186 MICHIGAN ACADEMY OF SCIENCE. 



Michigan is not the only State having trouble along that line. In Ohio, 

 an old physician who insisted that the disease was not smallpox, said "If 

 this is smallpox we must rewrite all our text books on the subject;" but 

 when asked "How about chicken-pox?" admitted that the same would be 

 equally true if the prevailing disease was chicken-pox. In this State, other 

 old practitioners, who at first doubted the disease being smallpox, have, 

 after having had a number of cases and seeing the disease in all its forms, 

 become convinced that it is smallpox in a mild and modified form. 



Failure of Health Officers and Health Authorities to Act. 



In a few instances the failure to restrict the spread of the disease has 

 been because the health officer refused to accept the diagnosis of the at- 

 tending physician, and at first utterly failed to do anything for the pre- 

 vention or restriction of the disease. In a few instances the local board of 

 health has failed to cooperate with the health officer for the restriction of 

 the disease. The office of the State Board of Health has uniformly urged, 

 and with perhaps one or two exceptions, finally succeeded in arousing the 

 local health authorities to action, but sometimes not until the disease 

 had gained a strong foothold, and considerable difficulty has been ex- 

 perienced in attempting to stamp out the disease. 



Failure of cooperation mioii the jxirf of the People. 



In man}' of the milder cases of the disease there has been an entire lack 

 of cooperation upon the part of those having the disease, and of those 

 in whose homes the disease was present. When the attention of the 

 health authorities has been called to the fact that the disease was present, 

 there has been an attempt, not only upon the part of those having small- 

 pox, but also upon the part of their friends, to cover up or hide from 

 the authorities all of the facts possible, denying that they have or did 

 have the disease. In some instances the cases have entirely recovered 

 before the health officer had any knowledge that the disease 

 was present in his jurisdiction and when the health officer has 

 attempted to disinfect the infected premises, he has often been met 

 with stubborn resistance, and there is no doubt that in some instances 

 there have been cases that have been so mild that no physician has been 

 called, and they have thus entirely escaped the attention of the health 

 authorities, therefore nothing has been done in the way of disinfecting 

 the infected premises, and they have thus remained centers of infection. 



Lach of Vaccination and Rcvaccination. 



The comparative freedom from smallpox in this State previous to the 

 beginning of the epidemic of the mild form, undoubtedly led the people 

 to become careless and neglect vaccination and rcvaccination, and upon 

 this point the report of the health officer of one of our cities is as follows : 

 "Not only was the mildness of this epidemic a phenomenal surprise, but 

 the large number of unvaccinated adults, as well as school children, 

 brought to light by the necessary vaccination rules of our city Board of 

 Health ; and the number discovered of unbelievers in the value of vaccina- 

 tion as a prophylactic against smallpox, was really astonishing, and is a 

 matter calculated to cause every medical man to view the situation of 

 the country with apprehension." 



