It is the duty of the local health officer to see that all persons in his district who have tuberculosis shall take the proper sanitary precautions for the protection of others. There can be no doubt that the various county sanatoria for tuberculosis are a great humanitarian as well as life-saving project. In them the sick and depressed individual, who may be without proper home attention, finds a place to be adequately taken care of.

TABLE XV-NUMBER OF REPORTED CASES AND DEATHS FROM TUBERCULOSIS IN WISCONSIN WITH ANNUAL DEATH RATE PER 100,000 POPULATION IN WISCONSIN AND UNITED STATES REGISTRATION AREA FROM

A review of ten years represented by the table does not show a diminution of the disease. It does show, however, that the cases are being reported in greater numbers in comparison to the death rate. During 1912 there was one death in about five reported cases while in 1921 there was one death in about thirty reported cases. Undoubtedly the true death rate is at a still lower proportion than this. The total number dying from the disease in Wisconsin in the last ten years is nineteen hundred and thirteen. The fact that about 90 per cent of them were under five years of age should be made plain to the mothers of the state in order that especial care may be given children under that age. Fresh Pertussis Vaccine is declared by some physicians to be worthy of use in the prevention of whooping cough and the State Laboratory of Hygiene furnishes it to physicians without cost.

TABLE XVI-NUMBER OF REPORTED CASES AND DEATHS FROM WHOOPING COUGH IN WISCONSIN WITH ANNUAL DEATH RATES PER 100,000 POPULATION IN WISCONSIN AND UNITED STATES REGISTRATION AREA FROM

Lethargic encephalitis was not described as a disease until the year 1917. In all probability there were outbreaks of it prior to that year, which occurring with influenza escaped classification into a clinical entity.

Just what the connection with influenza is, is uncertain other than the fact that so far epidemics of the two diseases occur simultaneously. It is regarded as a communicable disease due to an uncertain specific agent. The degree of communicability is the lowest of all known communicable troubles being more pronounced in this respect than poliomyelitis.

The nose and mouth secretions are known to contain the causative organism.

It occurs in greater numbers in the winter and spring months and no age is exempt, although the preponderance of cases is below 45 years of age. It is considered to be more frequent in males. The death rate is between 20 and 40 per cent. It is variously stated that from 10 to 30 per cent make a good recovery and the rest of the surviving cases show a variety of residual symptoms. Some of these symptoms may appear after a lapse of time in which apparent recovery has taken place.

It is a disease to be feared and the cause of chronic invalidism in many cases.

It was made reportable by the State Board of Health in 1920 and isolation but not quarantine is required. It is the part of wisdom not to transfer the secretions any further than necessary notwithstanding the limited effect it may have in lessening the centers of infection.

TABLE XVII-NUMBER OF REPORTED CASES AND DEATHS FROM
LETHARGIC ENCEPHALITIS IN WISCONSIN AND THE AN-
NUAL DEATH RATE PER 100,000 POPULATION IN WIS-
CONSIN AND UNITED STATES REGISTRATION
AREA DURING 1920 AND 1921

Comparison of Death Rates From Combined Causes

The total deaths from the principal communicable diseases outside of influenza in 1920 was 3,622 and in 1921 was 3,149. The following table gives the death rates per 10,000 people for each county of the state arranged in the order of their magnitude. There is a shifting of county rates each year but the counties having the larger cities are mostly in the second column which has the larger rates and a study of these tables for the last four years shows this to be generally true. TABLE XVIII-DEATH RATES PER 100,000 POPULATION IN WISCONSIN COUNTIES DURING 1920 FROM MENINGITIS, DIPHTHERIA, MEASLES, POLIOMYELITIS, SCARLET FEVER, SMALLPOX, TUBERCULOSIS, TYPHOID FEVER AND WHOOPING COUGH (ARRANGED IN ORDER OF MAGNITUDE)

TABLE XIX-DEATH RATES PER 10,000 POPULATION IN WISCON-
SIN COUNTIES DURING 1921 FROM MENINGITIS, DIPH-
THERIA, MEASLES, POLIOMYELITIS, SCARLET FEVER,

SMALLPOX, TUBERCULOSIS, TYPHOID FEVER
AND WHOOPING COUGH (COMBINED).
(ARRANGED IN ORDER OF MAGNITUDE)

During the week of October 30th to November 5th, 1921, a Cancer Campaign was conducted in Wisconsin. This had for its object the

calling of the attention of the people at large to the dangers of neglecting treatment in early cancer and to the advisability of treatment or removal of the precancerous lesions in the hopes that the high mortality from that disease may be lessened.

The American Society for the Control of Cancer with headquarters in New York are the instigators of programs in various states of the union and at their request the State Board of Health assumed responsibility for the work. Letters were sent to medical men, the clergy, various clubs and state organizations and to some individuals asking their cooperation. The response was good. Many lectures were given throughout Wisconsin and much information on Cancer

reached the people. The pamphlets "What We Know About Cancer." "What Every Adult Should Know" and "Fourteen Points About Cancer" were widely distributed. Dr. I. F. Thompson of the State Board of Health assumed charge of the actual work of conducting this campaign.

FINANCIAL STATEMENT-COMMUNICABLE DISEASE DIVISION From July 1, 1921 to December 31, 1921

FINANCIAL STATEMENT-COMMUNICABLE DISEASE DIVISION From January 1, 1922, to June 30, 1922.