sively in other States with which we have such constant intercourse." Of the eighteen city and twenty-two borough health officers, all have reported; and of the 168 towns, 161 reported: an evidence of co-operative work with, as remarkable as it surely is gratifying to, the State Board. With a few exceptions, these reports show an intelligent appreciation of the sanitary regulations; and, as a whole, an intelligent characterization of the local conditions in relation to preventive medicine.

"Miscellaneous Papers" consist of Reports of delegates to health organizations and conferences; "The Powers of Town Health Officers," by Edward Yeomans, Esq.; "Ought Local Health Officers to be Qualified Physicians?" by W. U. Pearne, Esq.; "Report of the Epidemic of Typhoid Fever in New Haven During the Spring, 1901," by Herbert E. Smith, M.D., chemist of the Board; "Report of the Cause of the Prevalence of Typhoid Fever in Ridgefield," ibid.; "Report on the Investigation of River Pollution and Water Supplies," ibid.; "Sewage Disposal at Simsbury, Conn.," by T. H. McKenzie, C.E., member of the Board.

Vital statistics, 1900: Births, 2,560; marriages, 6,991; divorces, 452; deaths, 16,368; 1 birth to every 44.1 persons; I marriage to every 129.9 persons; I divorce to every 15.57 marriages, and I death to every 50.1 persons. Death rate, 18.0. Causes of death: Zymotic diseases, 3,591; parasitic diseases, 3; dietetic diseases, 88; constitutional diseases, 2,636; developmental diseases, 956; local diseases, 7,644; violence, 848; ill-defined and cause not stated, 602. Deaths from consumption and other tubercular diseases, 1,692. Bulletin for April, 1902: By monthly reports received there were 1,191 deaths; 48 less than in March, and 62 less than in April of last year, and III less than the average number of deaths in April for the five years preceding. The death rate was 16.1 for the large towns, for the small towns 14.7, and for the whole State, 15.7. The deaths reported from infectious diseases were 252, being 21.1 per cent. of the total mortality.

Cases of infectious diseases reported: Smallpox, 61, in 13 towns; measles, 127, in 26 towns; scarlet fever, 338, in 54 towns; diphtheria and croup, 113, in 35 towns; whooping cough, 68, in II towns; typhoid fever, 37, in 16 towns; consumption, 18, in II

towns.

The smallpox prevalence has almost entirely ceased. Fresh cases of the disease have appeared since the last Bulletin was issued, in only a few towns. This peculiar exemption of Connecticut, as compared with other States, can only be attributed to the

protective influences of vaccination. School visitors have required vaccination as a prerequisite to attendance of pupils. Health officers have advised and promoted vaccination in many towns in advance of an invasion of the disease, and so the people have been protected.

DISTRICT OF COLUMBIA.--278,880-86,467 colored. Report for the fiscal year ended June 30, 1901. Total deaths, white, 3,430, death rate, 17.82; colored, 2,657, death rate, 30.73: 21.83. Deaths of children under 5: white, 15,905; colored, 7,258. Deaths from diphtheria, 86; typhoid fever, 193; tuberculosis of the lungs, 871; other diseases of the respiratory system, 749.

Returns of births, 4,531-2,780 white, 1,751 colored; 524 still births 195 white, 329 colored. Marriages, 1,877-1,274 white, 603 colored.

Report for the week ended May 3, 1902: Deaths, 108, as compared with 113 in the previous week and 110 in the corresponding period of last year. The annual death rate fell from 20.1 last week, and 20.5 last year, to 19.2. Of the decedents 60 were white and 48 colored. Mortality from pneumonia decreased from 20 week before last to 10, and consumption from 18 to 16. There were 5 fatal cases of whooping cough and 3 of diphtheria. No new case of smallpox developed during the week and none was discharged, leaving two cases in the hospital holding over from the previous week. The 54 cases of typhoid fever under medical treatment at the last report were increased by 11 new cases and lessened by 6 discharged, leaving 59 cases at the close of this report under supervision.

Of scarlet fever 4 new cases were reported and 2 discharged, which increased the number of cases in isolation from 22 to 24, in 16 premises.

There were II cases of diphtheria in quarantine at the close of last week. New cases, numbering 11, developed, and 7 being discharged left 16 cases with warning cards in 9 premises.

A report in reference to Major Sylvester's recommendation that a law be enacted to regulate bath and massage houses has been submitted to the District Commissioners by Dr. W. C. Woodward, District Health Officer. He holds that the business of conducting such houses is so distinct from the practice of medicine that it would be unreasonable to require the would-be proprietor to comply with the law regulating the registration of physicians. The alternate proposition that an application signed by at least six

physicians be required for permission to conduct such establishments would probably fail to accomplish the purpose of the proposed law unless the endorsers were held responsible to some extent. The proposition is made that the establishment of such houses for improper purposes can be best restricted by requiring the proprietor to file with the commissioners a bond conditioned on the maintenance of his establishment for the sole purpose of giving baths and massage, and that it will be maintained in a manner entirely in accordance with the law and not detrimental to public morals. It is further suggested that the proprietor keep a register of the full name, age, present and former residence of each employee and attendant. A second register should show the name and address of each person receiving a bath or massage, unless such person presents a written order for treatment from a duly qualified medical practitioner. These records should be kept for a specified time, and should be open to inspection by the mayor, superintendent of police or any authorized person. A penalty should be imposed for violations.

