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ANNUAL REPORT OF THE PROVINCIAL BOARD OF HEALTH. 1908. British Columbia. Legislative Assembly 1910

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-OF   THE-
1908.  10 Ed. 7 Provincial Board of Health. D 3
Provincial Board of Health,
Victoria, B. C, July 1st, 1909.
The Honourable Dr. H. E. Young,
Provincial Secretary,   Victoria, B. C.
Sir,—I have the honour to submit the Twelfth Annual Beport of the Provincial Board of
Health, being for the year 1908.
The health conditions throughout the Province continue about the same as in previous
years. I am satisfied that through the energy of our officers epidemics have been avoided, but
I regret to be compelled to admit that certain diseases have removed many citizens who should
yet be left to fulfil their duties to their families and the state.
The following returns show the number of cases of infectious diseases reported during
the year:—
Typhoid Fever—213 cases, 29 deaths. Small-pox—75 cases, 1 death.
Measles—329 cases, 4 deaths. Diphtheria—235 cases, 19 deaths.
Scarlet Fever—120 cases, 3 deaths. Cerebro-Spinal Meningitis—4 cases, 3 deaths.
Typhoid Pever.
In view of the fact that this disease can be avoided by knowing certain simple truths and
acting on this knowledge, the large number of deaths attributable to it is matter for regret. In
my report of last year the following may be seen :—"Dr. McCormack, speaking to the American
Medical Association, says :—
" ' Typhoid is not only a preventable disease, but the most typical of the filth diseases, for
no one can have it except by getting into his mouth and stomach some of the discharges from
the bowels or kidneys of some one who has typhoid fever. This is not a nice thing to think
about, but it is so much worse to do it that nice people ought to think and plan how to stop
doing it.    It usually gets into the mouth through infected water.'"
In order that the truth of Dr. McCormack's statement may be realised, I may be permitted
to give some of the accepted and leading facts regarding typhoid fever.
In the year 1880, Eberth discovered and isolated a germ and proved it to be the one and
only cause of typhoid fever. This germ cannot develop spontaneously and its propagation and
multiplication are practically confined to the intestines of a person sick with typhoid fever.
How long the germs remain in the system of persons who have been ill with the disease is not
certain, but it is now known that in the large percentage of cases the germ is not present when
the person attacked is in a fit condition to return to his ordinary avocations.
The disease is contracted by swallowing the germs. All who swallow the germs do not
necessarily contract the disease. Why they do not, need not here be dealt with, and all that
is now advanced is that the disease cannot be contracted unless by entrance of the germ into the
system. The germ leaves the body of the patient in the passages from the bowels and through
the urine. D 4 Provincial Board of  Health. 1910
It is therefore plain that typhoid fever is maintained among us by want of proper handling
of existing cases.
Dr. William Osier, whose opinion few will question, says :—" Typhoid bacilli do not
naturally inhabit water or milk ; they may exist in it for a time and even multiply, but their
natural dwelling place is man, and these are only carriers from one host to the next. The
lesori is easy to learn but hard to carry into practice. Let us make sure that every typhoid
bacillus is killed immediately on leaving every host and the disease is at an end."
Knowing, then, these fundamental principles, it is not too much to demand that attendants
on typhoid-fever patients give special attention to the bowel and urinal discharges and the
clothing, especially soiled sheets and underclothing. The proper disinfection of bowel
discharges and urine is useless unless well and carefully carried out. The most effective way
is by heat, but this cannot be done under ordinary conditions, and so we must depend on
chemical disinfectants, the most effective of which is milk of lime, or carbolic acid (I in 20),
Whatever disinfectant is used, it must be added in large quantities (at least three times the
amount of the discharge), mixed freely, breaking up solid masses, and allowed to stand for four
hours. Clothing should be soaked in 1 in 20 solution of carbolic acid for two hours, and their
Bed-pans and urinals should be scalded after each disinfection of their contents, and so
kept that flies have no access to them. It is well to keep a little disinfecting solution in bedpan or urinal when it is not in use.
