REPORT B.-RE EXPERIMENTAL STATION.

To the Chairman and Members of the Provincial Board of Health.

GENTLEMEN,-I beg to report in reference to the above Station that the building is completed and the 10 large tanks, each of the capacity of one four-hundredth of an acre, have been placed in position. The storage and liquifying tanks have been constructed and it is expected that early in the New Year the electric pumps will be placed in position and thus permit the early initiation of the work.

I have pleasure in submitting a set of photographs of the exterior and interior, together with the plans as prepared by the Public Works Department of Ontario. I have the honour to be,

Your obedient servant,

CHAS. A. HODGETTS, M.D.,

Secretary.

December 15th, 1908.

REPORT C.-RECOMMENDATIONS IN RESPECT TO COMPULSORY INSTRUCTION TO MEDICAL STUDENTS RE COMMUNICABLE DISEASES.

To the Chairman and Members of the Provincial Board of Health.

GENTLEMEN,-I wish to direct your attention to a question which I have. felt for some time should, in the interests of both the medical profession and the public, receive the serious attention of the Medical Council. It is the placing upon the curriculum the attendance at clinics of diseases of the communicable group.

In my experience the errors in diagnosis are upon the increase, and as a consequence the public suffer unnecessarily. This group of diseases is most important no matter from whatever standpoint it is considered, and it does seem somewhat strange that in this Province men can be licensed to practice without ever having satisfied the Council of C. of P. and S. as to their having had practical instruction in reference thereto. Apparently, the knowledge to be acquired from text books in respect to scarlatina, smallpox, chickenpox and measles is deemed sufficient. If the many mistakes which are being made every day, and of which this office has knowledge of, were but known to the general public, mistakes from which they suffer financially and other-` wise, the present requirements of the Medical Council would not be permitted.

The chief reason, apart from the failure on the part of municipal councils to provide and enforce vaccination, for the spread and continuance of smallpox in the Province has been the mistakes in diagnosis. There is hardly a municipality but has had one or more experience during the past ten years when such errors on the part of medical practitioners have cost them dearly.

Where medical students have received this very necessary instruction, and it is gratifying to have to say that in one college in this Province such clinical instruction has been given for the past few years, I can testify to the good results in the practice of many who as students received such 'instruction and their work stands out in marked contrast to that of those whose work has been only theoretical.

I would therefore suggest to this Board the advisability of making representation to the Medical Council for making it compulsory that medical students attend a given number of clinics in diseases of the communicable

group. In respect to the work of Laboratories of Local Boards of Health I have written the attached letter to the secretaries of the different Boards asking for a statement of the work done locally, hoping in this manner to avoid any confliction or duplication.

All of which is respectfully submitted.

CHAS. A. HODGETTS, M.D.,

Secretary.

December 15th, 1908.

REPORT D.-THE SMALLPOX SITUATION, WITH STATISTICAL TABLE, 1908. To the Chairman and Members of the Provincial Board of Health of Ontario.

GENTLEMEN, Smallpox is present in a large number of municipalities in different portions of the Province, in many of which it has been found upon investigation, either by the Local Health Authorities or by the Inspector of the Board, that there had been mild cases existing for weeks, if not months, before its presence was known to the Local M. H. O.

It has been found with but few exceptions that those suffering from the disease have never been vaccinated, for during the past twenty years municipal councils have uniformly been indifferent to the question and the Act respecting Vaccination and Inoculation, Chap. 249, R.S.O. 1897, is so far as I can ascertain, a dead letter.

The wise provisions of this Act are, briefly, the providing of the machinery by municipal councils which is operative from year to year, whereby compulsory vaccination and revaccination is carried on by public vaccinators at the cost of the municipality.

The failure on the part of municipal councils to make the Act operative has resulted, particularly in the large centres of commerce, most disastrously to the business community. Invariably large volumes of trade are diverted from these centres owing to their neglect of this sanitary provision, and business is still further crippled by the failure on the part of the councils of such municipalities even when in the face of an outbreak of considerable extent, to take a firm stand and immediately enforce vaccination--which it is clearly their duty to do. They will frequently reject the recommendations of their M. H. O. and Local Board of Health, and then complain of the heavy bills of cost for the treatment of cases and the incidents of quarantine and disinfection and endeavor frequently to shift the blame to the shoulders of others, whereas it very properly rests upon the council for neglecting to enforce what is as public a duty as the extension of a sewerage system or the providing of a public water supply.

If the municipal authorities of this Province desire to be rid of these nuisances which have been smouldering in their midst for over ten years, then they must avail themselves of the only known method to prevent it-viz.Vaccination and Revaccination. To do so simply means the enforcement of the Act above referred to. The annual cost is small-quite insignificant compared to the expense of even a few cases of smallpox.

Appended is a list of the twenty-six municipalities in which smallpox has been reported during the past few weeks, with an approximate number of cases.