blood. Leucocytosis was not universally present. The amount of hemoglobin was about 70 per cent. according to the Tallquist scale. Vacuolation appeared in the red corpuscles, and their peculiar shape, as well as the fact that they were in reasonably small numbers, probably made the resemblance to hyaline forms of the aestivo-autumnal parasite most striking. Aside from this, the specimens contained large numbers of colorless granules, about 2 microm. in diameter, each of which contained a slightly refracting dot, giving the appearance of a minute nucleus. These granules were so much larger than the ordinary blood test that I was in doubt for some time as to their exact classification. I am of the opinion that they were merely evidences of an extreme hemolysis, but must confess that they resemble the spores of plasmodium malariae in some respects.

I sent several preparations to Dr. Ludwig Hectoen of Chicago, with a short note; but as my letter of explanation, which I subsequently wrote, was not delivered to him, but returned to me, the preparations were spoiled before he could make a careful examination, and it was impossible to determine whether or not malarial parasites were present in the blood.

The letter from Dr. Hectoen stating his opinion is appended to this report.

In summing up the conditions, it is readily seen that with symptoms of the kind described, these cases when they occured in October and November, could be taken for the algid type of aestivo-autumnal malaria (Osler on Malaria), rare though that condition may be in our climate. Indeed, Dr. Gray, who was affected with this trouble last fall, made this diagnosis of his own case. He admitted suffering from a train of symptoms the same as detailed, which readily improved under anti-periodic treatment. Dr. Marshall developed the same disease and treated himself for malaria with good results. On the other hand, the purely abdominal type of influenza, as it would appear to be here, is not a frequent condition either (Osler on Influenza), and the absence of respiratory symptoms would make the diagnosis at least a little doubtful unless the epidemic feature of the disease were prominent. That this was not the case is shown very well by the history obtained in some families where one member was attacked in the early fall season, the others remaining well for weeks, eventually to become ill with the same symptoms.

Altogether I saw sixty cases, some of them having recovered entirely, some convalescent. Fifteen developed the disease during the time from February 25th to March 12th. The history was alike in all cases.

I have no doubt that at least a certain number of those occurring last fall were of true malarial origin, especially so since the conditions in the vicinity of Young America are such that malaria might be present to some extent.

Dr. B. W. Egan of Carroll, Indiana, a small town near Young America, informed me that he had a patient in February, who, in the doctor's opinion, was suffering from a true malaria (no blood examination made).

As to the cases developed during my stay at Young America, I did not feel justified in pronouncing them either malaria or influenza before I had carefully examined all the blood specimens from these cases. This. however, was impossible under the conditions obtaining, and I reserved that part of the work until after my return to the Laboratory of Hygiene. The presence of influenza bacilli in nose and throat of these patients would have made very little difference in my opinion, as, from the results of sputum examination in the Laboratory of Hygiene, I infer that Pfeiffer's bacillus is at present found in nearly every case of catarrhal condition affecting the upper air passages.

Under ordinary circumstances, I should have had no hesitation in suggesting the possibility of influenza, but as the professional discontent here was greater than I have ever experienced anywhere, and besides disseminating many untrue rumors about statements I was alleged to have made one physician going so far as to secure the aid of a third person to get from me a confidential statement of my opinion regarding the situation-I thought it the best policy to withhold my opinion entirely, stating that the State Board of Health would probably inform Dr. Marshall as to their conclusion in the matter, if they should think fit to do This kind of procedure may not be what is expected of me, but I beg to be permitted to say that I believe it served to the best advantage in the situation as I saw it.

So.

It has been my constant endeavor to avoid such actions as might be construed as if I favored any of the parties concerned, at the same time trying to do all that was possible for the interest of the patients and to maintain the dignity of an employe of the State Board of Health. Respectfully,

HELENE KNABE, M. D.

The secretary announced that the term of Dr. M. M. Haas, of Evansville, éxpired June 1, 1907, as a member of the State Board of Dental Examiners, and that it was the duty of the Board of Health to elect his successor.

Dr. Tucker moved that Dr. M. M. Haas be elected a member of the State Board of Dental Examiners for the two years term beginning June 1, 1907. Seconded by Dr. Wishard.

Unanimously carried.

Ordered, that the Annual Conference of Health Officers be held for one day, May 21st, 1907, and that the secretary prepare a program.

Ordered, that Drs. Tucker and McCoy act as delegates from the Board to attend the annual meeting of the National Tuberculosis Association, which will be held May 6-7-8, 1907, in Washington, D. C.

Ordered, that the secretary go as a delegate of the Board to the annual conference of State and Provincial Boards of Health.

After discussion, the following rule was unanimously adopted:

RULE IN REGARD TO THE DISPLAY FOR THE PURPOSE OF SALE OF FOOD PRODUCTS UNLESS PROPERLY PROTECTED. Rule. "No manufacturer, dealer, vender or other person shall expose for sale or exchange, or sell, any bread, pastry, confectionery, shelled nuts, or other food so prepared that it is ready for consumption, unless such food is properly protected from insects, dust, dirt and other foreign or unwholesome material by suitable coverings."

