The principal cause of death in California is tuberculosis, which caused 15.5 per cent of the total deaths. The death-rate for tuberculosis of the lungs and other organs is 234.4 per 100,000 population.

Next to tuberculosis come diseases of the circulatory, respiratory, and nervous systems, which caused respectively 12.6, 10.8, and 9.8 per cent of the total deaths. Or, from another point of view, the deathrate per 100,000 population, is 191.3 for diseases of the circulatory system, heart disease, etc., 163.6 for pneumonia and other diseases of the respiratory system, and 147.8 for meningitis and other diseases of the nervous system.

The proportions are next highest for diseases of the digestive system (diarrhea and enteritis, etc.), violence other than suicide or public calamity, cancer, Bright's disease, and early infancy.

The most fatal epidemic disease was typhoid fever, causing 425 deaths, or 1.6 per cent of the State total. Next were diphtheria and croup, influenza, whooping-cough, measles, malarial fever, scarlet fever, and smallpox.

There are 709 deaths known to have resulted directly or indirectly from earthquake and fire, distributed as follows: San Francisco, 463; Santa Clara, 141; Sonoma, 72; Alameda, 12, and other counties, 21. The deaths in Santa Clara county were mainly at Agnews State Hospital, and in Sonoma county mainly in Santa Rosa city. Most of the deaths in Alameda and other counties occurred among refugees from San Francisco suffering from fright or exposure.

Analysis of causes of death in different localities reveals marked contrasts between the several geographic divisions in the relative prevalence of various diseases.

In the coast counties of both Northern and Central California, as well as in the six counties of Southern California other than Los Angeles, relatively high proportions of all deaths are due to diseases of the nervous system, the explanation being the presence of State hospitals in these three geographic divisions.

The interior counties of both Northern and Central California have high proportions of total deaths due to malarial fever, typhoid fever, and other epidemic diseases. The present low death-rates for these geographic divisions could be further reduced by stricter enforcement of the health laws.

In San Francisco, and to a less extent in the other bay counties, the proportion is very high for diseases of the circulatory system; heart disease and kindred complaints.

In Los Angeles, as well as the other counties of Southern California, the proportions are very high for tuberculosis, on account of the many deaths occurring among newcomers from the East.

Tuberculosis caused 4,183 deaths, or 15.5 per cent of the State total. The per cent ranges from 22.2 for Los Angeles, and 20.8 for the other counties south of Tehachapi, to 11.9 for the bay counties other than San Francisco, and only 10.6 for the interior counties of Northern California. However, deaths from tuberculosis in Southern California occur largely among newly arrived consumptives. Thus, 27.8 per cent of the tuberculosis victims in Southern California had lived in the State less than a year, and altogether 58.2 per cent had lived here less than ten years, the corresponding per cents for the entire State being 13.3 and 33.2, and for Northern and Central California together being 4.6 and

18.2 respectively. In fact, of all who died of tuberculosis in Southern California, 3.5 per cent had been in the State less than a month, altogether 10.8 per cent less than three months, and altogether 18.4 per cent less than six months.

In Northern and Central California, on the other hand, considerable numbers of native Californians and old-time residents fall victims to the "great white plague." The per cent of native Californians among tuberculosis victims is 37.3 for Northern California, and 36.9 for Central California, as compared with only 14.1 for Southern California, and 28.4 for the State as a whole. Similarly, the per cent who had lived here at least ten years is 33.7 for both Northern and Central California, against 19.5 for Southern California, and 28.4 for the entire State.

Geographic Divisions.-For convenience in tabulation the fifty-seven counties of California have been grouped in three main and eight minor geographic divisions. The three main divisions are Northern, Central, and Southern California. The line between Northern and Central California has been drawn at the southern boundary of Placer, Sutter, Colusa, Napa, and Sonoma counties, or the northern boundary of El Dorado, Sacramento, Yolo, and Marin counties. This dividing line extends irregularly from Lake Tahoe to the Pacific Ocean somewhat north of San Francisco Bay. The line between Central and Southern California has been drawn at the southern boundary of Inyo, Kern, and San Luis Obispo counties, or the northern boundary of San Bernardino, Los Angeles, Ventura, and Santa Barbara counties. This line is familiarly located by Tehachapi pass.

In both Northern and Central California, divisions have been made between the coast and the interior counties. In each case the coast counties include some counties not actually contiguous to the Pacific Ocean but yet on the westward side of the Coast Ranges. Moreover, in Central California, San Francisco, and the other bay counties (Alameda, Contra Costa, Marin, and San Mateo) have been made minor geographic divisions. Similarly, in Southern California, Los Angeles has been made a minor geographic division in contrast with the other six counties south of Tehachapi. The counties included in each geographic division have been shown before in the Monthly Bulletin (Vol. 1, No. 8, p. 55, January, 1906).

Death-rates. Under the law of 1905 requiring the proper registration of deaths prior to the issuance of burial permits, returns of varying completeness were received in the fiscal year 1905-1906 from all the fifty-seven counties in the State. In order to calculate death-rates the population of California in 1905 has been estimated conservatively according to the Census Bureau method by adding to the population in 1900 five tenths of the increase between 1890 and 1900, except that for the few counties showing decreases between the last two Federal censuses the population in 1900 has been taken for 1905, and for the three principal cities arbitrary estimates have been made because of their exceptionally rapid growth. The estimate for San Francisco in 1905 is 450,000, for Los Angeles 180,000, and for Oakland 90,000.

