MISSOURI.-St. Louis, 598,000. Report for March: Total deaths, 1,030-222 under 5 years; death rate, 19.48. Deaths from typhoid fever, II; scarlet fever, 14; whooping cough, 16; smallpox, 2; croup and diphtheria, 35; consumption, 97; pneumonia, 141; bronchitis, 73; other respiratory diseases, 38; cancer, 35.

NEW JERSEY.-Smallpox continues extensively epidemic. The State Board of Health has issued (February) a circular urging vaccination as the absolutely essential means of protecting the community; and giving needful directions to sanitary inspectors, railroad employees and others, with regard to the detection, prompt and complete segregation of first cases of it and other dangerous and communicable diseases, and subsequent disinfection of premises and effects.

Newark, 250,000.

For the week ended May 3: Deaths, 87; from contagious and infectious diseases, 19-2 from smallpox; from consumption, 10; pneumonia, 8; grippe, 5; bronchitis, 2. Annual death rate, 17.74.

NORTH CAROLINA.-The State Board of Health Bulletin reports for March: Total deaths in 29 towns, with an aggregate population of 154,550 (61,750 colored): deaths, 251-117 colored; death rates, white, 17.3; colored, 22.6: 19.6; deaths under 5 years, 56; from pneumonia, 52-23 colored; consumption, 42-21 colored.

OHIO.-State Board of Health Bulletin for nine weeks ended March 29, 1902.--Cases of infectious diseases and deaths therefrom in 77 localities, with an aggregate population of 1,433,098: Croup and diphtheria, 363 cases, 63 deaths; scarlet fever, 587 cases, 31 deaths; typhoid fever, 337 cases, 67 deaths; whooping cough, 89 cases, 7 deaths; measles, 2,214 cases, 24 deaths. Smallpor, January 1 to March 31, in 99 places, 825 cases, 16 deaths.

PENNSYLVANIA.-Philadelphia, 1,293,697. Report for week ended May 10: Deaths, 456-106 under 5 years; from typhoid fever, 15; smallpox, 2; croup and diphtheria, 7; consumption, 58; pneumonia, 56; cancer, 13.

Pittsburg, 346,000. Report for week ended May 10: Deaths, 134-49 under 5 years; death rate, 20.14; from measles, 6; scarlet fever, 6; typhoid fever, 9; consumption, 10; pneumonia, 23; bronchitis, 3: cancer, 2.

SOUTH CAROLINA.-Charleston, 55,857-31,522 colored. Department of Health Report for 1901: Deaths, 1,626-1,149 col

ored. Death rates: white, 8.53; colored, 20.56: 29.09.-Deaths from consumption, white, 26; colored, 83; malarial fever, white, 12; colored, 34; typhoid fever, white, 17; colored, 31; pneumonia, white, 19; colored, 97; apoplexy, white, 29; colored, 30; enterocolitis, white, 28; colored, 41; enteritis, white, 3; colored, 36; heart diseases, white, 27; colored, 46; kidney diseases, white, 61; colored, 147; marasmus, white, 10; colored, 50; stillborn and premature births, white, 39; colored, 188. The names of 22 white persons are given, whose ages, at death, were from 80 to 92 years; of 30 colored persons, 28 from 80 to 96, 2, respectively, 102 and

106.

TENNESSEE.-Memphis, 110,000-49,000 colored. Board of Health reports for January, February and March, 1902: Total deaths and death rates, respectively, 72 white, 83 colored; 14.96, 19.31: 16.90-52 white, 97 colored; 10.22, 23.74: 16.22-67 white, 85 colored; 13.17, 20.56. Preventable diseases and deaths therefrom in March: Typhoid fever, 3; malarial fever, 2; scarlet fever, 2; purulent infection, 4; tubercle of lungs, 20.

WASHINGTON.-Seattle, 115.000. Report for March, 1902. Deaths, 74-13 under 5; death rate, 7.68; deaths from consumption, 8; pneumonia, 10; typhoid fever, 4; scarlet fever, I; smallpox, I; cancer, 3.

WISCONSIN. Milwaukee, 300,000. Report for March, 1902: Deaths, 320-110 under 5 years; death rate, 12.58; deaths from tubercular diseases, 31; pneumonia, 34; bronchitis, 31; diphtheria, 5; typhoid fever, 4; measles, 5; cancer, 15.

HAVANA.-271,363-72,492 colored. Report, March, 1902, shows the smallest number of deaths for any March since 1889. The minimum number for this month occurred in 1893, when there were 503 deaths; the maximum, in 1898, when there were 1,519 deaths. The death rate, 20.85, would be excellent for a city of Havana's size in any part of the world. Another month has passed without yellow fever, making six months since Havana had a single case. The table in the body of the report goes back to 1889, and if it went back 150 years, the character of the record would be the same. A reference to the table shows that in the years before 1900, only two months passed in Havana in which no deaths were reported. These months were May, 1899, and April, 1900. The number of cases of other infectious and contagious diseases

is also small. Diphtheria caused one death, typhoid fever, 7; and leprosy, 1.

While malarial fevers are not required to be reported under the head of infectious and contagious diseases, and are not, therefore, individually cared for as is yellow fever, the general work for the destruction of mosquitoes would be expected to affect malaria also. The reports for the last year show this to be the case.

