FORCE ON SMALLPOX. 185 



that the eruption ai)i)ears in successive crops, each running an inde- 

 pendent course, so that all forms of the vesicles may be seen side 

 by side; that the eruption first appears upon the trunk and spreads ir- 

 regularly over ihe entire body, being most abundant upon the back and 

 breast and least so upon the face, where it is usually limited to the fore- 

 head. The health officer is advised that because smallpox has so often 

 been diagnosed as chicken-pox and the mild form of smallpox having made 

 the error more common than formerly, the same precautions should be 

 taken in all cases of chicken-pox as are taken in cases of recognized small- 

 pox, until it is proved beyond a doubt that the disease is not smallpox, 

 thus giving the public health interests t-he benefit of every doubt. 



State Inspector of Dangerous Communicable Diseases. 



Act No. 47, Laws of 1893, provides among other things for the pre- 

 vention and spread of dangerous communicable diseases within the State 

 of Michigan, and also provides for the appointment of an inspector by 

 the State Board of Health; and whenever it shall be shown to the satis- 

 faction of the State Board of Health that a dangerous communicable dis- 

 ease exists in any locality within the State and that there is danger of 

 the disease being spread from that locality, the State Board of Health 

 may establish a system of quarantine for such locality, to prevent persons 

 who are likely to carry infection from going from place to place, and 

 to detain them at the place where they have been exposed, until in the 

 opinion of the State Board of Health such persons are free from all 

 danger of infection. During the epidemic of mild form of smallpox, many 

 applications have been made to the Board for an expert, or for the State 

 Inspector to be sent to assist in diagnosing the disease, and to assist 

 in restrictive measures being taken for the prevention of the spread of 

 the disease. Whenever it has been shown to the satisfaction of the Board 

 that there was danger of the disease spreading and that the local health 

 authorities were unable, or were not taking any precautions to prevent 

 the disease spreading, the State Inspector has been sent, but in no case 

 has it been necessary for the State Board of Health to establish a system 

 of quarantine, the State Inspector having in each instance succeeded in 

 arousing the local health authorities to take action for the restriction of 

 the disease. In many other instances where the facts would not warrant 

 the sending of the State Inspector at State expense, he has gone at the 

 expense of the locality where such disease existed, and in each instance 

 has rendered valuable assistance to the local health authorities. 



Some of the difficulties experienced hy the State Board of Health in its 

 Work for the Prevention and Restriction of the mild form of Small- 

 pox. — Failure of Physicians to recognize the Disease. 



Many of the older physicians who have had experience with more severe 

 types of smallpox have failed to recognize the mild form, and at first 

 called the disease, chicken-pox, "Cuban itch," "cedar itch," syphilis, im- 

 petigo contagiosa, or acne, and did not report to the health oflQcer so that 

 restrictive measures could be taken. Other younger physicians who have 

 had but little experience, if any, with smallpox, have consequently failed 

 to recognize the disease and therefore did not report to the health officer. 

 Some of the physicians still insist that the disease is not smallpox, and 

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