SPECIAL MEETING INDIANA STATE BOARD OF HEALTH. MAY 21, 1907.

Called to order by President Tucker at 1 p. m. Present: Drs. Tucker, McCoy, Davis, Hurty.

President Tucker announced the object of the special meeting was to consider affairs concerning the annual health officers' school and to act upon such matters as might be brought before the Board.

The secretary announced the attendance at the conference to be 276. Sixty-eight counties, 110 cities and 164 towns were represented.

According to the resolution of the State Board, the meeting was. for only one day, with morning, afternoon and evening sessions. The program was as follows:

FIRST SESSION.

Tuesday, May 21, 1907, 10:00 a. m.

Called to order by F. A. Tucker, I'resident.

Address "The Health Officer and Public Charity Work."

Mr. Amos W. Butler, Secretary Board of State Charities. Paper "The Sanitary Disposal of Garbage and Night-soil in Small Towns." Dr. George Lake, Health Officer, Wolcottville.

"The Preparation and Standardization of Diphtheria Antitoxin.” C. S. McKee, Chicago Memorial Institute for Infectious Diseases. "Streptococcus Infection in Diphtheria."

Hugh A. Cowing, Health Officer Delaware County. Discussion-Opened by H. R. Spickerman, Health Officer, Muncie. "How the Bacteriological and Pathological Laboratory Can Help Physicians in the Cure and Prevention of Disease."

J. B. Rucker, Jr., Superintendent State Laboratory of Hygiene.

THIRD SESSION.

8:00 p. m.

"A Review of the New Laws Pertaining to the Public Health.”

J. N. Hurty, Secretary State Board Health.

KEMPTON, TIPTON

TIPTON COUNTY, IND. INSPECTION OF SCHOOL
HOUSE, DISTRICT No. 3, May 1, 1907.

Site. The building is situated in the southern part of the town, just outside of the corporation. The plat of ground upon which it is situated is somewhat higher than the surrounding territory and could be properly drained. The yard contains about two acres and is well sodded. The water supply comes from a dug well and every opportunity is afforded for surface water to drain into it.

Approaches.-There are two walks leading to the building. The one to the west entrance is of brick and is in fair condition. The one to the east entrance is part of cinders and part of boards. There are no walks to the outhouses.

Outhouses.--The outhouses are in bad condition, being worn and filthy and affording no privacy for individual pupils.

Building. The building is a two-story brick with a slate roof and a

brick foundation. There are two layers of limestone laid in the walls at the ground surface. The floors are not elevated much more than the ground surface. The building consists of a very old part containing four rooms, two above and two below, and a new addition, built in 1901, containing one main room on each floor, with small recitation, cloak and storage rooms communicating with each, and a large hallway on each floor, which connects the rooms of the old and the new parts. The walls of the old part are cracked in many places and are stayed by iron or steel rods passing from the west to the east walls. Those rods are four in number, and are about 11⁄2 inches by two inches in diameter. The water spout from the roof down the south wall of the building is gone and the wall is watersoaked outside and inside.

The roof is in bad condition. The ceilings of the upper rooms in the old part and the ceiling of the upper hall in the new part are much damaged by leakage.

Basement. The basement is located in the northeast corner of the new part under the primary room. It is 25 by 31 feet and is 8 feet deep. It has a dirt floor. The boiler for the hot-water heating plant and the coal room are located in the basement. The basement is not well drained and water lines on its walls show that the water has risen as high as four feet. The janitor says that the fires have been put out several times, that the school has been dismissed for a week at a time and that it is not an uncommon thing for him to have to use rubber boots to wade in the basement when attending to the fire. He attributes the above condition to the back water of a tile drain.

Ventilation. There are no means of ventilation except by the windows and doors.

Heating. The building is heated by a hot water system. There are two radiators placed along the rear walls of each room. On the lower floor, water pipes 5 inches in diameter run along the baseboards to the registers and small pipes 2 or 3 inches in diameter lead from these pipes to the radiators on the upper floors. The janitor says that in cold weather it is impossible to get the rooms warm.

Stairways. The stairways lead from each end of the lower hall and wind about and come to the same landing in the upper hall. This landing is about 4x6 feet. There would be great danger in case of fire, as this landing is the only exit for over one hundred pupils.

Primary Room. The primary room is located on the first floor of the new part, just over the basement. It is 25x30 feet in area. It is lighted by six windows, each 3x7 feet. Three are in the north wall and three are in the east wall. This room seats thirty pupils. To the west of the room are two small rooms, each 12x12 feet, used for cloak and storage rooms.

High School Room.-This is situated just above the primary room and is a duplicate of it, except that instead of there being two rooms west of it, all the space is thrown into one room and used for the recitation of classes. The high school room seats thirty pupils.

Room of Second and Third Grades.-This.room is located in the east end of the old part on the first floor. It is 36 feet by 26 feet in area and