Flies.—Every effort should be made to keep away flies from the patient's room. They
light on fsecal material and on urine. Thus their many legs become contaminated, and when
they alight on milk and other foods infection follows, and what the results may be no one can
foretell. If possible the windows should be screened ; but if flies do get into the room, every
effort should be made to kill them.
From the above may be seen the difficulty and great importance of the proper method of
handling typhoid-fever patients. When hospital accommodation is within reach, it should be
taken advantage of. It is beyond doubt the best for the patient, and it safeguards the family
and the community.
When hospital accommodation or trained nurses' attention cannot be obtained, the
attendant should wear a white over-dress, and should be careful to disinfect hands whenever
patient has been touched. This is best done by thoroughly washing with hot water and soap
and then soaking in a solution of 1-1,000 bichloride of mercury solution, or a solution of 1-20 of
carbolic acid.    The bichloride is the best, but being so poisonous must be carefully guarded.
The cooking and handling of food should be done by others than the attendant on the
During the year 235 cases and 19 deaths from diphtheria were reported. This is an
average report; but considering the conditions of living in British Columbia, both the number
of cases and the death rate might be lower.
The beneficial results of antitoxin in the treatment of diphtheria are now so fully
demonstrated that no intelligent person questions its use.
In the year 1890 Behring advanced the use of antitoxin. Since that date the methods
of its preparation have been improved, and larger and more concentrated doses are being used.
Prior to the use of antitoxin, even under the best medical supervision, the death rate from
diphtheria varied from over 60 to 55 %; while under its use the death rate varies from 16
to 3 or 4 %, provided it is used early and in sufficient doses. 10 Ed. 7 Provincial Board of Health. D 5
In the Boston City Hospital, before antitoxin was used, the death rate from diphtheria
varied around 48 %. At the present date the death rate varies from 11 to 9.5 %. This is
strong evidence, and the consequent duty of responsible authorities is plain.
At the present day antitoxin is a commercial article, and, naturally, the producers, the
agents and sub-agents look for their percentage of profits. I cannot think this is right. The
article is too essential to the community to be made a means of money-making.
The antitoxin used in Canada comes from England, Prance and the United States.
There are many obvious reasons why this article should be manufactured in this country. In
England and France the authorities doubtless have proper regulations governing the purity of
this article ; but I know that in the United States, from where we get most of our antitoxin,
it is examined as to purity and potency. Whether this examination extends to that imported
into Canada I do not know ; but I do know that there is no medical inspection or examination
made by the Canadian authorities.
The instability of antitoxin is one of its characteristics, and to maintain its purity and
potency great care must be exercised in its keeping. The passing of such an article from
producer to agent and from agent to sub-agent carries its risk of carelessness. It will thus be
seen that on account of its use being of such overwhelming importance, no chances should
be taken.  ■
The length of time antitoxin keeps pure and potent largely depends on how it is kept,
and, when it is remembered that diphtheria appears at such irregular intervals, it will be
apparent how difficult it becomes to successfully handle it from a commercial aspect. I am
sure that druggists as a class do their best, but, on the other hand, I have personal knowledge
of the sale to the public of antitoxin below standard.
The manufacture of antitoxin and other sera should, in my opinion, be carried on by the
Government, and supplied to fixed stations throughout the country, and be obtainable by the
public at cost, on the direction of physicians. To effect this in the safest way and with
economy, one producing station would be sufficient to supply all Canada. I therefore beg to
recommend that the Dominion Government be petitioned to establish a laboratory for the
supply of sera, especially diphtheria antitoxin.
Scarlet Fever.
The showing of 173 cases of scarlet fever with only three deaths is excellent, and our
physicians are to be congratulated on such results. To date it is not known what is the definite cause of this disease. All we know is that it is an actively infectious disease, that
rigid quarantine of patient and nurse prevents its spread, and that good medical treatment
reduces the mortality. In the City of Boston the death rate from scarlet fever from 1866 to
1880 varied each year from 6.1 to 4.1 per 10,000 inhabitants. At the present date it rarely
exceeds 1 per 10,000, showing clearly what may be effected by efficient and careful handling.
During the year there were 75 cases of small-pox and one death. This is not a heavy
showing as compared with other Provinces, but when it is remembered that this disease is the
one over which we have absolute control, it must be regretted that the certain preventive—
vaccination and revaccination—is not more generally taken advantage of.
