There was a marked increa e in typhoid fever in 1907, but not such an increase as the bare number of cases would seem to indicate. Allowance must be made for the freer reporting of cases in that year, expressed by a mortality rate more nearly approaching the normal. The excessive death rate of previous years clearly shows that all cases were not reported.

The usual mortality of typhoid fever in private practice is from 10 to 15 per cent; in hospital practice it frequently exceeds 20 per cent. One-fifth of the cases reported in 1907 were hospital cases and gave a mortality of nearly 30 per cent, while the mortality for both domiciliary and hospital cases was 18 per cent.

As usual, a large part of our typhoid fever, both in 1906 and 1907, was due to importation.

The actual increase in the disease in 1907 (about 250 cases) was due to local infection, the source of which for a while could not be discovered by the Board of Health. The inability of the typhoid bacillus to live any length of time in water in the presence of other germs, together with the long period of incubation of the disease. and the delay incident to proper diagnosis, may account for the absence of specific germs in suspected samples at the time of examination.

The discovery of infection in three dairies, however, acting as so many distributing foci, eventually served to explain part of our typhoid, and the application of the proper remedy in each instance was followed by a marked diminution in the spread of the disease.

The increase of typhoid fever in 1907 was ascribed by the unthinking to the use of ventilated metal tops for the covering and screening of cisterns, permitting of direct exposure of the water to the rays of the sun-a strange theory lightly advanced and abundantly disproven by every fact within the knowledge of the Board, but still clinging, we believe, in the minds of some.

SMALL POX.

The bulk of our infection was due to repeated importation of cases both in the incubative and the eruptive stage; the spread of infection from individual cases being limited in most instances to one or two cases of the disease at most. To this general rule there were two notable exceptions: a small outbreak of the disease in the Third District, in the fall of 1907, traced to a private school where vaccination was not a pre-requisite for admission, and a more exten

To Bears bares dether dime or money in igen sna! et and ret *e malen Touses exposed metun: quare, vataning n'ection and he sat at acent quars vere ara ve sunument for Joable cases and inuse--inuse vonaton ** stars 18. # Delal saris if vagnaron emplorei or the puz ***

nstance of The Board's eamet eteamer

proud of the fine mye sted the inspection in ine 1. I work at vome si quay mean undred employees exposed a mafon na factor) where one of the hands was known to have worked anapipient age of ama.. pox, and the vaccination of over fua lundred employers requiring protection.

Vaccination, unfortunately is not compulsory, except as a preaag vote for aden wion to the public schools, and complete immuniza Kon of rockij wersjad ne ginonoods cannot always be accomplished.

BOLATION HOSPITAL.

From time to time the need of a modern Isolation Hospital for the care of infections and contagious diseases, more especially small pre, has been keenly felt and the matter agitated awhile by the prise and the press, to be soon abandoned however in the face of the city's disinclination or inability to provide the necessary hospital.

The present method of caring for small pox is at the hands of a contractor, employed by the city, who owns and uses for the purpose the square of ground bounded by Tulane avenue, Gravier, South Hagan and Julia streets. The buildings used are a few large wooden huts, usually sufficient to accommodate the number of patients conveyed there for treatment. Floored tents, heated by oil stoves have been used when the number of cases was excessive. The grounds and buildings remind one of a well-kept plantation camp. While no serious criticism can be directed at the treatment proper, the buildings and appointments are crude and unsatisfactory in many respects, and the general conditions and underlying principle itself