Deaths, 1,926 1,044 colored. Death rates, white, 14.45; colored, 20.30: 17.50. Contagious diseases: Smallpox, 423 cases-336 colored, a decrease of 153 cases as compared with 1900. Scarlet fever, 104; diphtheria, 44: "fewer cases and deaths from these diseases, in proportion to population, than any city in the Union." Deaths from tuberculosis have gradually increased during the past three years. This year 261, or one out of every seven deaths, were due to tuberculosis, but, acting under instructions to have all houses disinfected where deaths from tuberculosis occur, and also those from which patients suffering from the disease have moved, we have reason to expect a decrease in the future.

From typhoid fever there were only 44 deaths, and of that number 12 occurred in patients sent to Memphis for treatment. Of the 32 remaining deaths, 31, or 96 per cent., of the patients lived on premises where, other than artesian water was obtainable for domestic purposes. Reference is made to shallow wells and seepy cisterns. When these are either put in sanitary condition or filled, typhoid fever in Memphis is expected to cease.

UTAH.-Salt Lake City, 75,000. Deaths, 74-10 under five years. Death rate, 11.84. Deaths from typhoid fever, 2; diphtheria, 6; tubercle of lungs, 2; pneumonia, 5; cancer, 2.

WASHINGTON.-Seattle, 115,000. Report of the Department of Health for November, 1902: Total number of deaths, 75-12 under five years. Death rate, 7.92. Deaths from pulmonary tuberculosis, 9; typhoid fever, 4; diphtheria, 1; cancer, 6. Infectious diseases reported during the month: Scarlet fever, 33; diphtheria, 3; measles, 3; smallpox, 4; typhoid fever, 6; varicella, 5.

WISCONSIN.-Milwaukee, 300,000. Report for November: Deaths, 297-82 under five years. Annual death rate, 12.08. Deaths from typhoid fever, 7; whooping cough, 4; measles, 2; diphtheria and croup, 13; other infectious diseases, 2; pulmonary tuberculosis, 31; other tubercular diseases, 5; cancer, 14.

PORTO RICO, 953.947. Superior Board of Health reports for November, 1902: Total deaths, 2,328-808 under five years. Death rate, 27.1. Deaths from cerebrospinal fever, 21; diphtheria, 2; typhoid fever, 4; pneumonia, 58; puerperal fever, 13;

diarrhoeal diseases, 28; anemia, 706; bronchitis, III; tuberculosis, 132; heart diseases, 24; accidents and violence, 19.

The Climate of Porto Rico.-Dr. Groff thinks (Philadelphia Medical Journal) there is no process of acclimatization to persons from a temperate climate in Porto Rico. The trade winds prevent San Juan is a hot city on

the heat and humidity being oppressive. account of its being closely built with brick; in other places one needs blankets at night. There are no diseases which one from temperate latitude need fear. Tuberculosis is prevalent owing to the low state of nutrition and the less resistance of the natives. Dysentery is localized, as is leprosy. The anemia of ankylostomiasis is almost invariable among the poor and is spread by eating with soiled fingers. Scarlet fever is unknown. Pneumonia is seldom fatal. Malaria is rare. Yellow fever has not appeared for ten years. Diphtheria occurs, but generally in a mild form, and smallpox has been prevalent in the past. All Americans sometime contract dengue, from which they soon recover. What the people need is instruction in sanitation and better nutrition. They are honest, industrious, intelligent, law-abiding and proud of their American citizenship.

CUBA.—Havana, 275,000—73,000 colored. The Chief Sanitary Officer reports for October, 1902: Total mortality, 412-35 under five years. Annual death rate, 17.63. Deaths from typhoid fever, 3; tetanus, 6; intermittent fever, 5; tuberculosis of lungs, 79; bronchitis, 15; grippe, 3; cancer, 14. Havana and the rest of the island continue to be free from yellow fever and smallpox.

PREVENTION OF RAILWAY ACCIDENTS.

The Railway Safety Appliance Act seems to have greatly decreased the number of casualties to employees. According to recent reports the number of persons killed in train accidents during the months of April, May and June last, according to a bulletin issued by the Inter-State Commerce Commission of reports made by the railroad companies, was 140, and the injured 1,810. Accidents of other kinds, including those sustained by employees and by passengers getting on or off cars, etc., swell the aggregate to 616 killed and 9,250 injured, a total of 10,136 casualties.

The total number of collisions and derailments was 2,010, of which 1,094 were collisions. Of these, 157 collisions and 101 derailments affected passenger trains. The damage to cars, gines and roadways aggregated $1,813,833. The average loss by

each collision was approximately $824, and by each derailment $995. The total casualties during the fiscal year ended June 30 last, including the above figures, was 2,819 killed and 39,800 injured.

The number of employees killed shows a diminution of 68 per cent. since 1893, when the Safety Appliance Act was passed.

OBITUARY.

MAJOR WALTER REED, of the Medical Corps of the U. S. Army, died at the Army General Hospital in Washington, on November 23, at the age of fifty-one years. His death was due to appendicitis, for which an operation was performed on November 17.

Major Reed was born in Gloucester county, Va., in 1851, and was a graduate of the Medical Department of the University of Virginia, and of Bellevue Hospital Medical College in 1875. He was appointed as Assistant Surgeon in the Army the year of his graduation, and at the time of his death was first on the list of majors in the Medical Department of the Army. In 1893 he was appointed Curator of the Army Medical Museum, in Washington. During the Spanish-American war he was a member of the board to investigate typhoid fever in the Army.

