HONORARY AND CONSULTING OFFICERS. GEORGE HENRY FOX, ROGER S. TRACY, CHARLES F. CHANDLER, Ph. D., Consulting Sanitarian. CLARENCE C. RICE, M. D., Consulting Laryngologist. Consulting Statistician. DEPARTMENT OF HEALTH. REPORT FOR THE YEAR ENDING DECEMBER 31, 1902. DEPARTMENT OF HEALTH, CITY OF NEW YORK, SOUTHWEST COR. FIFTY-FIFTH STREET AND SIXTH AVENUE, Hon. SETH Low, Mayor of the City of New York: SIR-In accordance with the provisions of section 1168, chapter 466, Laws of 1901, the Board of Health has the honor to submit the following report of the operations of the Department of Health for the year ended December 31, 1902: PUBLIC HEALTH. The condition of the public health during the year, in spite of the steady increase in population and the continued congestion in the more crowded districts, has been better than for any year since the organization of this Department. The death rate has fallen to 18.75 per thousand as compared with 20.00 in 1901 and 20.57 in 1900. The deaths numbered 68,085 as compared with 70,720 in 1901 and 70,872 in 1900. The death rate in the section corresponding to the former City of New York was 19.49 per thousand, not only the lowest on record, but not approached in any year since 1814, which year presented an unusually low death rate, 19.66; but the latter has always been questioned by statisticians on the ground that in the first half of the nineteenth century records of mortality were loosely kept. The death rate of 17.88 in the Borough of Brooklyn is the lowest in that section since 1866, and in all probability the lowest ever recorded in the history of the City of Brooklyn. While the mortality from infectious diseases varied considerably from that of the previous year, presumably following certain laws regarding which students of medicine must still confess ignorance, yet it is to be noted that in 1902 there was a marked decrease in the number of deaths from those diseases, chiefly the contagia, which are regarded as largely preventable. For example, deaths from smallpox decreased 100, from scarlet fever 222, from diphtheria and croup 53, and from pulmonary tuberculosis 566. There was also a marked decrease in the deaths from diarrhoeal diseases occurring in children under two years, the figures showing a saving of 858 lives; this was due in part, no doubt, to the less trying meteorological conditions prevailing during the summer of 1902, and partly, it is hoped, to measures taken by this Department to assure medical care and proper feeding to children. in the tenement districts; particularly, also, to the efficient work of the Tenement House Department in improving the conditions under which a large proportion of the city's population lives, and to the work of the Department of Street Cleaning, which has kept the streets of the more crowded sections of the city cleaner, we believe, than ever before, and, by the generous use of water from the City hydrants, has done much to cleanse the streets of disease-breeding filth. Various activities of the Department of Health in connection with the suppression of the diseases cited above will be found in detail below, and in the reports of the several division chiefs hereto appended. SMALLPOX. The most interesting medical problem confronting the Department on January 1, 1902, was that of the suppression of smallpox, which had gained a strong hold upon this city in 1900 and 1901, in the latter of which years 1,198 cases and 410 deaths were recorded. The disease was not confined to this city, but had been, and still is, very prevalent in several of the larger cities of this country as well as in the smaller towns and the country districts. In this city an extra force of from 150 to 200 vaccinators was immediately set to work and kept continuously employed for six months. Letters were sent to all the larger manufacturing establishments and business houses urging the importance of vaccination, and no effort was spared to make the news generally known that the Department would vaccinate freely any one desiring it, and would send a vaccinator or vaccinators to any factory or shop, where vaccination might be done at the convenience of the persons there employed. The result of this work was a total of 810,000 vaccinations, or more than twice the number obtained by the Department in any previous year. Within six months the disease was under control, and the year which had opened with 140 cases of smallpox in January closed with 9 in December, in spite of the fact that the inhabitants of this city are frequently exposed to con |