The following table shows the population as thus estimated in 1905, the deaths, exclusive of stillbirths, reported for 1905-1906, and the

death-rate per 1,000 population, for each geographic division indicated above as well as for certain combinations of these divisions:

TABLE 1.-Estimated Population (1905), Deaths, and Death-rate per 1,000 Population, for Geographic Divisions: 1905-1906.

It appears from Table 1 that for an estimated State population of 1,784,521 in 1905, the 27,026 deaths in 1905-1906 give a rate of 15.1 per 1,000 population.

Of the main geographic divisions, Northern California shows the lowest death-rate, 11.5, and Southern California the highest, 17.6, the rate for Central California being the same as for the State, 15.1.

Of the minor divisions, both the coast and interior counties of Northern California have death-rates, 12.0 and 11.1 respectively, which are considerably below the State average. In explanation of these low death-rates, however, it should be noted that the returns were not particularly complete for several counties in Northern California.

The death-rate is highest, 17.9, for Los Angeles and next, 17.1, for the other six counties of Southern California. The relatively high death-rates in this part of the State are due largely to the many deaths of recent residents, especially from tuberculosis.

The death-rate is also above the State average for the coast counties of Central California, 16.4, as well as for San Francisco, 15.6. In each of these geographic divisions, however, the death-rate was increased materially by the excessive mortality in April, 1906, resulting from a seismic disturbance.

The rate is below the State average, 15.1, not only for the coast and interior counties of Northern California, but also for the bay counties other than San Francisco (Alameda, Contra Costa, Marin and San Mateo), as well as for the interior counties of Central California, extending from Yolo, Sacramento and El Dorado on the north, to and including Kern on the south. The death-rate is 14.5 for the bay counties

other than San Francisco and 14.4 for the group of interior counties just described.

For Northern and Central California together the death-rate is only 14.4, as compared with 17.9 for Southern California. The rate for the coast counties from Del Norte to San Luis Obispo inclusive is 15.0, against 13.3 for the interior counties from Siskiyou and Modoc to and including Kern. That the death-rate is higher for the coast than for the interior counties is due mainly to the relatively great mortality usual in a metropolis like San Francisco. Thus, the death-rate is 15.2 for the metropolitan area, comprising San Francisco and the other bay counties, against only 13.6 for the rural counties of Northern and Central California.

Causes of Death.-The following table gives the number of deaths in California in 1905-1906 from certain principal causes, as well as the proportion from each cause per 1,000 total deaths and also the deathrate per 100,000 estimated population (1,784,521):

TABLE 2.-Deaths from Certain Principal Causes, with Proportion per 1,000 Total Deaths and Death-rate per 100,000 Population, for California: 1905-1906.

Tuberculosis is the principal cause of death in California. Over one seventh (15.5 per cent) of all deaths were due to this disease, 13.4 per cent of all deaths being caused by tuberculosis of the lungs and 2.1 per cent by tuberculosis of other organs. The death-rate is 234.4 per 100,000 population for all forms of tuberculosis.

Next to tuberculosis come diseases of the circulatory system, heart. disease, etc. These diseases caused one eighth (12.6 per cent) of all deaths and have a death-rate of 191.3 per 100,000 population.

Next come diseases of the respiratory system, which caused nearly one ninth (10.8 per cent) of all deaths in the State, pneumonia and broncho-pneumonia causing 8.0 per cent and other diseases of the respiratory system 2.8 per cent of all deaths. The death-rate for all diseases of the respiratory system is 163.6 per 100,000 population.

Following pneumonia and other diseases of the respiratory system come meningitis and other diseases of the nervous system. These diseases caused nearly one tenth (9.8 per cent) of all deaths and have a death-rate of 147.8 per 100,000 population.

The proportions are next highest for diseases of the digestive system (diarrhea and enteritis, etc.), 8.9 per cent; violence other than suicide or earthquake and fire, 7.2 per cent; cancer, 5.3 per cent; Bright's disease and nephritis, 5.2 per cent; and early infancy, 3.2 per cent.

Of the epidemic diseases, typhoid fever was by far the most fatal, causing 425 deaths, or 1.6 per cent of the State total for the year. The number of deaths from other important epidemic diseases in 1905-1906 was as follows: diphtheria and croup, 234; influenza, 217; whoopingcough, 174; measles, 128; malarial fever, 90; scarlet fever, 45; and smallpox, 27. The deaths from smallpox were only 1 in each 1,000 from all causes and represent a death-rate of no more than 1.5 per 100,000 population.

Altogether, 709 deaths, or 2.6 per cent of all for the year 1905-1906, are charged against the earthquake and fire of April, 1906. The number given includes only the deaths known to have resulted from this public calamity, and may perhaps understate the loss of life resulting from this seismic disturbance. However, the total does include several deaths resulting only indirectly from earthquake and fire, as deaths of aged persons from fright or heart disease and deaths of infants from exposure.

The 709 deaths resulting directly or indirectly from earthquake and fire occurred in the following counties: San Francisco, 463; Santa Clara, 141; Sonoma, 72; Alameda, 12; Santa Cruz, 6; San Benito and Sacramento, 3 each; Mendocino, Napa, and Solano, 2 each; and Glenn, Nevada, and Los Angeles, 1 each. The bulk of the deaths in Santa Clara county were at the State Hospital at Agnews, and nearly all in Sonoma county were in Santa Rosa city. Most of the deaths in the other counties named occurred among refugees from San Francisco suffering from fright or exposure.

Table 3 gives for the three main geographic divisions the number of deaths from certain principal causes, and also the proportion from each cause per 1,000 total deaths. The death-rates for each disease per 100,000 population are not shown for geographic divisions, because the registration of deaths was not equally complete throughout the State.