Cerebro-Spinal Meningitis.
The limitation of the presence of this disease to four cases reported is a matter for congratulation. This disease was first recognised in 1805. It is generally accepted as originating in America and later extending to Europe. It is, as a rule, confined to young persons,
but some epidemics seem to affect persons between the ages of 26 and 30 years. D 6 Provincial Board of Health. 1910
That spinal meningitis is communicable from person to person there is little doubt,
although this varies in different epidemics, being scarcely apparent in some. The present
accepted channels of communication are through the secretions of the mouth, the nose and
the eye.
In the majority of cases the main characteristics of the onset is that it is sudden—
sometimes tragically so. A person in apparent health is taken with sudden severe headache,
vomiting, fever and rapid pulse. Following this, rigidity of neck with stupor and coma, point
to cerebro-spinal meningitis.
All cases, or suspected cases, should be rigidly isolated. Definite diagnosis should be
established as soon as possible, and to assist in this the fluid obtained by lumbar puncture
should be sent without delay to the nearest reliable laboratory. We are ready at all times to
handle this work in the Provincial Board of Health Laboratory.
The treatment of this disease is not satisfactory, the best known being Flexner's Serum.
This is kept in moderate quantities in the Provincial Board of Health Laboratory and will
always be forwarded on request.
Bubonic Plague.
The plague conditions existing to the south of this Province are extending in area. The
reported cases among humans are few, but the great point is that the disease is yet present.
During the month of January, Dr. Underhill, Medical Health Officer of Vancouver, asked
whether it was necessary to continue the precautionary measures adopted by the Provincial
Board of Health Department.    Acting on your instructions, I gave the following answer :—
"The advent of plague in any port is always attended by alarm, and, as serious consequences are looked for, the authorities adopt stringent precautions. If, afterwards, no
evidence of high mortality be forthcoming, the terror of the people subsides, and, generally,
one and all commence to think that the precautionary measures are no longer necessary.
Later no mortalities occur, and, once more reassured, the populace abandons its vigilance.
But, in the meantime, there is quiet evidence that vermin, especially rats, are affected ; and,
in my opinion, here is the whole crux of the question. The humans we can isolate and
quarantine and so stamp out the disease, but with the vermin it is quite another proposition.
The disease slowly but surely spreads among them, and what power of control have we otherwise than by exterminating every rat in the infected area. Thus it is that the history of
plague shows that the eradication of the disease, when once it has obtained a foothold, may be
a question of many years and, for many reasons, is one of the most difficult problems facing
sanitarians to-day.
"We have strong examples of this in San Francisco, Honolulu and Australia. The
plague appeared in San Francisco some seven years ago, and, although it has been announced
many times that it was no longer present, yet we now know it was there all the time among
the rats, and periodically spread on to the humans. Some of the latest reports show the
human death rate to be high and the area of rat infection to be extending, so that now not
only is the infection present in San Francisco, but it has spread on to six or seven points in
the State of California.
" The financial loss to a country in which plague appears is very great. San Francisco
has already disbursed some $200,000 in its endeavours to extirpate the disease, but, so far,
has been unable to do so. Honolulu has, I understand, expended the immense sum of
$2,000,000 for the same purpose, with a like result.
" From this, it seems to me that the proposition for the cities of Vancouver and Victoria
to consider is :—In view of the fact that we are entirely free from bubonic plague, is it worth 10 Ed. 7 Provincial Board of Health. D 7
our while, commercially and otherwise, to expend a reasonable sum of money in a reasonable
endeavour to keep ourselves free ? The question is one to be looked at from a business as
well as from a health point of view, and I have reason to believe that the business community,
as sound and sensible men, will rise to the occasion. There have been a few deaths from
plague in Seattle, and some rats (26) have been found to be infected, so that we have special
reason to take precautions. The people in that city, when last I was there, were expending
the sum of over $8,000 per month.
" In conclusion, I would say that, while it would not be advisable to adopt vexatious
restrictions, I most certainly advise, and will recommend the Provincial Board of Health to
insist on, the regulations at present in force being continued."
