Causes of Death.-The following table gives for the State in June the number of deaths due to certain important causes, as well as the proportion from each cause shown per 1,000 total deaths:

Tuberculosis, as usual, was the leading cause of death, though the per cent of all deaths caused by tuberculosis of the lungs and other organs was only 15.7 for June, against 16.4 for May. Next after tuberculosis come diseases of the circulatory system, diseases of the nervous system, and pneumonia and broncho-pneumonia, in the order named.

The principal epidemic diseases in June were: Typhoid fever, 40; measles, 20; whooping-cough, 19; diphtheria and croup, 17, and influenza, 10. The number of deaths from typhoid fever was the same in June as in May. The deaths from measles fell from 41 in May to 20 in June, while the deaths from whooping-cough rose from 10 to 19, the deaths from diphtheria and croup being not far from the same in each month, 22 for May and 17 for June.

MEETING OF STATE BOARD OF HEALTH,

The quarterly meeting of the State Board of Health was held July 6th at the State Capitol building, Sacramento. There was a general review of the work done by the Secretary, and a discussion and outlining of future work. It was decided to appeal to the United States Public Health and Marine Hospital Service to investigate the epizoötic among the squirrels, in order to ascertain if it was in any way communicable to man. A resolution was adopted congratulating the Health Commission of San Francisco on their effective work in maintaining sanitary conditions after the recent fire, and another thanking Walter Wyman, Surgeon-General United States Public Health and Marine Hospital

Service, and his officers for the help rendered the State after that catastrophe.

Perhaps the most important work done was the adoption of the following resolution, after a discussion of water pollution:

I move that the Secretary be instructed to notify again the various cities and towns, including Sacramento, which are now polluting the Sacramento river by depositing sewage either directly or indirectly in the river channel-that this is in direct violation of the State law, which it is the duty of the board to execute; and at the same time to offer his services, if desired, in indicating the best method of sewage disposal in each particular case.

The board has, for three years, been working to purify and keep pure the water supply of the State, and it is a satisfaction to report that many towns have already taken steps to destroy their sewage. Others seem not to feel the necessity of such action, and it is evident to the board that legal means must be taken in order to protect the lives of the people using the water thus polluted. This is not pleasant nor profitable to the city or town, but it is the only way left open.

REPORTS FROM HEALTH OFFICERS.

Dr. E. N. Mathis, Los Angeles County, reports that "Many complaints come from mountain resorts that picnickers bathe and wash dishes and garments in mountain streams, thus contaminating the water."

We have frequently called attention in the Bulletin and elsewhere to this danger to the public health. Already one epidemic of typhoid fever in the State has been traced to this source, and no doubt many isolated cases result from a like cause. The State law and regulations against contaminating the water of streams used for domestic purposes are ample and arrests should be made for their violation.

Dr. Charles Pratt, Fallbrook, San Diego County, reports whoopingcough and measles as epidemic. There were 12,866 deaths from measles in 1900 in the United States, not a few of them the victims of the popular idea that measles is a mild disease, and devoid of danger. Many parents purposely expose their children to it, sometimes with the result of losing them. All cases of measles should be carefully isolated, and thorough disinfection practiced.

Dr. Strong, San Bernardino County, reports a smallpox case, which exposed many, but vaccination of all contacts stopped spread of disease.

Captain J. W. Howell, Napa, reports health conditions fairly good. Typhoid disappearing. The State has been an offender in the Napa Valley in allowing the sewage of the Veterans' Home at Yountville to drain into the Napa river. The efficient commandant of that institution, Dr. H. G. Burton, notified the State Board of Health of the condition, and a system of sewage destruction is being worked out.

Dr. S. Z. Peoples, Petaluma, has a few cases of smallpox on hand. They came, as is quite common, from cases of chicken pox. The doctor

proposes to vaccinate the whole town, and if he succeeds he will have no more trouble until the inflow of population gives him more nonimmunes.

Dr. S. H. Rantz, Placerville, reports a few cases of malaria.

Have the Trustees pass an ordinance making the breeding place of mosquitoes a public nuisance, and then enforce it, and malaria will leave with the pests.

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Dr. W. H. Cope, Pleasanton, Alameda County, who reported a case of smallpox last month, reports no cases coming from it. The case was handled admirably, and no chance given for infection to spread.

Dr. J. M. Wheat, Redlands, reports smallpox contracted in Los Angeles, and typhoid fever from Arizona. Also three cases of diphtheria, the first of which was not reported. If all cases of communicable diseases were promptly reported to the health officers such an unnecessary spread of disease would be avoided.

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Dr. T. P. Peery, Sutter County, reports scarlet fever stamped out by strict quarantine.

Dr. H. G. Plymire, San Mateo County, has numerous cases of typhoid, the cause of which he is investigating. Water is reported safe, and milk is from different sources. Watch out for the flies and personal contact. We give these sources of spread too little attention.

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Dr. S. F. Priestley, San Joaquin County, has numerous cases of smallpox on hand, but prompt and thorough work with vaccine and quarantining is checking its spread.

