INFLUENZA IN THE UNITED STATES.

CASES REPORTED BY STATES, FEBRUARY 11 TO 17, 1923-DEATHS FROM INFLUENZA AND PNEUMONIA IN CITIES, OCTOBER 29, 1922, TO FEBRUARY 10, 1923.

The following table shows the number of cases of influenza reported by State health officers, by telegraph, for the week ended February 17, 1923, compared with similar reports for the corresponding week of 1922, 1921, and 1920:

Cases of influenza reported by State health officers for the week ended February 17, 1923, and corresponding week of the years 1922, 1921, and 1920.

The following table shows the number of deaths from influenza and from pneumonia (all forms) in certain large cities of the United States from October 29, 1922, to February 10, 1923, inclusive. This table is taken from the Weekly Health Index, issued by the Division of Vital Statistics, Bureau of the Census.

DEATH RATES IN A GROUP OF INSURED PERSONS. COMPARISON OF DEATH RATES FOR PRINCIPAL CAUSES, NOVEMBER AND DECEMBER, 1922, AND YEARS 1912 TO 1922, INCLUSIVE.

The accompanying tables are taken from the Statistical Bulletin of the Metropolitan Life Insurance Co. for January, 1923, and compare the mortality experience of the company for the months of November and December, 1922, and the years 1912 to 1922, inclusive. The rates for 1922 are based on a strength of approximately 14,000,000 insured persons.

The death rate for December, 1922 (9 per 1,000), was stated. to be the lowest figure for this month ever recorded for this group of policyholders. Practically all of the important causes of death show lower rates for December, 1922, than for the same month of 1921. Influenza shows a large increase and pneumonia, organic diseases of the heart, and Bright's disease show a slight increase. The influenza death rate was 14.2 per 100,000 for December, 1922, as compared with 7.4 for December, 1921, and 8.6 for December, 1920. Death rates (annual basis) for principal causes per 100,000 lives exposed, November and December, 1922, and December and year, 1921.

[Industrial department, Metropolitan Life Insurance Co.]

MORTALITY RECORD FOR 1922.

The gross death rate for 1922 was 877.2 per 100,000, as compared with 870.6 for 1921. Lower mortality rates for 1922 as compared with 1921 are shown for tuberculosis, typhoid fever, three of the common diseases of childhood (diphtheria, scarlet fever, and whooping cough), diarrheal diseases, and puerperal diseases and conditions. The annual death rate in this selected group, from 1911 to 1921, has varied between 73 and 87 per cent of the death rate in the registration area of the United States.

Tuberculosis. The death rate for tuberculosis for 1922 (113.4 per 100,000) was stated to be the lowest in the records of the company. It shows a decline of 3.4 per cent from the rate for 1921 (117.4), and of nearly 50 per cent from the rate for 1911 (224.6), a more rapid decline in this special group than is indicated for the registration area of the United States. The decline in the rate for 1922 from that for 1921 was greater among the colored than among the white policyholders.

Typhoid fever. The death rate for typhoid fever for 1922 (5.6 per 100,000) was also the lowest in the records of the company, and represents a reduction of 16 per cent from the rate for 1921, and of nearly 75 per cent from the rate for 1911 (22.8 per 100,000).

Common infectious diseases of children.-Death rates for diphtheria, scarlet fever, and whooping cough were lower for 1922 than for 1921, while the death rate for measles was slightly higher. The diphtheria death rate was the lowest recorded during the 12-year period 19111922, suggesting a promising outlook for a successful fight on this disease.

Diarrheal diseases.-The death rate for diarrheal conditions declined from 14.2 per 100,000 in 1921 to 10.7 in 1922, the lowest figures for these diseases in the records of the company, suggesting continued improvement in the protection of water and food supplies.

Puerperal diseases. Only a small decrease was registered during 1922 in the death rates for puerperal diseases and conditions. It is stated that the effect of the influenza epidemic upon the death rate for these causes was important during the first quarter of the year; also that the records show no general tendency of the rate to decline, even in spite of the declining birth rate.

Higher death rates for 1922 over those for 1921 are shown for influenza and pneumonia, organic heart diseases, and diabetes. Slight increases are also shown for chronic nephritis and cerebral hemorrhage.

Death rates per 100,000 lives exposed, for principal causes of death, 1912 to 1922. [Industrial department, Metropolitan Life Insurance Co.]

1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912

Cause of death.

All causes of death.. 877.2 870, 6 989. 41, 063. 01, 559. 21, 161. 11, 168, 11, 130. 9'1, 152. 8'1, 199. 4 1, 201. 2

Examination for Entrance into the Regular Corps of the Public Health

Service.

Examinations of candidates for entrance into the Regular Corps of the United States Public Health Service will be held at the following-named places on the dates specified:

Chicago, Ill., March 12, 1923.

San Francisco, Calif., March 12, 1923.

Washington, D. C., March 12, 1923.

Candidates must be not less than 23 nor more than 32 years of age, and they must have been graduated in medicine at some reputable medical college, and have had one year's hospital experience or two years' professional practice. They must pass satisfactory physical, academic, and professional examinations before boards of commissioned medical officers.

Successful candidates will be recommended for appointment by the President, with the advice and consent of the Senate.

Requests for information or permission to take this examination should be addressed to the Surgeon General, United States Public Health Service, Washington, D. C.

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