Milk Supplies of Cities and Towns.
Acting on your instructions, I submitted, during the past year, a report on milk, a copy
of which is herewith appended. I respectfully and strongly recommend that some action be
taken and that the question as to whether the Dominion or Provincial Government has
authority will soon be settled. The existing conditions, while no worse than in many other
countries, are not what they should be. At the present day it is not necessary to point out
the possible evil results of the use of adulterated milk, or of that below standard or unclean.
Bailway Sanitation.
During the year I attended a meeting of American and Canadian Boards of Health.
Sanitary laws and regulations were among some of the many questions discussed. A Committee, appointed to report on the possibility of adopting railway sanitary laws, presented,
through their chairman, Dr. Bracken of Minnesota, the following :—
" The Committee tried to get in touch with two railway organisations, one in Chicago
and the other in New York City. The one with headquarters at Chicago was made up largely
of men connected with mechanical work, and these did not seem much interested in sanitary
problems. The other was made up largely of the heads of the roads, superintendents, etc.,
and they did not seem much interested in sanitation. It was impossible to get anything
started with either of these organisations.
" As stated at the time this Committee was formed, we have regulations governing the
transportation of the dead, but none covering the transportation of the living. The Committee
has nothing further to report."
Briefly, it may be seen from this that railway authorities do not see the need of sanitary
improvements in their present systems.
During the course of the meeting it was shown that certain States -had rigid laws
pertaining to railway sanitation. The following taken from the official printed report of the
proceedings represents my views :—
" Dr. Fagan, British Columbia: It always strikes me that regulations regarding transportation, sleeping cars and carriages generally, adopted by any particular State or Province
in the country from which I come, bring the whole of our regulations into ridicule. Take the
State in which these active and stringent regulations are in force—the State of Texas; that
is all right; that is good. But all they have to do is to pass into another State, and they are
entirely free from any such regulations. We are the same way in Canada. It always struck
me that the only way to handle this question, which is an important one, would be for
different States in America and the different Provinces in Canada to request and demand the
respective Federal Governments to take charge of this whole question of transportation and D 8 Provincial Board of Health. 1910
make a law covering it, that would be general and common throughout the whole country.
It is absurd for one particular State to have stringent regulations, and for another State to
say : ' You can do as you please.'"
It would seem that this question would come well within the scope of the work of the
Dominion Bailway Commission.
School Hygiene.
During the past and previous years I have read papers on the teaching of hygiene in our
public schools. The views advanced were honestly believed, but I now know were not
Judging by what can be observed almost anywhere, it is evident that the majority of
men and women know very little about hygienic conditions; and when it is considered that
the teacher alone has an opportunity of reaching all classes through the children, it becomes
of the greatest importance that children should not only work under hygienic conditions and
be under a teacher who not only understands and appreciates such conditions, but also that
they should be carefully instructed in the principles of hygiene, so that the men and women
of a few years hence may themselves know the meaning of proper conditions of living.
Opinions will doubtless differ as to the best method to be adopted for:—
(a.) Attending to the health of the children :
(6.) Imparting a reasonable and practical knowledge on health matters.
As to attending to the health of the children, I would strongly recommend the constant
and systematic supervision by a medical practitioner. If this cannot be obtained, because of
monetary or other reasons, I would then advise that a specially trained nurse be employed.
Provided the nurse is well trained, there are many matters she can attend to herself, and the
graver problems may be referred by her to the regular physician.
Begarding the teaching of health, I am satisfied that the public school teacher is the
person best suited to impart this knowledge. He understands the children and the children
understand him.
I therefore beg to recommend that means be adopted to qualify school teachers to impart
instruction in sanitary science.
Inspection of Lumber  Camps.
The inspection of lumber camps is being actively attended to; 83 reports were submitted
this year.     It is hoped a larger number of camps will be inspected during the coming year.
I have the honour to be,
Your obedient servant,
0. J. FAGAN,  Secretary. 10 Ed. 7 Provincial Board of Health. D 9
Provincial Board of Health.
Victoria, B. C, January 1st, 1909.