In 1900 he was sent to Havana and was placed at the head of the commission appointed to determine, if possible, the cause of yellow fever and the means by which it is spread. Starting from Finlay's theory of the agency of the mosquito in the dissemination of the disease, the commission, by a series of painstaking experiments, demonstrated most conclusively the causal relation of Stegomyia fasciata to yellow fever epidemics, and disproved the theory that the disease could be conveyed in fomites, or that it was contagious in the ordinary acceptation of the term. Sanitary measures based upon the conclusions of Major Reed's commission have freed Havana from the disease.

Major Reed enjoyed the reputation of being a bacteriologist of the first rank. Upon his return from Cuba he was stationed at the Army Medical Museum as curator, a position he had occupied nine years before, and one for which his attainments eminently fitted him. He was also professor of bacteriology and pathology in the Army Medical School, and lecturer on those subjects in the Columbian Medical College of Washington.

BOOK REVIEWS.

INDEX-CATALOGUE OF THE LIBRARY OF THE SURGEON-GenERAL'S OFFICE, UNITED STATES ARMY. Authors and subjects. Second Series, Vol. VII, Hernia-Inquiry. It contains, besides, the seventh addition to the list of abbreviations of the titles of medical periodicals published in Vol. XVI of the first series of the IndexCatalogue. The text makes 1,003 pages, and excellently gotten up in conformity with the preceding volumes of the greatest work of its kind.

PROGRESSIVE MEDICINE, Vol. IV, 1902, maintains its excellence. Contains "Diseases of the Digestive Tract and Allied Organs," by Max Einhorn, M. D.; "Anaesthetics, Fractures, Dislocations, Amputations, Surgery of the Extremities and Orthopedics," by Joseph C. Bloodgood, M. D.; "Genito-Urinary Diseases," by William T. Belfield, M. D.; "Diseases of the Kidneys," by John Rose Bradford, M. D., F. R. C. P.; "Physiology," by Albert P. Brubacker, M. D.; "Hygiene," by Charles Harrington, M. D.; "Practical Therapeutic Referendum," by E. R. Thornton, M. D.

It is scarcely necessary to say that every one of these essays is a cogent statement of the most advanced knowledge of the subject to date. 8vo., pp. 422. Quarterly, $10.00 per annum. Lea Brothers & Co., Philadelphia.

A TEXT-BOOK OF NURSING, FOR THE USE OF TRAINING SCHOOLS, FAMILIES AND PRIVATE STUDENTS, by CLARA WEEKS SHAW. Third edition, thoroughly revised and enlarged. 12mo, pp. 400. Illustrated. Price, $1.75. New York: D. Appleton & Co.

A book replete with knowledge absolutely essential for every nurse who would be competent to care for the sick, and for every mother and housekeeper who would know how to maintain healthful conditions of the house and family.

MILK IN RELATION TO PUBLIC HEALTH, by GEORGE M. KOBER, M. D., Chairman of Committee on Public Health, Civic Center, and Chairman of the Committee on Legislation, Medical Society of the District of Columbia. A brochure of 235 pages, Senate Document No. 441, 57th Congress, June 28, 1902.

Dr. Kober has been long known as a devoted student of hygiene, and of milk in particular, in its relation to public health; hence, upon the introduction of "A bill to regulate the production. and sale of milk and cream in and for the District of Columbia," introduced by Hon. Jacob H. Gallinger, December 16, 1901, he was well equipped to supply needful information on the subject, and it is greatly to his credit that he availed himself of the occasion to address the substance of this brochure to the Hon. Chairman of the Senate Committee on the District of Columbia.

It comprehends such a complete summary of the results of the use of impure milk in the propagation of disease, above all, among infants; of the ignorance and carelessness of the milk dealers and pedlers; of the unhealthful conditions of cow stables, and the liability to the pollution of milk from such causes; of foul water dilution and unclean utensils, and the common use of adulterants, as to carry conviction to all intelligent minds. It proceeds to consider what constitutes a pure milk supply. As the result of numerous analyses, gives the standard of pure milk, its chemical constituents; its liability to morbific agents by exposure, when ever so pure, if not properly cared for, even to the extent of acquiring infective properties. It points out the necessity for sanitary supervision of all the conditions related to milk and cream supply: dairy stock, stables, feed and care of cows, milking and care of milk, sickness among milkers and employes. The bill was passed.

Taken altogether, the brochure is replete with knowledge of milk and milk products in all their relations to public health; of the requirements for their healthfulness, and in default of enforcement of such requirements, of the diseases liable to be propagated by their use.

An

LESSONS AND LABORATORY EXERCISES IN BACTERIOLOGY. outline of Technical Methods, introducing the Systematic Study and Identification of Bacteria. Arranged for the Use of Students. By ALLEN J. SMITH, M. D., Professor of Pathology in the University of Texas. 8vo, pp. 300. Illustrated. Price, $1.50, net. Philadelphia: P. Blakiston's Son & Co.

A practical work deduced from a series of class exercises, with intervening blank pages for notes: evidently well adapted to its intended purpose, "intended to be supplementary to the general