Dr. H. G. McGill, Livermore, says: "Physicians evidently do not understand their duty in regard to 'reportable diseases.' This is probably so, although the State laws and regulations have been sent to them. If the County Medical Societies would devote an hour at some meeting discussing this subject they would surely see the use of such reports. The municipal and county authorities should furnish the health officer with printed postal cards to be distributed to each physician. This was urged in last month's Bulletin.

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Dr. A. P. Tarter, Tehama County, has perhaps had the hardest task of any in the State dealing with smallpox. It came from chicken pox, and spread extensively in the mountains, and also at Corning, before the health officer was informed of the true nature of the disease; but with characteristic energy and skill he has circumscribed the disease, and has it under control.

Dr. A. B. Gilliland, Cottonwood, Shasta County, and J. A. Young. health officer, Wilmington, report localities free from contagious disease and very healthy.

Dr. N. E. Richardson, Salinas City, sends card showing no reportable sickness, and promising a copy of semi-annual report to this board. As the doctor has been very active in sanitary matters we expect an interesting report.

Dr. Theo. Snypp, Placer County, has been battling with smallpox in two or three localities in the county. Owing to the difficulty of enforcing quarantine on the ranches, the disease spread quite extensively.

Dr. R. B. Davy, Downieville, has no communicable diseases to report, neither has Dr. Charles F. Miller of Gardena.

Dr. Wm. Thurston, Orland, reports malaria and chicken pox. We sincerely hope the latter is not what it has proved to be in several other cases-smallpox.

J. W. Sumner, Kernville, has no reportable diseases.

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Dr. Ralph W. Avery, South Pasadena: Croup 2, measles 6, smallpox 2, erysipelas 1, chicken pox 2. No new foci of smallpox. All quarantines raised. Only personal cases; many not reported.

Dr. F. W. Coleman, Lodi: 11 cases of malaria, 1 of measles, and 2 of pneumonia.

Dr. S. W. R. Langdon, Stockton: Tuberculosis 4, pneumonia 1, diphtheria 1, smallpox 1.

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Dr. C. D. Watson, Ontario District: No contagious diseases.

Dr. W. W. Roblee, Riverside: Tuberculosis 14, pneumonia 3, scarlet fever 1, typhoid fever 2, diphtheria 4, influenza 13, erysipelas 2, chicken pox 1.

Dr. T. L. Magee, San Diego: Typhoid 2, measles 19.

Dr. J. Jones, Nevada County: Tuberculosis 9, pneumonia 4, typhoid fever 1, diphtheria 2, croup 1, measles 1, whooping-cough 2, malaria 10, smallpox 3, influenza 6, erysipelas 3, trachoma 1.

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Dr. James A. Young, Wilmington: No infectious or contagious diseases. Conditions of health excellent.

Dr. B. Woodbridge, Rocklin: Reports that there have been no more cases of typhoid fever since the pollution of the water was stopped. Wherever typhoid exists the water should be closely watched, for it is one great source of dissemination.

Dr. T. M. Hayden, Fresno, has succeeded in getting a pretty complete report from the physicians. With no epidemic, but a few cases of scarlet fever, measles, malaria, typhoid and one of diphtheria. Tuberculosis 12, pneumonia 1, scarlet fever 4, typhoid fever 3, diphtheria 1, measles 2, malaria 15, influenza 10, erysipelas 5, cerebro spinal meningitis 1, trachoma 5, chicken pox 1.

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Fred T. Bond, M. D., Vallejo, reports: Tuberculosis 2, diphtheria 1, measles 10, and cerebro spinal meningitis 1.

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Dr. J. I. Clark, Santa Ana, has had a case of leprosy to deal with, and no doubt feels the need of a national institute where lepers can be sent. Typhoid fever 1.

Dr. William F. Freeman, Needles: Tuberculosis 6, measles 2; all imported.

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Dr. E. C. Houston, Bieber, reports 10 cases of whooping-cough and 3 of malaria.

Dr. Wm. Simpson, Santa Clara County: No epidemics. Efforts being made to keep streams from pollution.

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Dr. J. E. Taylor, Trinity County: Smallpox cases well, with no new

ones.

Dr. Frances L. Newton, Woodland: One case of diphtheria.

Dr. O. W. Steinwand, Selma: One case typhoid. General health good.

The above comprises the reports from health officers throughout the State for the month of June. It is a distinct advance over former months, and is, therefore, encouraging, but it is far below what it should be in numbers. These reports do not show the exact condition in any place, nor are they all of equal reliability. In some towns all physicians report, in others part of them, and in too many none. This makes it impossible for the health officer to make reliable reports to this office, and we, in turn, are deprived of needed information.

There is a noticeable absence of reports from the large cities. The delay in printing their report is no doubt caused by tardy reports to them.

In the interest of the State and the people, who look to us to guard their sanitary and health conditions, we urge physicians to report promptly all cases of communicable disease to the health officer, and for him to be equally prompt in reporting to the State board.

It is a satisfaction to record the fact that we have no epidemics at present. By active work and vaccination smallpox is rapidly dying out. Measles and scarlet fever are prevalent in some parts, but not to the extent of being epidemic, and are generally being well handled. Typhoid is also less prevalent, but is still too broadly scattered.