Dr. C. J. Fagan, Secretary,
Provincial Board of Health, Victoria, B. C.
Sir,—I beg to report on the work of the Bacteriological Laboratory for the year 1908.
The Laboratory was placed under my charge in November, 1907, my chief duty at the
time being to search suspicious matters for the bacillus of bubonic plague.
Since that time the scope of the Laboratory has been extended, so that now sputa and throat
swabs are examined for medical practitioners, free of charge, and other examinations pertaining to Board of Health work are done. While many doctors do not, as yet, avail themselves
of the advantages this affords, still, the number of those who do is increasing. Vancouver-
having a City Laboratory, and so great a part of this Province being distant from Victoria,
will partly account for the Laboratory not being used more than it is. It has been the
endeavour, while extending the work of the Laboratory, not to encroach upon the practice
of the medical consultant; consequently, the examination of tumors and other tissues and of
urine have not been undertaken, private laboratories in the Province existing for this work.
During the year a cement house was added to the equipment of the Laboratory for the
inoculation of animals in making diagnoses of bubonic plague and other diseases. Laboratory
material has been added to and perfected, so that now any infectious material or any epidemic
disease may be fully investigated as to cause.
Early work with the bacillus of bubonic plague consisted first in the definite diagnosis of
an organism obtained from Seattle. The bacillus was examined as to size, shape, motility and
staining characteristics, and in culture with cocoanut-oil bouillon stalactite formations were
observed, and from 4 per cent, sodium chloride agar involution forms were recovered. Two grey
rats, Mus Norwegicus, were inoculated through the abraided skin, death resulting in four days.
The post-mortem appearances were similar to those seen after death from bubonic plague, and
the same organism was seen in smears and obtained in pure culture from the various organs,
agreeing in all respects with the recognised characteristics of the bubonic plague bacillus.
Various other work was carried on to obtain proficiency in readily recognising the characters
of this disease and its specific micro-organism. In June I made a visit to Seattle and did some
work in the City Laboratory with Assistant Surgeon Chapin, of the United States Public
Health and Marine Hospital Service, and so became acquainted with their Laboratory
methods and their manner of handling bubonic plague.
During the year 21 rats, suspected of being plague-infected, were sent here by health
officers for examination.    None, however, contained the plague bacilli.
Practical experiments with rats were carried on to test the efficiency of various bacterial
rat poisons. Of these, Batin proved to be quite powerful, the Liverpool Virus was much less
effective, and Azoa was found to be of but little value. No systematic destruction of rats was
followed out in any British Columbia town, but it is probable that as yet no rat plague has
gained entrance into our seaports. D 10 Provincial Board of Health. 1910
In 1908, 33 specimens of sputum were examined for the bacillus, of tuberculosis. Of
these, 12 were positive.
Cerebro-spinal fluid from five cases was examined. Three specimens contained the
organism of epidemic meningitis.
Of 36 throat swabs examined, 11 contained the bacillus of diphtheria.
Only two samples of blood serum were examined for the typhoid agglutination reaction,
of which one was positive and one negative.
In September I made a trip to Fernie to investigate health conditions after the big fire,
with special reference to the prevalence of typhoid fever. A special report on this was
submitted to the Honourable Dr. Young.
On account of a few mild cases of small-pox in Ladysmith, I made a trip to inspect
conditions there in October.    A separate report on this was also submitted to the Honourable
Dr. Young.
I have the honour to be,
Your obedient servant,
Walter Bapty.
Provincial Board of Health,
Victoria, B. C, September 21st, 1908.
The Honourable H. E. Young,
Provincial Secretary, Victoria, B. C.
Sir,—I have the honour to submit a report on conditions favourable to typhoid fever at
Acting upon your instructions of September 14th, to investigate an outbreak of typhoid
fever, reported from Fernie, I proceeded to that town, arriving there September 16th.
I drove over the greater part of Fernie that afternoon with Dr. Bonnell, the district
Medical Health Officer. In company we took a general survey of the town, which is divided
into three districts, Fernie, Fernie Annex, both incorporated as the city of Fernie, and Fernie
West. This latter consists of a number of houses lying on the west side of the Elk Biver.