INDIANA. The State Board of Health Bulletin reports 2,716 deaths in April, a rate of 13.1. In the corresponding month last year there were 2,839 deaths; a rate of 13.7. In the preceding month there were 3,045 deaths; a rate of 14.2. By important ages the deaths were: Under 1 year, 411; 1 to 5, 170; 5 to 10, 61; IO to 15, 76; 65 and over, 760. By important causes-pulmonary tuberculosis, 381; other forms of tuberculosis, 48; typhoid fever, 41; diphtheria, 24; scarlet fever, 12; measles, 12; whooping cough, 20; pneumonia, 352; diarrhoeal diseases, 22; cerebro spinal meningitis, 30; influenza, 37; puerperal septicemia, 14; cancer, 82; violence, 18; smallpox, 6.

All cities, representing a population of 857,840, reported 1,166 deaths; a rate of 16.5. The county, representing a population of 1,658,622, reported 1,550 deaths; a rate of 11.4.

SICKNESS. Smallpox was the most prevalent disease during the month. There were 878 cases reported in 55 counties and 6 deaths. The order of prevalence of diseases was: Smallpox, rheumatism, tonsillitis, pneumonia, bronchitis, measles, influenza, intermittent fever, pleuritis, typhoid fever, diarrhoea, scarlet fever, erysipelas, whooping cough, diphtheria, cerebro-spinal meningitis, dysentery, cholera infantum, puerperal fever.

ILLINOIS.-Chicago, 1,758,025. Health Board Bulletin for the week ended May 10, 1902:

While the 49 more deaths reported last week represent an increase of 8.3 per cent. over the mortality of the week previous and of more than 12 per cent. over that of the corresponding week of 1901, the Department sees nothing in the general conditions to cause a modification of the anticipation expressed in the Bulletin of May 3—of "a continuous decrease of mortality during the next two months." Within the past fortnight there has been a marked change in the type of all the contagious diseases. Scarlet fever, diphtheria, whooping cough and measles are much milder than a year ago; so much so that measles, which is epidemic throughout all sections, caused only one death last week, whooping cough but 3, diphtheria, 5; and scarlet fever, 9; or 10 less than the week before. Smallpox, on the other hand, has changed from the mild type to a much more severe form, as noted in the Bulletin of April 19, and the first deaths from the disease since Jan. 3 occurred during the week. This disease, however, is of minor importance in Chicago, as it is in any well-vaccinated community. The record for the year is another proof of the soundness of the maxim formulated by the Department: Smallpox is a disease of ignorance or of superstition-ignorance of the virtue of vaccination or a superstitious dread of one of the most benign of all the agencies of preventive medicine. Of the total 169 cases discovered and treated since the first of the year, not a single one had ever been properly vaccinated, and the great majority of the victims come from the lowest classes. It is a disgrace to have smallpox.

IOWA.-Health Bulletin for March and April: Infectious diseases have been reported to the secretary during the months of February and March-diphtheria in 17 localities; measles in 11; scarlet fever in 68; smallpox in 140! It would seem to be easier to report localities in the State where smallpox is absent.

KANSAS. The secretary of the State Board reports for April: Smallpox in 33 localities, with an aggregate of 457 cases and one death.

LOUISIANA.-New Orleans, 305,000-81,500 colored. Report for March: Total deaths, 563-197 colored; deaths under 5, 103. Death rates, white, 19.65; colored, 29.00: 22.11. Deaths from tuberculosis of lungs, 71-30 colored; typhoid fever, 10; malarial fevers, 6; diphtheria, 4; influenza, 22; Bright's disease, 42; pneumonia, 84; bronchitis, 13; broncho-pneumonia, 4: cancer, 11.

MICHIGAN. The Secretary of the State Board of Health reports for April, 1902, compared with the preceding month, measles,

erysipelas, remittent fever and meningitis were more prevalent; and pneumonia and typhoid fever were less prevalent. Compared with the average for April in the ten years, 1892-1901, smallpox and typhoid fever were more than usually prevalent; and consumption, intermittent fever, erysipelas, remittent fever, whooping cough and diphtheria were less than usually prevalent. Meningitis was reported present at 18 places; whooping cough at 34 places; diphtheria at 51 places; typhoid fever at 68 places; measles at 156 places; scarlet fever at 183 places; smallpox at 236 places, and consumption at 240 places.

Reports from all sources show meningitis reported at 9 places more; whooping cough at 6 places more; diphtheria at II places less; typhoid fever at 13 places less; measles at 30 places more; scarlet fever at 4 places less; smallpox at 9 places more; and consumption at 15 places more, than in the preceding month.-Death returns to the Department of State, for the month, 2,850; a decrease of 109 from the preceding month. The death rate, however, 14.1, was the same as that for March. There were 492 deaths of infants under one year of age, 219 deaths of children aged 1 to 4 years, inclusive, and 865 deaths of persons aged 65 years and over. Deaths from pulmonary tuberculosis, 206; other forms of tuberculosis, 37; typhoid fever, 37; diphtheria and croup, 31; scarlet fever, 30; measles, 35; whooping cough, 25; smallpox, 5; pneumonia, 354; influenza, 45; cancer, 134; accidents and violence, 153.

MINNESOTA.-Minneapolis, 240,000. Report for the year ending December, 31, 1901: Deaths from tuberculosis of lungs, 248; penumonia, 214; diphtheria, 190; heart disease, 163; suicides and accidents, 161; carcinoma, 133; typhoid fever, 121; Bright's disease, 117; senility, 74.

Smallpox. During the year 1901 there were reported in the State of Minnesota 8,475 cases of smallpox. Of this number Minneapolis, with about one-fifth of the State's population, had but 361 cases. This small number is due, in no small degree, to the crusade of vaccination and isolation of the patients at the quarantine hospital, and the enforcement of rigid quarantine. It can safely be said that the business interests of the city were conserved, but at no time was the dread or fear of an epidemic entertained by the department.

Total mortality from all causes, 2,510-655 under 5 years; death rate, 10.46.