be modified. The mode of procedure is as follows: About six outfits are kept on hand, each consisting of a cotton bag the size of a pillow-case containing a long gown and a hood with a crescent-shaped opening for the eyes; the bag also contains two small towels,-one done up in a paper. I try to make my Scarlet Fever calls last, and when I go I don a pair of rubber-boots and throw my bag into my carriage. At the infected house all I insist on having is a pail of water each visit and a pan. I select a back piazza or back yard or a room least likely to be infected as my dressing-place. On arriving at the house I call for a tea-kettle of water to fill my pan which pan I have kept for my private use during the illness. I have the pail filled from the faucet. I make up a solution of Bichloride one to five hundred in the pan and put on my robe and hood. Then I immerse the bag and one towel in the bichloride solution. On coming from the sick-room I wring out my bag and put my gown and hood therein. I wipe face with my towel wet in the antiseptic and rinse off my boots with the pail of water, and lastly I wipe hands and face with the dry towel in the paper. I take my bag home and put it in a sterilizer for boiling. Then I attend to throat and nose. Now this method is not above reproach, but anyone who has struggled to find a satisfactory technique for disinfection of person and clothes in humble homes, will, I think, find that there is less to be said against this method than against others. I claim that what ever infected dust the gown has received will be held within the wet bag and that there is no objection to carrying it home in this way. Before entering my home, I hold my boots under a faucet that is set in the wall of the house. I feel sure that two washings must remove all precipitated dust from the boots. The boots might easily be replaced by the overalls with cloth feet, if one objected to the boots on account of their appearance in the street. This method I find that I can carry out with very little trouble and in a very few minutes time and in carrying it out many times I have failed to observe at least many defective links in the chain of antiseptic or disinfectant measures. It is not as good a method as can be employed in the homes of the wealthy but in the house of few rooms and few appliances and little or no intelligence it has given me a sense of security. In closing I have only to add that we practitioners must stand empty-handed by the bed-side of many selflimiting diseases; we must acknowledge that we are without resources to abort, to limit or to modify most of the diseases of the patients whom we try to comfort by our smiles and our placebos, but not even once in twenty thousand times should we carry an ember to light a conflagration that we are powerless to contend with when once started. THE VARIOLA EPIDEMIC IN WATERBURY. T. J. KILMARTIN, M.D., WATERBURY. During the past four years Variola has been prevalent in many sections of this country presenting features somewhat different from former epidemics and giving rise to various assigned causes for its presence. Perhaps the most prominent feature responsible in many cases for the disease being overlooked was the mildness of its course and the low mortality following its presence. Another characteristic that caused doubt in the minds of many who had no opportunity to study the conclusive symptoms, was the absence of secondary fever in the pustular stage in a majority of the cases. In almost every city in the country where the disease ap-peared a difference of opinion existed oftentimes among experts as to the true nature of the malady. The prevalence of Variola has been accounted for by the return of troops from tropical countries bearing the contagion and has also been attributed to the large population of un-vaccinated persons that has grown up in this country during the past thirty years; the latter probably a stronger factor in the continuance of the disease than anything else. Well vaccinated communities seemed to enjoy a remarkable immunity. Small-pox assumed various forms, resembling other eruptive fevers and at times a positive diagnosis from Varicella was well nigh impossible. The epidemic in Waterbury differed in no particulars from the course followed by the disease elsewhere either as to severity, length of eruption, absence of fever, or va riety of forms presented. The first case, discovered in a young man thirty years of age, presented in all prob L. ability as typical a course, according to the accepted behavior of the disease as any encountered here. Found with an eruption in the papular stage well marked on the forehead and forearms, less prominent on the remainder of the body, the papules gave way to typical vesicles, umbilicated, in turn to pustules semi-confluent which were supplanted by crusts and followed by a long period of desquamation. The eruption was present in the mouth and throat rendering swallowing, very difficult, a suppurative conjunctivitis intervened and the pus tular stage was accompanied by a well marked secondary fever. The eruption was uniform throughout, convalescence marked by the appearance of several boils and a healthy growth of pits followed the departure of the crusts. The case was as typical as any ever described in a text-book and ran a course that could permit of no other diagnosis. Seven other cases, three the severest that occurred, were directly traceable to the above, each presenting features peculiar to themselves. Of the ninetynine cases treated covering a period of five months, three were confluent, seven semi-confluent, four varioloid and the remaining eighty-five were discrete variola. There was no case quarantined in which time left any doubt as to the correctness of the diagnosis. Three cases died, two of confluent and one of discrete, the latter an infant. In all three cases death was caused by septic absorption. In every case met with there was found sooner or later a history of exposure. Ninety cases were directly traceable to two brothers who conveyed the contagion from outside and went through the disease attended by a local physician without the true nature of the malady being recognized. Fourteen cases appeared simultaneously in the block occupied by the above varying in severity from an eruption covering the entire body, accompanied by high fever and prostration, to two cases in one of which the eruption was confined to the soles of the feet and on the other not more than three or four pustules were present at any time on the body with absolutely no subjective symptoms of the disease. The period of incubation varied from seven to twenty-one days. March four or seven days after exposure two cases were discovered in the Salvation Army Shelter. March thirtieth or twenty days after the last case had been taken from there to the isolation hospital the quarantine was removed. The next morning I found one of the inmates sitting in my front hall with all the premonitory symptoms of the disease. He was removed to the hospital and died three weeks later of confluent Variola. Four of the cases beginning from this place ran a very mild course, being modified in my opinion by a recent vaccination. I have in mind also another case vaccinated by a local physcian that was one of the mildest we had to contend with. Of the ninety-nine cases seventy-five had never been vaccinated. Ten had not been vaccinated in ten years. Five had been vaccinated since the epidemic began and of the remaining nine I could secure no accurate information. A party held in an infected house, the bed on which a child lay ill with the disease, serving for a coat-rest aided materially in spreading the contagion. In two houses the parents unvaccinated, contracted the disease while the children vaccinated, in daily contact with the contagion escaped. In all typical cases the period of invasion was four days beginning with a distinct chill, headache, and backache followed by a rise in temperature from two to six degrees. On the fourth day the eruption appeared usually on the forehead and wrists as a distinct colored spot, scarlet and termed a macule. In about two days the macules appeared on all parts of the body and were raised into papules, little pimply elevations having a hard feeling with distinct shotty movements under the finger. These papules gradually enlarge, assuming a more globular appearance filling up with fluid into a vesicle with a slight depression in the center, the umbilication which |