The greater part of Fernie lies upon a well-drained bench-land, sloping towards the Elk Biver.
Fernie Annex and Fernie West are on a much lower level, being but little higher than the
Dr. Bonnell informed me that annually about 50 cases of typhoid fever occur in Fernie,
the greater number of cases always coming from Fernie Annex and Fernie West. This year
he reports about 20 cases, six occurring in Fernie, most of these being imported, the rest
occurring in Fernie Annex and Fernie West. Thus he is rather optimistic regarding the
present year, as in previous epidemics all cases have occurred in August and early September.
However, to most of us, this will reveal that conditions existing there all the time are greatly
to be lamented.
The water supply to the main portion of the town is piped from a mountain stream above
common sources of contamination. I believe it to be of excellent quality and purity.
However, Fernie Annex and Fernie West depend upon wells for their supply.     The subsoil 10 Ed. 7 Provincial Board of Health. D 11
here is a loose gravel, and the water in the wells, while clear and cold, contains an amount of
surface drainage. In some of these cases wells are placed in close proximity to cess-pits; one
place, in Fernie Annex, where we measured, as close as 22 feet.
Since the fire, some water-closets have been installed, but a great number of cess-pits
have come into use. In Fernie Annex and Fernie West cess-pits are used entirely. I have
written a letter to Mayor Tuttle, a copy of which I enclose, recommending the closing of all
cess-pits, the use of water-closets where possible, and where not possible, the use of dry earth
closets, which are to be cleaned at least once a week and a liberal supply of chloride of lime
used. I am also recommending the extension of the city water supply to Fernie Annex.
This, I believe, could be done at very little cost and in a very short time. In the meantime,
the people in that section should be enjoined to use nothing but boiled water.
As, I believe, Fernie West is not incorporated, more trouble may be encountered in
enforcing hygienic measures. However, they should have a good water supply, which could be
obtained from a source at but little over a mile distant. As soon as possible, they should
instal a sewage system ; in the meantime, they should use dry earth closets and have them
cleaned at least once a week and the deposits burned.
The City of Fernie is constructing an incinerator, which will be completed before long.
This will be one more hygienic precaution.
Dr. Bonnell reports the health of the mine workers to be good, though no sanitary
precautions are taken in the mines. Practically all cases of typhoid from Fernie occur among
the English-speaking people. This may partly be accounted for by the fact that the mine
workers, mostly foreigners, occupy that portion of the town lying to the east of the Canadian
Pacific Bailway's track, and this is the highest point of the city.
W. R. Ross, Esq., M.P.P., points out the lack of accommodation for the sick, all cases of
sickness requiring hospital treatment having to be sent to the Cranbrook Hospital. However,
Drs. Bonnell and Corsan are constructing a hospital, to be completed December 1st; plans of
this I am enclosing, and at present there is not an immediate urgent need of much hospital
accommodation. Even yet, in case of an epidemic, large hospital accommodation may be
needed, but in that case there is no reason why the city should not construct a large frame
building, as I am informed that it has still a large amount of money at its disposal.
Dr. King, of Cranbrook, informs me that 45 cases of typhoid fever have been sent to the
Cranbrook Hospital from the Fernie District. This includes Fernie, Hosmer, Waldo and
many smaller camps. These places lie all along the Elk River, and this valley appears to have
been a hotbed for typhoid fever ever since the early years of railway construction.
Hosmer is having a water system installed, but I regret to state that the source of supply
is contaminated by waste water from the mines. This could easily be remedied by going
above the mines for a supply.    At present most people are using the Elk River water.
Cranbrook, I am informed, has no typhoid fever of its own, but from one of the neighbouring camps, Myook, 14 cases have been sent in. Myook is an old camp and is shortly to
be abandoned. Dr. King, who does the medical and surgical work for this camp, inspected
their sanitary conditions and recommended that they change their water supply, and this, he
states, has been done.
No Medical Health Officer is in charge of the Cranbrook District. I do not need to
point out the necessity of this. Dr. Green, of Cranbrook, would, I believe, make a most
efficient officer. I) 12 Provincial Board of Health. 1910
I am preparing a pamphlet somewhat similar to the enclosed, which we received from the
Minnesota State Board of Health, to be distributed in districts where typhoid fever is
epidemic.    I trust this will meet with your approval.
