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among the recognized sources of contagion, but I doubt if many realize how great a factor it really is in the spread of contagious disease. There can be little question that the vast majority of minor *Read before the Section on Public Health of the American Medical Association, June 10, 1914. contagious diseases are contracted in school. A study of an epidemic in a classroom or in a school or in a city will show that the disease spreads from child to child in a room, from room to room in a school, from school to school in a city. And I am firmly convinced that an epidemic can be checked in a room, checked in a school, and checked in -a city. In my papers on "Latent Diphtheria, a Public Health Problem,'" and "Diphtheria Carriers; Their Isolation and Control,'" I showed how diphtheria spreads in schools, institutions, and dwellings, and how it can be checked. In a more recent paper, "Reporting of Suspicious Cases by the Laity indian generic viagra a Pre- requisite to the Efficient Control of Communicable Diseases,"" read before this section two years ago, I described several epidemics of scarlet fever, show- ing how they originated in unrecognized cases. Dr. Walter N. Roach of Philadelphia, in a paper on "The Role of the indian generic viagra School in the Spread of Scarlet Fever," presented a diagram map (which I have reproduced) tracing twenty-two cases of scarlet fever to one school of eighteen hundred pupils, al- though many of the infected children lived at some distance from this school and nearer four other schools with forty-five indian generic viagra hundred pupils, not one of whom developed scarlet fever.* Studij of indian generic viagra a Measles Epidemic. — To show how the minor diseases spread, I have made a study of the epidemic of measles that occurred in Philadelphia during the fall of 1910, the winter of 1910-1911 and the spring of 1911. I have prepared a series of shaded maps showing the location of the cases at monthly intervals during this period. The records on which these maps are based show that the epidemic began — not throughout the city with the opening of schools — but in the week ending October 15, 1910, in one indian generic viagra ward, spreading two weeks later to a contiguous ward, and three weeks later to another contigU'^us ward. During compra de viagra that week compra de viagra twenty-four cases were re- ported from three contiguous wards and only fifteen cases from the rest of the city. indian generic viagra The next week this area extended, four contiguous wards having thirty- seven cases and the rest of the city having twenty- seven. The following compra de viagra week ninety-seven cases were reported from six contiguous wards ; sixty-two from the ward where the epidemic started, while through- out the rest of the city there were forty-eight cases. Of the one hundred and fifty-six cases reported the next week, indian generic viagra eighty-eight were from these same six wards, thirty from the original one and twenty-nine from one next to it. The epidemic was also begin- ning to spread to other parts of the city, two wards some distance away having eight and nine cases re- spectively, and one a little nearer having eight cases. The next week the six original wards and four other contiguous wards had a total of ninety-five cases. Included in the latter was one of the three wards to compra de viagra which the epidemic had spread the previous week. Another had a total of fortv-nine cases, while from 552 MEDICAL RECORD. [Oct. 2, 1915 the third and from four wards adjacent to it thirty- two cases were reported. From the other thirty-one wards only fortj^-seven cases were reported. The DIAGRAM MAP SHOWING SPRE.4D OF SCABLET FEVER cases. There were seven cases this week, however, in a West Philadelphia ward, separated by the Schuylkill River from the original ward, and seven Map 1. — The small circles locate houses of scarlet fever patients. The lines of contact leading direct to the Pierce Scliool as a focus : no other cases occurred in any families or in pupils attending other public or private schools in this territory. (W. X Roach'.) A • • • • • • 2 N ^^\ indian generic viagra