Our statistics show that we had in the neighborhood of 350 deaths from malarial fever in Havana in 1900. In 1901, the first year of the mosquito work, we had 151. This month, only 4. The results with regard to the malarial work in Havana are very important. Havana is the first city in the world, of any consequence, that has put to practical hygienic use the scientific knowledge with regard to the mosquito as a conveyor of disease, and it is the only place where we can measure the results with any accuracy. We have been at work just one year killing mosquitoes, and have spent in the neighborhood of $50,000, employing constantly an average of 100 men. The return from this expenditure is represented by the extermination of yellow fever which annually cost 400 lives, and the saving of about 250 lives per annum from malarial fever. This does not take into account the decrease in the number of sick who recovered and who do not show in the mortality statistics.

Attention is also invited to the large amount of work being done with regard to tuberculosis; in fact, the energies and attention of the Department are directed now principally against tuberculosis. It has always been the cause of the greatest mortality in Havana, as it is everywhere else. The question of yellow fever overshadowed all other things in our early work, on account of its bearing upon commerce and quarantines, but, as far as the question of saving human life is concerned, tuberculosis is more important.

The Department, under the able supervision of Major C. L. Furbush, has established a most comprehensive plan of campaign against this disease. A dispensary has been established, arranged in an attractive manner, and attended by an able corps of physicians, where the municipal poor are invited to apply for assistance. The report shows how successful it has been. Medical inspectors, who dwell very extensively upon the subject of tuberculosis, are systematically sent to tenement houses and tobacco manufactories. The great object of the Department has been to get the cases of tuberculosis located, and through the various measures used, we have now about 2,500 cases on our lists. These names are carded,

with residence and other data, and popular literature sent to them, explaining their disease, its communicability and the best manner of care. I believe that, if the system can be continued for four or five years, tuberculosis can be eradicated as yellow fever has been. We had 900 deaths last year from tuberculosis; placing the average length of a case of tuberculosis at three years, which is a longer period than is generally given to this disease, we would have 2,700 cases of tuberculosis on hand in the city. As we have at present 2,500 located and carded, it can be seen how thorough and successful our system of reporting has been. W. C. GORGAS,

Major, Medical Corps, U. S. A., Chief Sanitary Officer.

RECENT SANITARY PATENTS.

695399.-Water Purifying Apparatus; Isaac P. Kinsey, Chicago, Ill.

695083-Bath Cabinet; Charles M. Robinson, Toledo, O.

695535-Exercising Machine; A. de Clairmont, Topeka, Kas. 695761.-Vaccination Shield; Josiah Peacock, Philadelphia, Pa. 696105. Disinfectant; Abiel W. Nelson, New London, Conn. 696647.-Water Purifying Device; J. M. Alacomme, Brooklyn, N. Y.

697125-Car Ventilator; Emanuel Anderson, Somerville, Mass. 697369.-Mode and Means for Ventilating and Flushing House Drains or Other Drains and Sewers; Isaac Shone and Edwin Ault, Westminster, London, England.

697085.-Smoke Preventer; John H. Hobart, Denver, Col. 697526-Dust and Cinder Guard for Railway Coaches; J. S. McKenzie, Birmingham, Ala.

699032.-Water Supply and Filtering System; Lloyd E. Smith, Portsmouth, Ohio.

699635.-Cremator for Refuse; Robert Robinson, Portland,

Ore.

699345-Apparatus for the Treatment of Sewage; Andrew J. Provost, Brooklyn, N. Y.

699982.-Disinfective Device for Sink-drains; Jacob F. Seabury, Newark, N. J.

699655.-Apparatus for Purifying Water; William C. Clarke, Pittsburg, Pa.

BOOK REVIEWS.

HYDROGRAPHY, PART IV.: TWENTY-FIRST ANNUAL REPORT OF THE UNITED STATES GEOLOGICAL SURVEY, 1899-1900. F. H. NEWELL, Hydrographer in Charge. 4to, pp. 779, with numerous Maps and Plates. Washington: Government Printing Office.

It consists of three parts: First, on the results of measurements of the flow of various streams in different parts of the United States, the data being presented in diagrammatic form, as well as by statistical tables; arranged geographically, beginning in the extreme northeastern part of the United States and ending in the extreme southwestern. A number of papers prepared independently by the engineer officers of the army and other individuals or corporations, have been incorporated after necessary modifications to bring them into accord with the general arrangement and unification, all the facts adduced being included and credited to their sources. The great body of them, however, are the result of the field work of the hydrographers of the Geological Survey and from engineers in co-operating with them.

The second part is the report of stream measurements by N. H. Darton, giving the result of field work in the vicinity of the Black Hills in South Dakota and Wyoming. The detailed study of the geological conditions of the Black Hills area gives results of interest and value not only to the citizens of that vicinity, but to all throughout the country who are seeking an underground water supply.

Part third is by Willard D. Johnson, and treats of the high plains. It is the result of field work that began in 1896 in Western Kansas, and extending over portions of Nebraska, Colorado, Oklahoma and Texas. Altogether the report is a mine of information on the hydrography of the country and of great practica! utility to all hydraulic engineers and others interested in the natural sources and courses of the water supply.

NEW KEY TO THE REPORTS OF THE UNITED STATES GEOLOGICAL SURVEY.-The United States Geological Survey has just issued, in Bulletin No. 177, a catalogue and index of its publications. This compilation has been made necessary by the increase in the number of the publications, since the last catalogue was published in 1893, and by the need of a convenient classification.