Dr. Bonnell informed me of an epidemic of diphtheria occurring at Carbonado about
September 1st. He is sending a report of it to this department. Three deaths occurred
before he was called in. He found 13 more cases with well-marked diphtheria, all of which
he treated with diphtheria antitoxin, besides 30 other children who had been exposed. He
quarantined that portion of the town and the disease disappeared with no further fatalities.
Dr. Higgins reports that the sanitary conditions of the two dairies that supply Fernie
with milk are bad. The grade of milk is fair. Fortunately, no disease can be traced directly
to the milk supply. The Fernie Dairy is situated in the lee of the coke ovens in a poorly
drained place. They agree to build new byres if a road is constructed to a farm of theirs, a
short distance out of town.
I wish to express the kindness shown me and assistance given me by W. B. Ross, Esq.,
M.P.P., J. H. McMullin, Esq., Government Agent, and S. Bonnell, Esq., M.D.
I have the honour to be,
Your obedient servant,
Walter Bapty.
Provincial Board of Health,
Victoria, B. C, October 7th, 1908.
The Honourable H. E. Young,
Provincial Secretary,   Victoria, B. C.
Sir,—I have the honour to report upon an epidemic of small-pox occurring at Ladysmith.
Acting upon your instructions of October 4th, I proceeded to Ladysmith, arriving there
on the day following.
With the assistance of Dr. Frost, Medical Health Officer for that city, I made my investigation. Dr. Frost reports that chicken-pox has been epidemic in Ladysmith this summer;
consequently, when a child with no prodromal symptoms, no fever or malaise, was seen with a
rash on the 18th September, it was thought to be chicken-pox. This rash appeared as a few
papules upon the face and body and quickly dried up without pustulation, the child in the
meantime mixing with the other children of the household. Shortly after this the four other
children and the mother became ill, two of the children and the mother developing characteristic, shotty, poly cellular, umbelicated, pustules.
The children and also the mother, so far as we could learn, have never been vaccinated.
However, a nurse who was in the house we vaccinated. The house has been quarantined and
placarded and a special constable placed over it. Dr. Frost has since vaccinated all the clerks
in the store, of which the father is manager, and also disinfected the store. The house is not
very near other residences, being situated on a corner with no other house on the adjoining lot,
and a wide lane runs behind. 10 Ed. 7 Provincial Board of Health. D 13
In the family of a neighbour we were also able to establish a diagnosis of small-pox in a
child. This family consists of father, who is the town postmaster, mother, one girl, one boy,
all of whom have been vaccinated, and a younger boy who had not been vaccinated. It is this
latter child that now has small-pox. We had this child conveyed to the quarantined house,
the rest'of the family being revaccinated, and before I left the house was undergoing active
formaldehyde disinfection.
Dr. Frost, of his own initiative, has transferred the post-office, until the present building
is disinfected. He reports since that he has forbidden public gatherings. We have also had
the schools closed for a while until any latent cases may develop.
I regret to report that many in Ladysmith, owing for the most part to misunderstanding,
are opposed to vaccination. It is to be hoped that the present small epidemic will cause more
to be vaccinated.
I also left with Dr. Frost a few copies of the enclosed pamphlet, "Facts about Vaccination,"
which may influence a few of the unprejudiced opponents.
It is to be regretted that a community can grow up in a civilised country like Canada
with so many unvaccinated persons. Once small-pox gains any headway in such a community
it is difficult to state just where it will end or what havoc will be wrought.
It is unfortunate, too, that we have any such loophole as a " conscience clause " in our
vaccination regulations, and it is to be hoped that this will be remedied before long.
I am pleased to state that of these seven cases seen by us all appear to be mild, and we
do not expect any mortality amongst them.
I wish you to understand the kindness shown and the assistance give to me by Dr. Frost.
I have the honour to be,
Your obedient servant,
Walter Bapty.
victoria b. cc:
Printed by Richard Wolfenden, I.S.O., V.D., Printer to the King's Most Excellent Majesty.


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